Mounjaro Doses Explained: The 2.5mg to 15mg Titration Schedule

Mounjaro (tirzepatide) is started at 2.5mg once a week for four weeks, then increased to 5mg. After that, the dose can go up in 2.5mg steps (to 7.5mg, 10mg, 12.5mg and 15mg), with at least four weeks at each dose before the next increase. The UK product information names 5mg, 10mg and 15mg as maintenance doses, and 15mg is the maximum. Increases are not automatic: your prescriber decides whether to step up, hold or step down based on your weight loss, side effects and overall health.

This guide explains each step of the schedule, why it is structured this way, how prescribers make dose decisions and what to do in common situations such as missed doses or breaks in treatment. For background on the medicine, see our complete guide to Mounjaro in the UK or the Mounjaro hub.

The Mounjaro dose schedule at a glance

The table shows the fastest possible route through the doses under the UK product information. In practice, many people spend longer on some steps.

All doses are given once a week, on the same day each week, by injection under the skin of the stomach area, thigh or upper arm. The time of day does not matter, and it can be taken with or without food.

Why Mounjaro starts low and increases slowly

The gradual approach is called dose titration. Tirzepatide slows stomach emptying and acts on appetite and nausea pathways in the brain. These effects are strongest when the body first encounters a new dose, so jumping straight to a high dose would make digestive side effects such as nausea, vomiting and diarrhoea much more likely.

The SURMOUNT trials used this four-week escalation, and side effects in those trials were mostly mild to moderate and concentrated in the escalation period. Starting low and stepping up gives the digestive system time to adapt. See How Mounjaro works for more on the mechanism and Mounjaro side effects for how side effects are managed.

Each dose in more detail

2.5mg: the starting dose

Everyone starts at 2.5mg, including people switching from another GLP-1 medicine unless their prescriber advises otherwise. The 2.5mg dose is not considered a therapeutic dose for long-term weight management. Some people notice reduced appetite straight away, while others notice little change. Both are normal. See our Mounjaro 2.5mg page.

5mg: the first treatment dose

After four weeks, the product information says to increase to 5mg. For some people, 5mg is enough: in SURMOUNT-1, participants on 5mg lost about 15% of their body weight on average over 72 weeks, compared with about 3% on placebo. If weight loss is steady and side effects are tolerable, a prescriber may keep you here. See our Mounjaro 5mg page.

7.5mg: a step up

7.5mg is mainly a stepping stone towards 10mg, though some people remain on it if it suits them, at their prescriber's discretion. See Mounjaro 7.5mg.

10mg: a common maintenance dose

10mg is one of the three recommended maintenance doses. In SURMOUNT-1, the 10mg group lost about 19.5% of body weight on average at 72 weeks. See Mounjaro 10mg.

12.5mg: a step up

Like 7.5mg, 12.5mg is primarily a bridge to the maximum dose. See Mounjaro 12.5mg.

15mg: the maximum dose

15mg is the highest licensed dose. In SURMOUNT-1, the 15mg group lost about 21% of body weight on average. The additional average benefit over 10mg was modest, and digestive side effects were somewhat more common at higher doses, so the decision to go to 15mg is individual. See Mounjaro 15mg.

What the evidence says about dose and results

Approximate figures from the SURMOUNT-1 publication (treatment-regimen estimand). Individual results vary.

Two practical points follow. First, there is a dose-response: higher doses produced more weight loss on average. Second, the step from 10mg to 15mg added less on average than the step from 5mg to 10mg. That is one reason why prescribers weigh benefit against tolerability rather than treating 15mg as the goal for everyone.

In the head-to-head SURMOUNT-5 trial, participants took the maximum tolerated dose of tirzepatide (10mg or 15mg) or semaglutide (1.7mg or 2.4mg), reflecting this individualised approach. See Mounjaro results over time.

How prescribers decide whether to increase your dose

There is no single formula. A good prescriber, whether NHS or private, will usually consider:

• Weight loss so far. Steady progress may mean there is no need to increase yet.
• Side effects. Ongoing nausea, vomiting or diarrhoea are reasons to wait or step down.
• Eating and drinking. If you are struggling to eat enough or stay hydrated, a higher dose may not be appropriate.
• Other health conditions and medicines. For example, diabetes medicines that can cause low blood sugar may need adjusting.
• Your goals and preferences. Some people prefer a slower pace with fewer side effects.

Under NICE TA1026, NHS prescribers are advised to review treatment if less than 5% of initial weight has been lost after six months on the highest tolerated dose, and decide whether to continue. Many private providers use a similar review point.

Holding, stepping down and stepping back up

These are illustrations of common practice, not instructions. Do not change your dose yourself.

The KwikPen and dose strengths

In the UK, Mounjaro is supplied as a KwikPen, a multi-dose pre-filled pen. Key points:

• One strength per pen. Each pen is a single strength (2.5mg, 5mg, 7.5mg, 10mg, 12.5mg or 15mg).
• Four doses per pen. Each pen contains four weekly doses, so one pen typically lasts four weeks.
• Fixed doses. You dial a full dose each time; the pen is not designed for partial or split doses.
• Priming before each injection. The UK instructions say to prime the pen before every dose, so a small amount of medicine is used each time and some will be left over after four doses. That leftover is expected and should not be used.
• Needles are not included. Compatible pen needles are supplied separately, and a new needle should be used for every injection.

The Mounjaro KwikPen became available in the UK in early 2024, with the MHRA the first major regulator to authorise this presentation. See our step-by-step guide to using the Mounjaro KwikPen.

