Tirzepatide Dosing Guide: The Full Schedule

Tirzepatide has more dose steps than semaglutide and a longer ramp-up. That's not a bug — it's because dual-receptor activation (GLP-1 + GIP) means more knobs to turn, and your body needs time to calibrate.

Here's the complete schedule, what each level does, and why many people never need to reach the max.

The Full Dose Escalation Schedule

Weeks	Dose	Purpose
1-4	2.5mg	Initiation — GI system adaptation
5-8	5.0mg	First therapeutic dose — appetite effects begin
9-12	7.5mg	Mid-range — significant appetite suppression
13-16	10.0mg	Strong therapeutic effect
17-20	12.5mg	Near-maximum effect
21+	15.0mg	Maximum dose

Total time to max dose: 20 weeks (5 months). One month longer than semaglutide's 16-week schedule.

What Happens at Each Dose

2.5mg (Weeks 1-4): Getting Started

Sub-therapeutic for weight loss — this is pure adaptation
Mild nausea, possibly some GI changes
Subtle appetite changes at best
Weight loss: 0-3 lbs (mostly water)

5.0mg (Weeks 5-8): First Real Dose

This is where the dual GLP-1/GIP mechanism starts showing up
Clear appetite reduction — portions shrink naturally
Food noise begins to quiet
SURMOUNT-1 trial showed 16% average weight loss at this dose (over the full trial)
Weight loss: 3-8 lbs cumulative

Many providers note that tirzepatide 5mg already outperforms semaglutide 2.4mg in the data. If you're getting good results here, your provider may slow the escalation.

7.5mg (Weeks 9-12): The Sweet Spot for Many

Strong appetite suppression
Significant daily calorie reduction without feeling deprived
Weight loss accelerating: 1.5-2+ lbs/week
Blood sugar improvements becoming measurable

This is where many patients stay. If side effects are manageable and weight loss is on track, 7.5mg is a great maintenance dose. Not everyone needs 15mg.

10.0mg (Weeks 13-16): Powerful

21.4% average weight loss at this dose in SURMOUNT-1 — nearly as much as 15mg
Very strong appetite control
Side effects usually mild by this point (body fully adapted)
Many providers use 10mg as the standard maintenance target

12.5mg and 15.0mg (Weeks 17-20+): Maximum

Reserved for patients who need additional effect beyond 10mg
22.5% average weight loss at 15mg in trials
Marginal additional benefit over 10mg for some patients
Higher cost per month at top doses

Not Everyone Needs 15mg

Here's something the marketing doesn't emphasize: the difference between 10mg and 15mg results is smaller than you'd think.

10mg average weight loss: 21.4%
15mg average weight loss: 22.5%

That's a 1.1 percentage point difference for a 50% dose increase. For many patients, 7.5-10mg provides 90%+ of the benefit at lower cost and fewer side effects. Discuss with your provider.

Tirzepatide vs Semaglutide Dosing Comparison

	Semaglutide	Tirzepatide
Starting dose	0.25mg	2.5mg
Max dose	2.4mg	15mg
Escalation steps	5	6
Time to max	16 weeks	20 weeks
Average weight loss (max)	14.9%	22.5%

Full comparison: semaglutide vs tirzepatide

Semaglutide dosing: semaglutide dosing guide

Frequently Asked Questions

Is 15mg tirzepatide the same as 2.4mg semaglutide?

They're not directly equivalent — different molecules, different mechanisms. But 15mg tirzepatide is the max dose and 2.4mg semaglutide is the max dose. In trials, tirzepatide 15mg produced more weight loss (22.5% vs 14.9%).

Can I switch from semaglutide to tirzepatide mid-treatment?

Yes. Your provider will typically restart you at a lower tirzepatide dose and escalate from there, possibly on an accelerated schedule if you tolerated semaglutide well.

What if I can't tolerate dose increases?

Stay at your current dose longer. Your provider may extend each level to 6-8 weeks instead of 4. Some patients do great at 7.5mg or 10mg and never need to go higher.