Tirzepatide Dosing After 40 mg: This Dose Does Not Exist
There is no 40 mg dose of tirzepatide—the maximum approved dose is 15 mg once weekly. 1, 2
Standard Tirzepatide Dosing Schedule
The approved tirzepatide dosing follows a specific escalation protocol:
- Starting dose: 2.5 mg once weekly for 4 weeks 1, 3
- Escalation schedule: Increase by 2.5 mg every 4 weeks until reaching the target maintenance dose 1, 4
- Available maintenance doses: 5 mg, 10 mg, 12.5 mg, or 15 mg once weekly 1, 2
- Maximum approved dose: 15 mg once weekly 1, 2
If Patient Is Already on 15 mg (Maximum Dose)
If a patient has reached the 15 mg dose and requires additional weight loss or glycemic control, continue at 15 mg weekly as this provides maximum benefit. 2
- The 15 mg dose produces the greatest weight loss (20.9% at 72 weeks) and HbA1c reduction (up to -2.37%) compared to lower doses 1, 4
- If weight or glycemic targets are not met at maximum dose, reassess other weight management strategies including diet and physical activity rather than exceeding the approved dose 2
- Nearly 40% of patients on 15 mg achieve ≥25% total body weight loss 1
Dose-Response Relationship
Higher doses consistently demonstrate superior outcomes:
- 5 mg weekly: 15.0% weight loss, -1.93% HbA1c reduction 1, 4
- 10 mg weekly: 19.5% weight loss, -2.20% HbA1c reduction 1, 4
- 15 mg weekly: 20.9% weight loss, -2.37% HbA1c reduction 1, 4
Common Pitfall to Avoid
Do not attempt to exceed the 15 mg maximum dose. There is no clinical trial data supporting doses above 15 mg, and doing so would be off-label use without established safety or efficacy data. 1, 2