What is the tirzepatide dosing schedule on the FDA-approved Zepbound® label?
The FDA-approved Zepbound® (tirzepatide) prescribing information from Eli Lilly, revised August 2026, sets out the brand-label schedule below. The weeks column shows the earliest weeks the Zepbound® label allows, based on a minimum of 4 weeks per dose, rather than a fixed calendar. The Zepbound® label lets the prescribing provider stop at a recommended maintenance dose or consider a lower maintenance dose if a maintenance dose is not tolerated. Compounded tirzepatide is not FDA-approved and has no FDA-approved dosing label of its own; the prescribing provider sets each patient's dose.
| Earliest weeks on the label | Weekly dose | What the Zepbound® label says |
|---|---|---|
| Weeks 1–4 | 2.5 mg | Starting dose for treatment initiation; not approved as a maintenance dose. |
| From week 5 | 5 mg | First recommended maintenance option for weight reduction and long-term maintenance. |
| From week 9 at the earliest | 7.5 mg | Escalation step: a 2.5 mg increase after at least 4 weeks on 5 mg. |
| From week 13 at the earliest | 10 mg | Maintenance option for weight reduction and long-term maintenance, and for OSA. |
| From week 17 at the earliest | 12.5 mg | Escalation step: a 2.5 mg increase after at least 4 weeks on 10 mg. |
| From week 21 at the earliest | 15 mg | Maintenance option for weight reduction and long-term maintenance, and for OSA; maximum dose. |
What are the tirzepatide maintenance doses on the Zepbound® label?
The FDA-approved Zepbound® (tirzepatide) label, section 2.2, lists 5 mg, 10 mg or 15 mg injected subcutaneously once weekly as the recommended maintenance doses for weight reduction and long-term maintenance. The Zepbound® label lists 10 mg or 15 mg once weekly for moderate to severe obstructive sleep apnea (OSA) in adults with obesity. The Zepbound® maximum for all indications is 15 mg once weekly.
The Zepbound® label directs the prescribing provider to consider treatment response and tolerability when selecting a maintenance dose. The Zepbound® label also allows consideration of a lower maintenance dose when a maintenance dose is not tolerated. The Zepbound® 2.5 mg dose is for treatment initiation and is not approved as a maintenance dose. Compounded tirzepatide is not FDA-approved and has no FDA-approved maintenance-dose label; the prescribing provider determines the dose for each patient.
How is Mounjaro dosing different from Zepbound dosing?
FDA-approved Mounjaro® and Zepbound® contain tirzepatide and are made by Eli Lilly. The Mounjaro® and Zepbound® labels specify a 2.5 mg once-weekly start, 2.5 mg increases after at least 4 weeks on the current dose, and a 15 mg adult weekly maximum. Mounjaro® escalation is conditional on additional glycemic control being needed.
The Mounjaro® label covers glycemic control alongside diet and exercise in adults and children aged 10 years and older with type 2 diabetes, plus major adverse cardiovascular event risk reduction in adults with type 2 diabetes at high risk for those events. The Mounjaro® pediatric weekly maximum is 10 mg. Mounjaro® is not approved for weight management. The Zepbound® label covers weight reduction and long-term maintenance in adults with obesity, or adults with overweight and at least one weight-related condition, plus moderate to severe OSA in adults with obesity, alongside a reduced-calorie diet and increased physical activity. Compounded tirzepatide is not FDA-approved and is not therapeutically equivalent to FDA-approved Zepbound® or Mounjaro®.
Why does the Zepbound® label start tirzepatide at 2.5mg and increase slowly?
The FDA-approved Zepbound® (tirzepatide) label states that gradual escalation is followed to reduce the risk of gastrointestinal adverse reactions. The Zepbound® label specifies 2.5 mg once weekly for treatment initiation for 4 weeks, then 5 mg once weekly, with further increases separated by at least 4 weeks on the current dose.
Contact your prescribing provider promptly for severe or persistent stomach symptoms such as nausea, vomiting, diarrhea or abdominal pain, or if you cannot keep fluids down. The Zepbound® label tells patients to stop the medication and contact their healthcare provider promptly if pancreatitis is suspected (severe abdominal pain that may spread to the back, with or without nausea or vomiting), and to stop the medication and seek medical advice promptly if symptoms of an allergic (hypersensitivity) reaction occur. For trouble breathing or swelling of the face, lips, tongue or throat, seek emergency care. Never change your dose without your prescribing provider. The tirzepatide side effects guide provides additional context. Compounded tirzepatide is not FDA-approved; the prescribing provider sets the dose and advises on symptoms. The Zepbound® label identifies the adverse reactions listed below as the most common reactions.
- Nausea
- Diarrhea
- Vomiting
- Constipation
- Abdominal pain
- Dyspepsia (indigestion)
- Injection site reactions
- Fatigue
- Hypersensitivity reactions
- Eructation (burping)
- Hair loss
- Gastroesophageal reflux disease
What is the boxed warning on the Zepbound® and Mounjaro® labels?
The FDA-approved Zepbound® and Mounjaro® (tirzepatide) labels carry a boxed warning for the risk of thyroid C-cell tumors. Tirzepatide causes thyroid C-cell tumors in rats, and it is unknown whether Zepbound® or Mounjaro® causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans. The Zepbound® and Mounjaro® labels contraindicate use in patients with a personal or family history of MTC, in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), and in patients with a known serious hypersensitivity to tirzepatide or to any of the product's other ingredients (excipients). The Zepbound® and Mounjaro® labels also tell patients to report symptoms of thyroid tumors, such as a lump in the neck, persistent hoarseness, trouble swallowing or shortness of breath, to their healthcare provider. Tell your prescribing provider about any personal or family history of thyroid cancer or MEN 2, and about any serious allergic reaction, before starting treatment. Compounded tirzepatide is not FDA-approved and has no FDA-approved label; the prescribing provider reviews each patient's history before prescribing.
