What is the starting dose of Mounjaro (tirzepatide)?

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Starting Dose of Mounjaro (Tirzepatide)

The starting dose of Mounjaro (tirzepatide) is 2.5 mg administered subcutaneously once weekly. 1

Dosing Schedule and Titration

  • Tirzepatide therapy begins with 2.5 mg weekly subcutaneous injections for the first 4 weeks 1
  • After 4 weeks at the initial dose, tirzepatide should be increased to 5 mg once weekly 1
  • Further dose escalations can occur based on clinical response and tolerability:
    • Can increase to 10 mg once weekly after at least 4 weeks on the 5 mg dose 1
    • May further increase to the maximum dose of 15 mg once weekly after at least 4 weeks on the 10 mg dose 1

Administration Considerations

  • Tirzepatide is administered as a subcutaneous injection once weekly 1
  • The injection can be given at any time of day, regardless of meals 1
  • No dose adjustments are required for patients with renal impairment 1

Side Effect Management

  • The gradual dose escalation schedule is designed to minimize gastrointestinal side effects, which are the most common adverse events 2
  • Common side effects include:
    • Nausea (10-31%, dose-dependent)
    • Diarrhea (7-23%)
    • Vomiting (2-12%)
    • Constipation (3-5%)
    • Abdominal pain (3-5%) 1

Clinical Considerations

  • Starting at the 2.5 mg dose and following the recommended titration schedule is crucial to improve gastrointestinal tolerability 2
  • Tirzepatide has dual agonistic activity on GIP and GLP-1 receptors, which contributes to its efficacy for both glycemic control and weight management 3
  • The medication has demonstrated superior weight loss compared to semaglutide in clinical trials (20.2% vs 13.7% at maximum doses) 4

Important Precautions

  • Monitor for signs of pancreatitis and discontinue if suspected 1
  • Use caution in patients with kidney disease when initiating or increasing the dose due to potential risk of acute kidney injury 1
  • Tirzepatide carries a black box warning regarding the risk of thyroid C-cell tumors in rodents (human relevance not determined) 1
  • Contraindicated in patients with personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia type 2 1

Special Considerations for Perioperative Management

  • Due to effects on gastric emptying, there are concerns about increased risk of pulmonary aspiration during anesthesia 1
  • Consider the pharmacokinetics of tirzepatide (elimination half-life of 5 days) when planning perioperative management 1

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Tirzepatide Once Weekly for the Treatment of Obesity.

The New England journal of medicine, 2022

Research

Tirzepatide as Compared with Semaglutide for the Treatment of Obesity.

The New England journal of medicine, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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