Zepbound dosage: what the label schedule says
Quick answer. The Zepbound label (Eli Lilly, tirzepatide) gives a starting dose of 2.5 mg injected once a week for 4 weeks, then 5 mg. After that the dose can rise in 2.5 mg steps, each after at least 4 weeks on the current dose. Maintenance doses are 5 mg, 10 mg or 15 mg once a week for weight reduction, and 10 mg or 15 mg for obstructive sleep apnea. The highest dose the label lists is 15 mg once a week. The 2.5 mg dose is for starting and is not approved as a maintenance dose. This page quotes the label for information. A prescriber sets the plan for each person.
What the Zepbound label says about dose
A label is the legal prescribing information a maker files with the FDA. These rows come from the Zepbound label as Lilly published it in August 2026, checked against the FDA-hosted copy. Zepbound is the weight-management brand of tirzepatide. The label lists weight reduction and long-term maintenance in adults with obesity or overweight with a weight-related condition, and moderate to severe obstructive sleep apnea in adults with obesity.
| Label item | What the label says | Section |
|---|---|---|
| Starting dose | 2.5 mg injected under the skin once a week for 4 weeks, for all uses. The label says the 2.5 mg dose is for starting treatment and is not approved as a maintenance dose. | 2.1 |
| First step up | After 4 weeks, 5 mg once a week. | 2.1 |
| Later steps | The dose may rise in 2.5 mg steps, each after at least 4 weeks on the current dose. The label says the schedule is meant to reduce the risk of digestive side effects, and that treatment response and tolerability guide the choice of maintenance dose. | 2.1 |
| Maintenance, weight reduction and long-term maintenance | 5 mg, 10 mg or 15 mg once a week. | 2.2 |
| Maintenance, obstructive sleep apnea | 10 mg or 15 mg once a week. | 2.2 |
| Highest dose | 15 mg once a week for all uses. The label lists no dose above 15 mg. | 2.2 |
| If a maintenance dose is not tolerated | The label says to consider a lower maintenance dose. | 2.1 |
| How often, and when | Once a week, at any time of day, with or without meals, together with a reduced-calorie diet and more physical activity. | 2.4 |
Label sections are numbered as in the prescribing information. Lilly published the label in August 2026 and the FDA-hosted copy is dated February 2026. The dose text matched in both.
The label schedule, step by step
The label sets a minimum of 4 weeks on each dose and no fixed calendar, so the table shows the earliest week each step could begin if every step took exactly 4 weeks. The weeks are simple arithmetic from the label rule. They are not a plan, and the label does not require a person to move up at every step or to reach 15 mg.
| Step | Weekly dose | Earliest week it can begin | What the label says about it |
|---|---|---|---|
| 1 | 2.5 mg | Week 1 | Starting dose, for 4 weeks. Not approved for maintenance. |
| 2 | 5 mg | Week 5 | First step up. A listed maintenance dose. |
| 3 | 7.5 mg | Week 9 | Rises in a 2.5 mg step after at least 4 weeks on 5 mg. |
| 4 | 10 mg | Week 13 | A listed maintenance dose. For sleep apnea it is one of the two listed maintenance doses. |
| 5 | 12.5 mg | Week 17 | Rises in a 2.5 mg step after at least 4 weeks on 10 mg. |
| 6 | 15 mg | Week 21 | The highest dose. A listed maintenance dose. |
In SURMOUNT-1 the dose-escalation period lasted 20 weeks, which matches the earliest path in this table. The label lists 7.5 mg and 12.5 mg as steps on the way and does not list them as maintenance doses.
Zepbound pens, vials and KwikPens
The label lists four ways Zepbound is supplied. The single-dose pens and single-dose vials hold one dose. The multi-dose vial and the KwikPen each hold four doses. The label lists the same six per-injection strengths for every form: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg and 15 mg.
