What should I do if I miss a dose of Mounjaro (tirzepatide) at its scheduled time?

Missed Dose of Mounjaro (Tirzepatide)

If you miss your scheduled weekly dose of Mounjaro, take it as soon as you remember, but only if there are at least 4 days (96 hours) remaining until your next scheduled dose; if less than 4 days remain, skip the missed dose entirely and resume your regular weekly schedule.

Timing-Based Action Plan

If You Remember Within 4 Days of Next Dose

• Skip the missed dose completely 1
• Resume your regular weekly injection schedule on your originally scheduled day 1
• Do not take two doses within 4 days of each other to avoid increased gastrointestinal side effects 1, 2

If More Than 4 Days Until Next Dose

• Take the missed dose as soon as you remember 1
• Continue with your regular weekly schedule thereafter 1
• Your injection day will remain the same going forward 1

Critical Safety Considerations

Why the 4-Day Rule Matters

• Tirzepatide has a 5-day elimination half-life, meaning taking doses too close together increases drug accumulation and adverse event risk 1
• Gastrointestinal side effects (nausea, vomiting, diarrhea) are dose-dependent and occur in 17-31% of patients at therapeutic doses 2
• Taking doses closer than 4 days apart effectively creates a higher-than-intended dose exposure 1, 2

Common Pitfalls to Avoid

• Never double up doses or take two injections within the same week to "catch up" 1, 2
• Do not adjust your maintenance dose without consulting your provider, as this disrupts the carefully designed titration schedule that minimizes side effects 1
• If you're using oral hormonal contraceptives, be aware that missed doses followed by resumption may require backup contraception for 4 weeks due to gastric emptying effects 1

When to Contact Your Healthcare Provider

Situations Requiring Medical Guidance

• If you've missed multiple consecutive doses and are uncertain how to restart 1
• If you experience severe gastrointestinal symptoms after resuming treatment following a missed dose 2
• If you're taking medications with narrow therapeutic indices (like warfarin) that may be affected by inconsistent dosing 1
• If you have kidney disease, as dose interruptions followed by resumption may increase acute kidney injury risk 2

Monitoring After Missed Doses

• Watch for increased gastrointestinal symptoms when resuming after a gap, as your tolerance may have decreased 2
• Monitor blood glucose more closely if you have diabetes, particularly if combined with insulin or sulfonylureas 1, 2
• Be alert for signs of pancreatitis (severe abdominal pain radiating to back) when restarting, though this is rare 2

Maintaining Adherence Going Forward

Practical Strategies

• Set a consistent weekly injection day and time with phone reminders 1
• Store your medication properly and keep track of your injection schedule 1
• If you frequently forget doses, discuss with your provider whether weekly injections are the right regimen for you 1