From the Guidelines
Mounjaro (tirzepatide) should be started at a dose of 2.5 mg injected subcutaneously once weekly for the first 4 weeks, with subsequent dose increases to 5 mg and potentially up to 15 mg based on tolerance and response, as this approach minimizes side effects and allows for optimal glycemic control 1.
Key Considerations for Initiating Mounjaro
- The initial dose of 2.5 mg helps the body adjust to the medication, reducing the risk of gastrointestinal side effects such as nausea, vomiting, and diarrhea.
- After the initial 4 weeks, the dose can be increased to 5 mg once weekly for at least 4 weeks, with further increases in 2.5 mg increments every 4 weeks as needed and tolerated.
- The maximum approved dose is 15 mg once weekly, but the target dose should be individualized based on the patient's response and tolerance.
Administration and Storage
- Injections should be administered on the same day each week, but the time of day can vary.
- Common injection sites include the abdomen, thigh, or upper arm.
- Mounjaro pens should be stored in the refrigerator (not frozen) and allowed to warm to room temperature for 30 minutes before injecting.
Monitoring and Follow-Up
- Regular follow-up with a healthcare provider is essential to monitor progress, adjust dosing as needed, and manage any side effects.
- Patients should be advised to stay well-hydrated and consider smaller, more frequent meals to help manage gastrointestinal side effects.
Evidence Base
The recommended dosing regimen for Mounjaro is based on the latest clinical guidelines and evidence, including the standards of care in diabetes-2025 1, which provides the most recent and comprehensive information on the pharmacologic approaches to glycemic treatment. While other studies, such as the standards of care in diabetes-2023 1, may also provide relevant information, the 2025 guidelines offer the most up-to-date recommendations for initiating Mounjaro therapy.
From the FDA Drug Label
The recommended starting dosage of MOUNJARO is 2.5 mg injected subcutaneously once weekly. Follow the dosage escalation below to reduce the risk of gastrointestinal adverse reactions [see Warnings and Precautions (5.6) and Adverse Reactions (6.1)]. The 2. 5 mg dosage is for treatment initiation and is not intended for glycemic control. After 4 weeks, increase the dosage to 5 mg injected subcutaneously once weekly. If additional glycemic control is needed, increase the dosage in 2. 5 mg increments after at least 4 weeks on the current dose. The maximum dosage of MOUNJARO is 15 mg injected subcutaneously once weekly.
The regimen for starting Mounjaro (tirzepatide) is:
- Initial dose: 2.5 mg injected subcutaneously once weekly
- Dosage escalation:
- Increase to 5 mg after 4 weeks
- Further increases in 2.5 mg increments after at least 4 weeks on the current dose
- Maximum dose: 15 mg injected subcutaneously once weekly 2 2
From the Research
Dosage and Administration
- The recommended dosage of Mounjaro (tirzepatide) is 2.5 mg, 5 mg, or 10 mg administered via subcutaneous injection once weekly 3
- The medication comes as single-dose prefilled pens and single-dose vials 4
Initiation of Therapy
- The initiation of Mounjaro therapy should be done under the guidance of a healthcare professional 5
- Patients should be started on a dose of 2.5 mg once weekly, and the dose can be increased to 5 mg and then 10 mg based on the patient's response and tolerance to the medication 6
Clinical Trials
- The SURPASS clinical trials have demonstrated the efficacy and safety of tirzepatide in patients with type 2 diabetes, with doses of 5 mg, 10 mg, and 15 mg showing significant improvements in glycemic control and weight loss 6, 5, 7
- The trials have also shown that tirzepatide is generally well-tolerated, with a safety profile consistent with that of GLP-1 receptor agonists 4