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Zepbound Dosage Guide for Weight Loss

Dorianne Green
Author:
Dorianne Green
Medical Writer
Dr. Michael Chichak
Medical Reviewer:
Dr. Michael Chichak
MD
The medications listed on this website are provided for informational purposes only.
Their inclusion does not guarantee they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. Healthcare providers may prescribe other medications or recommend non-pharmacological treatment based on the patient’s unique health circumstances and needs. Read more

Zepbound has a boxed warning[1] , the most serious type of warning from the Food and Drug Administration (FDA). Zepbound (tirzepatide) causes C-cell tumors in rodents and is contraindicated in patients with a personal or family history of MTC or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Remember to discuss the risks with your healthcare provider.

Highlights

  1. Zepbound is an injectable medication prescribed for specific individuals who need to lose weight or have obstructive sleep apnea.
  2. Zepbound’s starter dose is always low, 2.5 mg per week, to reduce the risk of side effects and ensure tolerability.
  3. Zepbound’s dosage is slowly increased to find a balance between what works for weight loss and what’s tolerated.
  4. The recommended Zepbound maintenance doses for weight loss are 5 mg, 10 mg, or 15 mg weekly, depending on individual circumstances.

If you read the Zepbound package information, it states that dosages must be started low and increased slowly. Your healthcare provider will also monitor your response to the medication to determine the right maintenance dose. This article explains in detail why this is necessary and how to do it safely.

Get a personalized weight loss plan and instructions on Zepbound use online.

What Is Zepbound

Let us begin with a brief overview of Zepbound.

​Zepbound (tirzepatide[2] ) is an injectable prescription medicine that is FDA-approved[3] :

  1. For weight loss and management in adults with obesity and individuals who are overweight and have specific co-existing conditions.
  2. To treat moderate to severe obstructive sleep apnea (OSA) in adults with obesity.

Zepbound works like the hormones GLP-1[4] and GIP[5] , which decrease hunger, reduce sugar cravings, and keep food in the stomach for longer, making you feel full even after small portions. Even so, Zepbound should be used if the person has made the following baseline lifestyle changes: eating a reduced-calorie diet and exercising more.

Zepbound Doses and Strengths

Zepbound is given via a subcutaneous (meaning just under the skin) injection only once weekly, which is convenient for people with a busy lifestyle or fear of needles.

The available dose strengths of Zepbound range from low to high: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, or 15 mg per 0.5 mL, and we’ll discuss the rationale for these different doses of Zepbound a little later.

If Zepbound is the appropriate weight-loss medication for you, after discussing your additional needs, a healthcare provider prescribes either a single-dose prefilled pen or a single-dose vial of Zepbound.

  • Pens contain four weekly doses
  • A vial contains one weekly dose

Zepbound Dosing Schedule or Titration Timeline

Remember that we mentioned the ‘start low, and go slow’ Zepbound prescribing schedule? Let us take a closer look at it.

Starting Dose

The standard Zepbound starting dose is always the lowest dose of 2.5 mg weekly. The only reason for this is to allow the person time to get used to the medication; they will not lose weight on this low dose.

​If they do not have side effects or have settled after at least 4 weeks on the 2.5 mg dose, it can be increased.

"It's important to start low and go slow, especially with this type of medication. Although you may be excited to begin your weight loss journey, remember that sustainability and consistency are important as we want results to be lasting and not short-lived. If the dose is increased too quickly, it increases the likelihood of significant side effects, which may cause the need to discontinue medication."
Dr. Michael Chichak
Medical provider at MEDvidi

Dose Escalation

Here comes the ‘go slow’ part of the treatment.

​For the same reason that you start on 2.5 mg per week for at least 4 weeks, you’ll increase the Zepbound dose by 2.5 mg each time, but only after at least 4 weeks on the previous dosage:

2.5 mg → 5 mg → 7.5 mg → 10 mg → 12.5 mg → 15 mg

Unfortunately, Zepbound often has dose-dependent side effects. This means the side effects are worse at higher doses, and this is why the doses are increased slowly. 