| Dose per injection | Single-dose pen or single-dose vial | Multi-dose vial (4 doses) | KwikPen (4 doses) |
|---|---|---|---|
| 2.5 mg | 2.5 mg in 0.5 mL | 2.5 mg in 0.6 mL. The vial holds 10 mg in 2.4 mL (4.17 mg per mL). | 10 mg in 2.4 mL (4.17 mg per mL) |
| 5 mg | 5 mg in 0.5 mL | 5 mg in 0.6 mL. The vial holds 20 mg in 2.4 mL (8.33 mg per mL). | 20 mg in 2.4 mL (8.33 mg per mL) |
| 7.5 mg | 7.5 mg in 0.5 mL | 7.5 mg in 0.6 mL. The vial holds 30 mg in 2.4 mL (12.5 mg per mL). | 30 mg in 2.4 mL (12.5 mg per mL) |
| 10 mg | 10 mg in 0.5 mL | 10 mg in 0.6 mL. The vial holds 40 mg in 2.4 mL (16.7 mg per mL). | 40 mg in 2.4 mL (16.7 mg per mL) |
| 12.5 mg | 12.5 mg in 0.5 mL | 12.5 mg in 0.6 mL. The vial holds 50 mg in 2.4 mL (20.8 mg per mL). | 50 mg in 2.4 mL (20.8 mg per mL) |
| 15 mg | 15 mg in 0.5 mL | 15 mg in 0.6 mL. The vial holds 60 mg in 2.4 mL (25 mg per mL). | 60 mg in 2.4 mL (25 mg per mL) |
The volumes and concentrations are the label's own figures from Section 3. For vials the label says to use a syringe suited to the dose (its example is a 1 mL syringe that can measure 0.5 mL or 0.6 mL) and a new syringe and needle for each injection. The Atlas gives no measuring steps. The label also says patients and caregivers should be trained on the exact form they receive, and that the KwikPen is not recommended for self-injection by people who are visually impaired.
What the label says about a missed dose
| Situation | What the label says |
|---|---|
| A dose is missed and 4 days (96 hours) or less have passed | Give the missed dose as soon as possible. The patient then goes back to the regular once-weekly schedule. |
| More than 4 days have passed | Skip the missed dose and give the next dose on the regularly scheduled day. |
| Changing the weekly injection day | The day can be changed if needed, as long as the time between the two doses is at least 3 days (72 hours). |
This is label text. What to do about a particular missed dose is a question for a prescriber or pharmacist.
Changing forms, or changing to Zepbound from another GLP-1 medicine
The label says that if the prescribed Zepbound form changes (for example from a vial to a KwikPen), patients and caregivers should be trained on the new form and told to read its instructions for use. It gives no conversion rule, but it lists the same per-injection strengths for every form.
The label gives no text on moving to Zepbound from Wegovy, Ozempic, Mounjaro or any other GLP-1 medicine. Its Section 1 says that using Zepbound with other tirzepatide products or with any GLP-1 receptor agonist is not recommended. Mounjaro also contains tirzepatide and is covered on the Mounjaro dosage page. The switching page covers what labels and small studies say about moving between medicines.
What the Zepbound dose trials tested
Trial results are group averages from the study named, not promises for any one person. The last column names the analysis approach the paper used, because changes the numbers.
- In SURMOUNT-1, average weight loss rose with each dose, and 85%, 89% and 91% of people on 5 mg, 10 mg and 15 mg lost at least 5% of their weight, against 35% on placebo. Stopping treatment because of side effects was 4.3%, 7.1% and 6.2% across the three doses, against 2.6% on placebo.
- The trial arms are assigned target doses. The label lets the maintenance dose be 5 mg, 10 mg or 15 mg, so the trial does not show which dose suits one person.
- SURMOUNT-MAINTAIN tested a lower dose only after weight had already come down on the maximum tolerated dose. It does not test starting on 5 mg, and it does not show what a lower dose does for someone who has not lost weight first.
