Mounjaro Dosing Schedule (2026 Guide)
Week-by-week titration from 2.5 mg starter to 15 mg maximum, with HbA1c and weight outcomes from the SURPASS program. Verified against the current Lilly label.
Mounjaro starts at 2.5 mg once weekly for the first 4 weeks (a starter dose, not a treatment dose). The dose is then increased every 4 weeks in 2.5 mg steps until you reach a maintenance dose of 5, 10, or 15 mg once weekly. For type 2 diabetes, the prescribing information lists 5 mg, 10 mg, and 15 mg all as approved maintenance doses. Most diabetes patients land at 5 or 10 mg for glycemic control. The full titration to the 15 mg ceiling takes about 5 months.
Mounjaro titration schedule, week by week
Six strengths total. Three of them (5 mg, 10 mg, 15 mg) are FDA-approved as maintenance doses for type 2 diabetes. The others are titration steps to get there.
| When | Dose | Purpose | What to expect |
|---|---|---|---|
| Weeks 1-4 | 2.5 mg | Starter dose | Body adjusts to the medication. Mild to moderate nausea is most common in week 1, usually settling by week 3. This dose is not intended for ongoing glycemic control on its own. |
| Weeks 5-8 | 5 mg | First maintenance optionMaintenance | Meaningful HbA1c reduction begins. Many type 2 diabetes patients land here as their long-term dose. Side effects often peak briefly after the dose increase, then settle. |
| Weeks 9-12 | 7.5 mg | Intermediate titration step | Stepping stone to a higher maintenance dose if 5 mg is not getting your HbA1c to goal. Some clinicians hold here longer if side effects are pronounced. |
| Weeks 13-16 | 10 mg | Second maintenance optionMaintenance | A common long-term dose for diabetes patients needing stronger glycemic control. SURPASS-2 showed about 2.4% HbA1c reduction at this dose over 40 weeks. |
| Weeks 17-20 | 12.5 mg | Intermediate titration step | Stepping stone to the maximum dose. Some clinicians stop here if side effects at higher doses become unmanageable. |
| Week 21+ | 15 mg | Maximum maintenance doseMaintenance | FDA-approved ceiling for type 2 diabetes. SURPASS-2 showed about 2.5% HbA1c reduction at 40 weeks, with mean weight loss of about 11 kg. Side effect rates are higher than at 5 mg or 10 mg. |
Most type 2 diabetes patients land at 5 or 10 mg long-term. Some escalate to 15 mg if HbA1c is not at goal. There is no clinical requirement to push to the maximum if your current dose is achieving glycemic control.
HbA1c and weight outcomes by maintenance dose
From the pivotal SURPASS-2 trial, 40-week mean HbA1c reduction and body-weight loss in adults with type 2 diabetes:
SURPASS-2, 40 weeks, adults with type 2 diabetes
SURPASS-2, 40 weeks, adults with type 2 diabetes
SURPASS-2, 40 weeks, adults with type 2 diabetes
Individual results vary widely. SURPASS-2 enrolled adults with T2D inadequately controlled on metformin. Weight loss in this population tends to track lower than in non-diabetic populations using the same molecule (Zepbound at 15 mg averaged ~21% in SURMOUNT-1).
How to inject Mounjaro
- Abdomen (at least 2 inches from the navel)
- Front of thigh
- Back of upper arm
Rotate the injection site each week. You can use the same general area but shift the exact spot.
Once weekly, any day of the week
Take with or without food, with or without other medications. Time of day does not matter clinically.
If you miss a dose
Take the missed dose as soon as you remember.
Skip the missed dose. Take your next dose on your regularly scheduled day.
If you remember within 3 days of your next scheduled dose, skip the missed dose. Do not double up.
Never take two doses to make up for a missed one. Doubling can cause severe nausea and vomiting and does not improve glycemic control.
When prescribers adjust the schedule
If side effects at a new dose are pronounced, your prescriber may keep you on the previous dose for an additional 4 weeks before stepping up.
If 5 mg or 10 mg gets your HbA1c to goal, there is no clinical requirement to escalate further. Many type 2 diabetes patients land at 5 or 10 mg long-term.
If side effects at a higher dose become unmanageable, your prescriber may step you back down. Lower doses still provide meaningful glycemic benefit.
Common side effects, with frequency
From the prescribing information at maintenance doses (5 mg and above). Side effects tend to peak briefly after each dose increase, then settle.
| Side effect | Frequency | Practical notes |
|---|---|---|
| Nausea | Up to 22% | Most common in the first 4 weeks of each dose increase. Eating smaller meals and avoiding fatty or spicy foods helps. |
| Diarrhea | Up to 17% | Often occurs in the first weeks. Hydration is important. |
| Vomiting | Up to 10% | More common at higher doses (10 to 15 mg). Worth raising with your clinician if persistent. |
| Constipation | Up to 7% | Adequate fiber and fluid intake helps. |
| Decreased appetite | Up to 11% | Often a desired effect alongside glycemic control. |
| Abdominal pain | Up to 6% | Persistent or severe abdominal pain warrants immediate clinical attention. |
| Hypoglycemia | Higher when combined with insulin or sulfonylureas | Mounjaro alone rarely causes hypoglycemia. Risk rises when stacked with insulin or sulfonylureas; your prescriber may lower those doses. |
Storage
- Refrigeration: Refrigerate at 36 to 46 degrees Fahrenheit (2 to 8 degrees Celsius) in the original carton, protected from light.
- Room temperature: Can be stored at room temperature up to 86 degrees Fahrenheit (30 degrees Celsius) for up to 21 days, one time. Do not put back in the refrigerator after that.
- Do not freeze: Do not freeze. Discard if frozen.
- Handling: Do not shake the pen vigorously.
Frequently asked questions
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Dosing schedule, available strengths, missed-dose guidance, storage, and administration come directly from the Mounjaro (tirzepatide) Prescribing Information from Eli Lilly. Trial outcomes are from SURPASS-2 (NEJM 2021). Side effect frequencies reflect the rates reported in the prescribing information at the indicated maintenance doses for type 2 diabetes.