Everyone is different, so some people may have no side effects; for other individuals, they may ease after 2 weeks, and for some people, the side effects may still be going on at 6 weeks after increasing the dose.

Maintenance Doses

The Zepbound maintenance doses are the long-term doses that result in weight loss; the recommended dosages from the prescribing information are 5 mg, 10 mg, or 15 mg weekly[3] .

​This dose will vary for everyone, and your healthcare provider will recommend continuing the lowest effective dose that doesn’t cause side effects. For this reason, you will follow up regularly with your provider to find your individualized maintenance dose. At MEDvidi, you can have online weight loss consultations and discuss your weight management plan conveniently from home.

​Importantly, the maximum recommended dosage for all individuals is 15 mg per week.

See a licensed medical provider online to discuss your weight loss plan and get personalized instructions.

Zepbound Dosage Chart (Week-by-week)

Here’s a summary of the Zepbound dosage levels by week, showing the purpose of each step, and what it might be followed by. Note that each change of dose requires approval from your provider.

Weeks

Dose (once weekly)

Purpose of stage

Common next step

Weeks 1–4

2.5 mg

  • Purely a starter dose
  • Monitor side effects

No side effects: Increase to 5 mg

Weeks 5–8

5 mg

  • Possible maintenance dose
  • Assess side effects & response

No side effects and good weight loss → maintain on 5 mg

No side effects and no response → increase to 7.5 mg after ≥4 weeks

Weeks 9–12*

7.5 mg

  • Assess side effects
  • Titration

No side effects → increase to 10 mg after ≥4 weeks

Weeks 13–16*

10 mg

  • Possible maintenance dose
  • Assess side effects & response

No side effects and good weight loss → maintain on 10 mg

No side effects and no response → increase to 12.5 mg after ≥4 weeks

Weeks 17–20*

12.5 mg

  • Assess side effects
  • Titration

No side effects → increase to 15 mg after ≥4 weeks

Weeks 21+*

15 mg

  • Maximum dose

Stay on this dose if there is a good response

*For simplicity, week ranges show that Zepbound (tirzepatide) dose increases every 4 weeks; but, in practice, for:

  • Mild side effects that haven’t settled at 4 weeks: take the same dose for longer.
  • Severe side effects that aren’t settling within a few weeks: drop to the previous dosage.

Expected Results and Timeframes

Next, let’s look at when you might start to see Zepbound working.

  • Decreased appetite: as early as 1 week
  • Less hunger and fewer cravings: between 3 and 8 weeks
  • Weight changes: as early as 4 weeks[6]

And what can you expect on your maintenance dose? Clinical trials found that after about 18 months:

  • People lose, on average, about 20%[7] of their baseline weight
  • 8 out of 10 people lost at least 10%[7]

But remember, you won’t see optimal results without the essential lifestyle changes.

"Although appetite suppression can begin at the starting dose, there may also be little impact on appetite at this stage. This varies quite a bit with the individual. If you feel like your starting dose is not strong enough, talk with your healthcare provider and see if a dosage increase may be appropriate at the correct time interval. Remember, weight loss isn't about quick results, it's about sustained results over time. The consistent changes that compound over time will help you get closer to your goal."
Dr. Michael Chichak
Medical provider at MEDvidi

How to Use Zepbound Safely

Knowing the Zepbound dosing instructions is essential for your safety and to make sure it works properly.

Let’s run through everything you need to know.

How to Store Zepbound

Generally, refrigerate Zepbound between 36°F and 46°F, and never freeze it.

However, if you’re traveling, only the Zepbound pen can be stored at room temperature for 21 days.

How and When to Self-inject Zepbound

Zepbound is a once-weekly injection, so choose a weekday that:

  • Is easy to remember
  • Fits into your schedule

Decide on a convenient time on that weekday. The medication can be taken at any time of the day, with or without food.