Practical tips for dose-increase weeks

The weeks after a step-up are when side effects are most likely. People commonly find the following helpful, alongside any advice from their prescriber:

• Plan your first injection at a new strength for a quieter week, if you can, rather than just before a holiday, a big event or a demanding work deadline.
• Eat smaller portions for the first few days, even if your appetite seems normal, and stop as soon as you feel full.
• Limit fatty, fried and very rich foods, which are more likely to trigger nausea and reflux.
• Keep fluids up, particularly if you have any diarrhoea or vomiting.
• Keep a short note of side effects, so you can describe them accurately at your next review.

If side effects are still troublesome after a week or two at the new dose, contact your prescriber rather than waiting for your next scheduled review. See Mounjaro side effects and managing nausea on GLP-1 medication.

Questions to ask at a dose review

A dose review is a chance to make a shared decision. Useful questions include:

• Is my rate of weight loss within the range you would expect at this dose?
• Would increasing the dose be likely to make a meaningful difference for me?
• Are my side effects a reason to stay where I am for longer?
• Do any of my other medicines need changing as my dose increases?
• What dose do you think I am likely to maintain on in the long term?
• How will we know if the treatment is not working well enough?

Common dosing myths

"Everyone needs to reach 15mg." The UK product information lists 5mg, 10mg and 15mg as maintenance doses. Many people do well at lower doses.

"Faster increases mean faster results." Increasing more quickly than every four weeks is outside the licence and makes side effects more likely, which can lead to people stopping altogether.

"You can stay on 2.5mg if it works." The SmPC describes 2.5mg as a starting dose, not a maintenance dose. Your prescriber will decide what to do if you are responding strongly at that dose.

"Side effects mean it is working." Side effects and weight loss are not reliably linked. Some people lose weight with very few side effects.

Changing your injection day

You can change the day you inject if needed, as long as there are at least three days (72 hours) between two doses. Once you have changed, continue weekly on the new day.

Missed doses

The UK product information says that if you miss a dose:

• within four days (96 hours) of the missed dose, take it as soon as possible, then continue on your usual day
• more than four days after the missed dose, skip it and take the next dose on your usual day

Never take two doses to make up for a missed one. See Missed a Mounjaro dose? for more detail, including what to do after longer gaps.

Restarting after a break

If you have stopped for several weeks, your tolerance to the digestive effects may have fallen. The SmPC does not set out a specific re-titration schedule for longer breaks, so prescribers use clinical judgement. Many will restart at a lower dose and step up again rather than returning straight to your previous dose. Speak to your prescriber before restarting.

Switching to Mounjaro from another medicine

People moving from Wegovy (semaglutide) or Saxenda (liraglutide) to Mounjaro usually start at 2.5mg, because there is no established direct dose equivalence between these medicines. The prescriber decides on timing and dose. See Switching from Wegovy to Mounjaro.

Trial dosing compared with everyday practice

In the SURMOUNT trials, participants were assigned to a fixed target dose (5mg, 10mg or 15mg) and stepped up every four weeks until they reached it, unless side effects got in the way. Everyday prescribing is usually more flexible:

This flexibility means your experience may not match the trial dose groups exactly. A slower climb, or staying on a lower dose, is a normal part of individualised care rather than a sign that treatment is going badly.

How long each dose takes to have its full effect

Tirzepatide has a half-life of about five days, so blood levels take roughly four weeks of weekly dosing to settle at each new strength. That is one reason the product information sets four weeks as the minimum interval between increases: it allows time to judge how you are responding to a dose before moving on. Judging a dose after only one or two injections can be misleading, because both the appetite effect and the side effects are still changing.

Special groups

The SmPC states that no dose adjustment is needed based on age, sex, kidney function or liver function, although experience in people with severe kidney or liver impairment is limited and caution is advised. People with type 2 diabetes follow the same escalation, but their other medicines, especially insulin or sulfonylureas, may need reducing to lower the risk of hypoglycaemia. Mounjaro is not recommended in pregnancy or breastfeeding.

How dose relates to cost

Higher strengths of Mounjaro generally cost more privately, and the difference widened when Eli Lilly raised UK list prices for private supply in September 2025, with larger rises at higher strengths. This is one reason why the right maintenance dose is worth discussing openly with your prescriber. We do not quote prices in our guides; see our Mounjaro prices page and Mounjaro price guide for what affects cost.

Different providers handle dose changes in different ways, including how quickly they review progress and whether dose changes affect subscriptions. Our providers page compares these service features.

Long-term dosing

Once you reach a dose that works, you may stay on it for an extended period. Evidence from SURMOUNT-4 shows that stopping tirzepatide usually leads to regain, while continuing helps maintain weight loss. Research such as SURMOUNT-MAINTAIN, presented in 2026, has looked at whether stepping down to a lower maintenance dose can preserve much of the benefit. Our Mounjaro maintenance guide explains the options.

When to speak to a professional

Speak to your prescriber, GP or pharmacist:

• before any change to your dose, including stepping down or stopping
• if side effects after a dose increase have not settled within a week or two
• if you have missed more than one dose in a row or had a break of several weeks
• if you are starting other medicines, especially for diabetes
• if you are planning a pregnancy, or think you might be pregnant
• before surgery or procedures under sedation or general anaesthetic

Seek urgent medical help (NHS 111, or 999 in an emergency) if you have:

• severe, persistent abdominal pain, which may spread to the back, with or without vomiting
• vomiting or diarrhoea so severe that you cannot keep fluids down
• pain in the upper right abdomen with fever or yellowing of the skin or eyes
• signs of a severe allergic reaction, such as swelling of the face or throat, or difficulty breathing