| Trial | People and length | Doses tested | Result | Analysis approach |
|---|---|---|---|---|
| SURMOUNT-1 | 2,539 adults with obesity, or overweight plus a weight-related condition, without diabetes. 72 weeks. | 5 mg, 10 mg and 15 mg once a week, against placebo | Average weight change: -15.0%, -19.5% and -20.9%, against -3.1% on placebo. | Treatment-regimen estimand: effects regardless of treatment discontinuation. |
| SURMOUNT-2 | 938 adults with obesity or overweight and type 2 diabetes. 72 weeks. | 10 mg and 15 mg once a week, against placebo | Average weight change: -12.8% and -14.7%, against -3.2% on placebo. | Treatment-regimen estimand: regardless of stopping treatment or starting rescue diabetes medicine. |
| SURMOUNT-5 | 751 adults with obesity, without type 2 diabetes. 72 weeks. Open label, with no placebo group. | The highest tolerated tirzepatide dose (10 mg or 15 mg), against semaglutide at its highest tolerated dose (1.7 mg or 2.4 mg) | Average weight change: -20.2% on tirzepatide and -13.7% on semaglutide. | Least-squares mean change from baseline, as the abstract reports it. |
| SURMOUNT-OSA | Two trials in adults with moderate to severe obstructive sleep apnea and obesity: one in people not using airway pressure treatment and one in people using it. 52 weeks. | The maximum tolerated dose, 10 mg or 15 mg once a week, against placebo | Breathing pauses per hour fell by 25.3 on tirzepatide and 5.3 on placebo in the first trial, and by 29.3 and 5.5 in the second. | The abstract does not name the approach. |
| SURMOUNT-MAINTAIN | 441 adults took tirzepatide at the maximum tolerated dose (10 mg or 15 mg) for 60 weeks. 378 were then assigned to continue it, drop to 5 mg, or switch to placebo for 52 more weeks. | Maximum tolerated dose, 5 mg, or placebo, from week 60 to week 112 | Average weight change from the start of treatment to week 112: -21.9% on the maximum tolerated dose, -16.6% on 5 mg and -9.9% on placebo. | Modified treatment-regimen estimand: people who started rescue tirzepatide were assumed to gain no further benefit from their assigned group. |
Sources: SURMOUNT-1 (2022), SURMOUNT-2 (2023), SURMOUNT-5 (2025), SURMOUNT-OSA (2024) and SURMOUNT-MAINTAIN (2026). The Atlas read the published abstracts. All five were funded by Eli Lilly, and SURMOUNT-5 and SURMOUNT-MAINTAIN were not run as blinded head-to-head or all-dose comparisons: SURMOUNT-5 was open label and let each person stay on the highest dose they tolerated.
What the makers list for the cash price
Lilly's LillyDirect page listed the same self-pay prices for Zepbound KwikPens and single-dose vials when the Atlas read it in October 2026. The prices depend on the dose. Lilly defines a month as 28 days, which is one KwikPen or four single-dose vials, and pen needles or syringes are bought separately.
| Dose | Price listed for a month |
|---|---|
| 2.5 mg | $299 |
| 5 mg | $399 |
| 7.5 mg | $449 when the prescription is refilled within 45 days. The regular price is $499. |
| 10 mg, 12.5 mg and 15 mg | $449 when the prescription is refilled within 45 days. The regular price is $699. |
The $449 price comes with what Lilly calls the Zepbound Journey Program, and Lilly's savings terms bar seeking reimbursement from any third-party payer. Prices and terms can change or end at any time and the Atlas has not independently verified them. The paying for GLP-1 medicines page and the cost tool cover insurance, Medicare and other prices.
How Zepbound doses relate to Mounjaro doses
Zepbound and Mounjaro both contain tirzepatide and both are made by Lilly, but they are separate products with separate labels. Zepbound is labeled for weight and sleep apnea. Mounjaro is labeled for type 2 diabetes. Both labels list 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg and 15 mg strengths, and both cap adult doses at 15 mg once a week. The Mounjaro dosage page lays out the Mounjaro label separately. Lilly's daily tablet Foundayo contains a different medicine, orforglipron, with its own label and dose steps on the Foundayo dosage page.
Compounded tirzepatide is a different matter
The strengths, steps and missed-dose rules on this page belong to the approved Zepbound product. Compounded versions are made by pharmacies, are not FDA-approved and are not reviewed by the FDA for safety, effectiveness or quality before they are sold. Their vials, concentrations and instructions differ from product to product. In July 2024 the FDA issued an alert about dosing errors with compounded injectable semaglutide products, many tied to measuring from a vial. See compounded versus brand-name medicines.
Quick answers
- What is the Zepbound dosage?
- The label starts at 2.5 mg once a week for 4 weeks, then 5 mg. The dose can rise in 2.5 mg steps, each after at least 4 weeks on the current dose. Maintenance doses are 5 mg, 10 mg or 15 mg once a week for weight reduction, and 10 mg or 15 mg for sleep apnea. The highest dose is 15 mg once a week. A prescriber sets the plan.
- How long does the label say to stay on the 2.5 mg dose?
- Four weeks. The label calls 2.5 mg a starting dose and says it is not approved as a maintenance dose.
- What are the Zepbound dose strengths?
- 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg and 15 mg. The label lists all six for the single-dose pens and vials, the multi-dose vial and the KwikPen.
- What is the highest Zepbound dose?
- 15 mg once a week, for all uses. The label lists no dose above 15 mg.
- Is the Zepbound dose different for sleep apnea?
- The starting dose and steps are the same. For sleep apnea the label lists 10 mg or 15 mg as the maintenance dose, while weight reduction lists 5 mg, 10 mg or 15 mg.