What if I miss a tirzepatide dose?
The FDA-approved Zepbound® and Mounjaro® labels give the same missed-dose instructions for those tirzepatide brands: administer a missed dose as soon as possible within 4 days (96 hours) after the missed dose. The Zepbound® and Mounjaro® labels say to skip the missed dose if more than 4 days have passed and administer the next dose on the regularly scheduled day. The Zepbound® and Mounjaro® labels then direct patients to resume the regular once-weekly schedule.
The Zepbound® and Mounjaro® labels allow a change in the weekly administration day when at least 3 days (72 hours) separate two doses. Compounded tirzepatide is not FDA-approved and has no FDA-approved dosing label. For compounded tirzepatide, follow the prescribing provider's and dispensing pharmacy's instructions for missed doses or schedule changes; contact those professionals if the directions are unclear.
Does tirzepatide affect birth control pills?
The FDA-approved Zepbound® (tirzepatide) label advises patients using oral hormonal contraceptives to switch to a non-oral contraceptive method or add a barrier method for 4 weeks after starting Zepbound® and for 4 weeks after each dose increase. The Zepbound® label states that non-oral hormonal contraceptives should not be affected. Tell your prescribing provider about any birth control before starting treatment and before a dose change. Compounded tirzepatide is not FDA-approved and has no FDA-approved label; the prescribing provider should discuss contraception and medication instructions for each patient receiving compounded tirzepatide.
How is compounded tirzepatide dosed compared with Zepbound or Mounjaro?
Brand-name and compounded doses are not interchangeable, and there is no dose conversion between them; your provider determines the right dose based on your history. Compounded tirzepatide is not FDA-approved and is not therapeutically equivalent to FDA-approved Zepbound® or Mounjaro®. Compounded tirzepatide prescribed through Cora Health is prepared under patient-specific prescriptions by US-licensed 503A compounding pharmacies, including Hallandale Pharmacy (PCAB-accredited) and VialsRx.
Compounded tirzepatide vial concentration (mg/mL) varies by pharmacy, so the same milligram dose can occupy a different injection volume from one vial to another. The dispensing pharmacy's label states the concentration, and the prescribing provider's instructions state the amount to draw. Never use a brand pen's markings or another vial's injection volume for a compounded tirzepatide vial. Ask the dispensing pharmacy and prescribing provider to clarify any mismatch before drawing an injection.
How much does compounded tirzepatide cost through Cora Health?
On the Cora Health Premium Plan, compounded tirzepatide prescribed through Cora Health has four standard billing tiers: annual at $135/month ($1,620 billed upfront every 12 months); semi-annual at $175/month ($1,050 billed upfront every 6 months); quarterly at $199/month ($597 billed upfront every 3 months); and monthly at $225/month ($225 billed monthly). Plans renew automatically until you cancel. Prices may change. Each price includes the provider consultation, the medication, pharmacy fulfillment, shipping and ongoing provider monitoring, and on the standard plans the price does not change with your dose. A licensed provider decides eligibility and prescribes only when clinically appropriate. Compounded tirzepatide is not FDA-approved. More pricing detail is in the tirzepatide cost guide; cancellation terms are in the refund policy.
Who prescribes compounded tirzepatide through Cora Health?
Cora Health does not prescribe medication. Cora Health connects patients with licensed providers at Wasef Health, PC, who evaluate each patient and prescribe compounded tirzepatide only when clinically appropriate. The prescribing provider reviews the patient's history, decides eligibility and sets the patient's dose. A consultation does not guarantee a prescription.
Compounded tirzepatide prescribed through Cora Health is prepared under patient-specific prescriptions by US-licensed 503A compounding pharmacies, including Hallandale Pharmacy (PCAB-accredited) and VialsRx. Cora Health does not compound medication. Cora Health is LegitScript-certified. Compounded medications are not FDA-approved. They are prepared by state-licensed pharmacies based on a valid prescription from a licensed provider. FDA does not verify the safety, effectiveness or quality of compounded drugs before marketing. The prescribing provider and dispensing pharmacy answer questions about the prescription and pharmacy label.
Sources
All brand-label dosing facts on this page come from the FDA-approved Zepbound® and Mounjaro® prescribing information (Eli Lilly, revised August 2026). Compounded tirzepatide is not FDA-approved.
- Eli Lilly — Zepbound® prescribing information, revised August 2026: pi.lilly.com/us/zepbound-uspi.pdf
- Eli Lilly — Mounjaro® prescribing information, revised August 2026: pi.lilly.com/us/mounjaro-uspi.pdf
- FDA — Compounding and the FDA: Questions and Answers: fda.gov
- LegitScript — Independent verification of Cora Health certification: legitscript.com/websites/?checker_keywords=trycora.io
Cora Health Content Team
Written by the Cora Health content team from the FDA-approved Zepbound® and Mounjaro® prescribing information (Eli Lilly, revised August 2026). This article was not medically reviewed. Compounded tirzepatide is not FDA-approved; your prescribing provider sets your dose.
Related reading
Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting any new medication or treatment. Cora Health does not prescribe medication; licensed providers at Wasef Health, PC review every patient assessment and prescribe only when clinically appropriate.
Ozempic®, Wegovy®, Mounjaro®, Zepbound® and other brand names are registered trademarks of their respective owners; Cora Health is not affiliated with Novo Nordisk or Eli Lilly.
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