What is the Zepbound dose schedule?

2.5 mg once weekly for 4 weeks, then 5 mg once weekly. After that the dose may rise in 2.5 mg steps, with at least 4 weeks on the current dose before each increase. The maximum is 15 mg once weekly.

What is the maximum dose of Zepbound?

15 mg injected subcutaneously once weekly, for all indications.

How long do you stay on 2.5 mg of Zepbound?

Four weeks. The label calls it a starting dosage, not a maintenance dosage.

Which Zepbound doses are maintenance doses?

For weight reduction, 5 mg, 10 mg or 15 mg once weekly. For obstructive sleep apnea, 10 mg or 15 mg once weekly.

The Zepbound dose schedule, week by week

The schedule

Weeks	Dose, once weekly	What it is
1–4	2.5 mg	Starting dosage. Not a treatment dose.
5–8	5 mg	The first dose the label treats as maintenance
9–12	7.5 mg	Only if the clinician steps up
13–16	10 mg	A maintenance option
17–20	12.5 mg	Only if the clinician steps up
21+	15 mg	The maximum for every indication

Read the right-hand column before the left. This is not a ladder everyone climbs. The label allows maintenance at 5 mg, 10 mg or 15 mg for weight reduction, and at 10 mg or 15 mg for obstructive sleep apnea. Plenty of people stay at 5 mg.

The rule behind the table: start at 2.5 mg for four weeks, go to 5 mg, then increase in 2.5 mg increments with at least four weeks on the current dose before each step. The maximum is 15 mg once weekly.

Why 2.5 mg is not a treatment dose

The first month exists so the gut can adapt. The label separates it from the maintenance doses deliberately.

That matters for expectations. Someone four weeks in who has lost little has not failed — they have finished the introduction.

Why the four weeks between steps is not optional

The digestive side effects cluster after an increase. The pooled trial data shows what each dose costs: nausea in 25% at 5 mg, 29% at 10 mg, 28% at 15 mg, against 8% on placebo. Severe gastrointestinal reactions ran 1.7% at 5 mg, 2.5% at 10 mg and 3.1% at 15 mg, against 1% on placebo.

Four weeks is the interval those numbers were measured at. Shortening it moves you to a higher dose without the adaptation the data assumes.

What the table does not cover

Compounded tirzepatide is not this product. It is made by a pharmacy, it is not covered by this labelling, and its concentration can differ from anything above — which is exactly why the units-versus-milligrams confusion happens with vials and rarely with pens.

Missing a week

Within four days (96 hours) of the missed dose, take it. After four days, skip it and go back to the normal day. Do not take two.