Where to Inject Zepbound

Choose a site that is clean, dry, and healthy.

​Self-inject into the:

  • Stomach, except 2 inches around your belly button
  • Thigh

Or with someone’s help:

  • The back of the upper arm

Alternate between the left and right sides to avoid overuse and irritation of a single site.

How to Give Yourself the Dose

Your healthcare practitioner will explain the exact method of how to measure and administer the injection; this is slightly different for the pens and vials, but generally, the steps are:

  • Check the Zepbound fluid to make sure it is clear and colorless (possibly slightly yellow)
  • Use an alcohol swab to clean the site
  • Create a small fold by pinching the skin
  • After measuring the dose, stick the pen or needle into the skin fold at a 90-degree angle
  • Inject the dose
  • Press the injection site with the swab or gauze after removing the needle

What to Do With the Needle

Never try to recap the needle. Throw it away into:

  • An FDA-approved container
  • A heavy-duty plastic leak-proof household container with a tight-fitting lid, and label it ‘Medication Needles’

What to Do About Missed Doses

The ‘missed dose deadline’ is 4 days.

  • Less than 4 days since the missed dose: Take it immediately
  • If more than 4 days have passed: Skip the missed dose and take the next dose on the regularly scheduled day.

Changing Your Injection Day

If necessary, you can change your chosen weekday[3] , as long as the time between the two doses is at least 3 days (72 hours).

Get ongoing support from a licensed provider online during your weight loss journey.

Potential Side Effects and Warnings

Common Side Effects

At least 1 of every 20 people[8] using Zepbound will experience the following common side effects:

  • Nausea or vomiting
  • Diarrhea or constipation
  • Stomach pain or indigestion
  • Heartburn
  • Injection site redness, swelling, or pain
  • Fatigue
  • Hypersensitivity reactions
  • Hair loss

Luckily, they usually settle within a few weeks[9] of starting a new dose.

Serious Side Effects

Sometimes, more serious reactions occur, and you should contact a healthcare professional immediately if you develop:

  • Ongoing or severe abdominal pain, which might be a pancreas or gallbladder problem
  • Changes in vision
  • Severe allergies like hives, swollen lips or tongue, or a tight throat or chest
  • New or overwhelming depression or anxiety, or having thoughts of self-harm

Your healthcare provider may also request tests to monitor for lower blood sugar levels and kidney function.

Who Shouldn’t Take Zepbound?

A black box warning, the most serious warning type, in the prescribing information states that there might be a risk of thyroid cancer with Zepbound use. So people with a personal or family history of thyroid tumors should not use Zepbound. Also, people with a known allergy to the medication or its components shouldn’t take it. Before getting prescribed Zepbound, you’ll discuss your health history and contraindications in more detail with your healthcare provider.

Tips for Using Zepbound Successfully

Pairing Medication With Healthy Habits

Zepbound may not be as effective when used alone. You need to eat a low-calorie diet and increase your physical exercise to achieve the desired results.

Tips for Managing Side Effects

If side effects aren’t settling, it’s possible it’s just too much Zepbound for your body, and you might need a lower maintenance dosage; your healthcare provider will advise you about this. 

​In the meantime, you can try a few things to manage the side effects.

  • Nausea: Eat smaller, more frequent meals and avoid greasy food.
  • Constipation: Increase your dietary fiber intake and make sure you drink plenty of water to stay hydrated.
  • Diarrhea: Follow a bland diet, for example, boiled chicken breasts, white rice, bananas, apple sauce, and white bread toast. Focus on drinking fluids such as water, clear broths, electrolyte drinks, and diluted apple or grape juice.

Get Nutritional and Mental Health Support

A weight loss journey can be difficult, and you don’t have to do it alone. Ask your healthcare provider for recommendations to nutritionists and therapists for help along the way.