- What does the label say if a dose is missed?
- Give it as soon as possible within 4 days (96 hours) of the missed dose. If more than 4 days have passed, skip it and give the next dose on the regular day. The weekly day can be changed if the doses are at least 3 days (72 hours) apart.
- Is the Zepbound dose the same in a pen and a vial?
- The label lists the same six per-injection strengths for every form. Vials are drawn into a syringe, and the label says to use a syringe suited to the dose, so vial users should be taught by a clinician or pharmacist. The Atlas gives no measuring steps.
- Is there a Zepbound dosage chart by week?
- The label sets a minimum of 4 weeks per dose and no fixed calendar. The step table above shows the earliest week each dose can begin: 2.5 mg at week 1, 5 mg at week 5, and so on to 15 mg at week 21.
- Can 5 mg be a maintenance dose?
- Yes, the label lists 5 mg, 10 mg and 15 mg as maintenance doses for weight reduction. In SURMOUNT-MAINTAIN, people who had lost weight on the maximum tolerated dose and then dropped to 5 mg were 16.6% below their starting weight at week 112, against 21.9% for those who kept the maximum tolerated dose and 9.9% for placebo.
- Does Mounjaro have the same doses as Zepbound?
- Both contain tirzepatide and list the same six strengths, up to 15 mg in adults. They are separate products with separate labels and different approved uses.
Questions to ask
- What maintenance dose does the label allow for the reason I am being treated, and how will we decide?
- If I miss a dose, who do I call, and what does your office want me to do?
- Which form will I get (single-dose pen, KwikPen or vial), and who will teach me to use it?
- What will each dose step cost me, with my coverage?
- What is the plan if I cannot tolerate a step?
What is still unknown
- The label gives a minimum of 4 weeks per dose and no fixed calendar, so how long a particular person stays at each step is a prescriber decision that no label or trial settles.
- The Atlas read the published abstracts of the trials, not the full papers. SURMOUNT-OSA's abstract does not name its analysis approach, and the number of people in each sleep apnea trial is not in the abstract.
- The trials tested assigned target doses. They do not show which maintenance dose is best for one person.
- The label lists no dose above 15 mg once a week. Trials of higher doses, if any, have not been summarized here.
- Self-pay prices are as listed in October 2026 and change often. The Atlas has no price data for insurance copays.
Sources
- Zepbound (tirzepatide) injection: prescribing information on the maker's site Eli Lilly and Company, uspl.lilly.com. Label version 8/2026, read November 2, 2026. Company announcement, not peer reviewed
- Zepbound (tirzepatide) injection: FDA-hosted prescribing information, 2/2026 Eli Lilly and Company, on Drugs@FDA (U.S. Food and Drug Administration). Supplement 042. Regulator
- Zepbound (tirzepatide) injection: prescribing information Eli Lilly and Company, on DailyMed (U.S. National Library of Medicine). Label version 8/2026. Official FDA label on DailyMed
- Tirzepatide once weekly for the treatment of obesity (SURMOUNT-1) Jastreboff AM, et al. N Engl J Med. 2022;387(3):205-216. PMID 35658024. Funding: Eli Lilly. Journal article
- Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2) Garvey WT, et al. Lancet. 2023;402(10402):613-626. PMID 37385275. Funding: Eli Lilly. Journal article
- Tirzepatide as compared with semaglutide for the treatment of obesity (SURMOUNT-5) Aronne LJ, et al. N Engl J Med. 2025;393(1):26-36. PMID 40353578. Funding: Eli Lilly. Journal article
- Tirzepatide for the treatment of obstructive sleep apnea and obesity (SURMOUNT-OSA) Malhotra A, et al. N Engl J Med. 2024;391(13):1193-1205. PMID 38912654. Funding: Eli Lilly. Journal article
- Tirzepatide for maintenance of bodyweight reduction in people with obesity in the USA (SURMOUNT-MAINTAIN) Horn DB, et al. Lancet. 2026;407(10545):2305-2318. PMID 42119587. Funding: Eli Lilly. Journal article
- Zepbound on LillyDirect: self-pay prices Eli Lilly and Company, LillyDirect. Self-pay prices as read in October 2026. Prices and terms can change or end at any time and are not independently verified. Company announcement, not peer reviewed
- FDA alerts health care providers, compounders and patients of dosing errors associated with compounded injectable semaglutide products U.S. Food and Drug Administration compounding alert, July 26, 2024. Regulator