Guide
Tirzepatide (Zepbound): the doses and who the label rules out
The newer of the two weekly injections, and the only one also approved for obstructive sleep apnea. Everything here is from the FDA-approved label.
What it is
Tirzepatide imitates two gut hormones, GIP and GLP-1, where semaglutide imitates one. Injected once a week.
Two names, one molecule:
| Name | Approved for |
|---|---|
| Zepbound | Chronic weight management, and obstructive sleep apnea in adults with obesity |
| Mounjaro | Type 2 diabetes |
The dose schedule
| Weeks | Dose, once weekly | |
|---|---|---|
| 1–4 | 2.5 mg | Starting dose, not a treatment dose |
| 5+ | 5 mg | First maintenance option |
| then | 7.5 → 10 → 12.5 → 15 mg | 2.5 mg steps, at least 4 weeks apart |
Maintenance for weight is 5, 10 or 15 mg; for sleep apnea, 10 or 15 mg. The maximum is 15 mg weekly. Plenty of people stay at 5.
Inject in the abdomen or thigh; the back of the upper arm only if someone else does it. Any time of day, with or without food. Missed a dose? Take it within 4 days (96 hours), otherwise skip it.
What it does to most people
From the pooled weight-management trials, with the placebo column included because it is the only way to read the rest:
| Placebo | 5 mg | 10 mg | 15 mg | |
|---|---|---|---|---|
| Nausea | 8% | 25% | 29% | 28% |
| Diarrhea | 8% | 19% | 21% | 23% |
| Vomiting | 2% | 8% | 11% | 13% |
| Constipation | 5% | 17% | 14% | 11% |
Stopping because of a digestive side effect: 3.3% at 10 mg, 4.3% at 15 mg, against 0.5% on placebo.
Who the label rules out
Boxed warning: in rats, tirzepatide caused dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures.
Compounded tirzepatide is a different product
Made by a pharmacy, not FDA-approved, and not covered by the label above — including the doses, because the concentration can differ. That difference is where the units-versus-milligrams dosing errors come from: with any compounded medication, follow the dose on your pharmacy label exactly and ask your pharmacist or clinician about anything unclear.
What MED Miami's program is
MED Miami's program uses compounded semaglutide, not tirzepatide: online, clinician-reviewed, in English, Spanish and Portuguese. Compounded drugs are not FDA-approved. Not open yet. The medicine, the price and the exclusions are on the program page.
Read next
Where this came from
- FDA, Highlights of Prescribing Information: ZEPBOUND (tirzepatide) injection, 2025 revision — accessdata.fda.gov
- openFDA drug label API, ZEPBOUND record, retrieved 23 September 2026 — api.fda.gov