Conclusion

Zepbound is an injectable weight loss medication that is effective but often has side effects. For this reason, the starting dose is low and is increased slowly, with at least a four-week trial on the newly prescribed dose. At each step, a healthcare professional will assess your progress and adjust the dose as needed.

If you’d like to learn more about being prescribed a weight loss medication or have a question about your current Zepbound prescription, schedule an online appointment with one of MEDvidi’s licensed healthcare providers.

FAQs

No, neither Concerta or Adderall are stronger than the other. They are two different medications that are in the same class of stimulants. One or the other may work better for certain people based on their treatment goals, age, or health history.

There is no universal better medication. Which medication is the right choice for you is an individualized decision. Your healthcare provider will evaluate your health history, lifestyle, and treatment goals to determine which medication will be better for you.

Neither Concerta or Adderall are FDA-approved for weight loss. Due to both medications being stimulants, they can cause a loss of appetite which can lead to weight loss. Specific amounts of weight loss were not reported in clinical trials.
No, this is not recommended. Neither Adderall or Concerta are meant to be combined with another stimulant medication to treat ADHD. Follow your healthcare provider’s instructions on how to safely take your medication.
No, both Concerta and Adderall have a risk of misuse, abuse, or addiction. It’s important to talk with your healthcare provider about how to take your medication safely.
Yes, both Concerta and Adderall can give you increased energy. That is because they are both stimulant ADHD medications.

It is important to talk with your healthcare provider before changing medications or changing the amount of Concerta or Adderall that you are taking. Generally, the amount of Adderall you will need to have the same effect is half the dose of Concerta. In this example, 27 mg of Concerta would be roughly 14 mg of Adderall. This calculation is provided for informational purposes only and cannot substitute professional advice. Talk with your healthcare provider about how to safely switch from one medication to the other.

Sources

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9 sources
  1. DailyMed - ZEPBOUND- tirzepatide injection, solution ZEPBOUND- tirzepatide injection, solution. Nih.gov. Published 2024.
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  2. Farzam K, Patel P. Tirzepatide. [Updated 2024 Feb 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-.
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  3. HIGHLIGHTS of PRESCRIBING INFORMATION. ZEPBOUND® (tirzepatide) Injection
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  4. Collins L, Costello RA. Glucagon-Like Peptide-1 Receptor Agonists. [Updated 2024 Feb 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-.
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  5. Liu QK. Mechanisms of action and therapeutic applications of GLP-1 and dual GIP/GLP-1 receptor agonists. Front Endocrinol (Lausanne). 2024 Jul 24;15:1431292. doi: 10.3389/fendo.2024.1431292. PMID: 39114288; PMCID: PMC11304055.
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  6. ZEPBOUNDTM (tirzepatide) Injection, for subcutaneous useInitial U.S. Approval: 2022. Fda.gov. Published 2022.
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  7. Aronne LJ, Horn DB, le Roux CW, Ho W, Falcon BL, Gomez Valderas E, Das S, Lee CJ, Glass LC, Senyucel C, Dunn JP; SURMOUNT-5 Trial Investigators. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity. N Engl J Med. 2025 Jul 3;393(1):26-36. doi: 10.1056/NEJMoa2416394. Epub 2025 May 11. PMID: 40353578.
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  8. HIGHLIGHTS of PRESCRIBING INFORMATION. ZEPBOUND® (tirzepatide) Injection
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  9. Qin W, Yang J, Ni Y, Deng C, Ruan Q, Ruan J, Zhou P, Duan K. Efficacy and safety of once-weekly tirzepatide for weight management compared to placebo: An updated systematic review and meta-analysis including the latest SURMOUNT-2 trial. Endocrine. 2024 Oct;86(1):70-84. doi: 10.1007/s12020-024-03896-z. Epub 2024 Jun 8. PMID: 38850440; PMCID: PMC11445313.
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Dorianne Green
Author:
Dorianne Green
Medical Writer
Dr. Michael Chichak
Medical Reviewer:
Dr. Michael Chichak
MD
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