Mounjaro 2.5 mg Dosing Terminology
The Mounjaro 2.5 mg dose is the initial starting dose, not an introductory dose—it is the first step in a mandatory dose escalation protocol designed to minimize gastrointestinal adverse effects.
Standard Dosing Protocol
Tirzepatide (Mounjaro) is initiated at 2.5 mg subcutaneously once weekly for the first 4 weeks, after which the dose should be increased to 5 mg once weekly 1, 2.
The 2.5 mg dose is specifically a starting dose for tolerability, not intended to provide therapeutic glycemic control on its own 1, 3.
After at least 4 weeks on 5 mg, the dose can be escalated in 2.5 mg increments (to 7.5 mg, 10 mg, 12.5 mg, or 15 mg) based on glycemic response and tolerability 1, 2.
Real-World Dosing Patterns
In clinical practice, 84.1% of patients initiate tirzepatide at ≤5 mg dose, with the majority starting at 2.5 mg 4.
The mean time to first dose escalation from the starting dose is approximately 59 days (about 8 weeks) 4.
At 6 months of treatment, 56.5% of patients remain on doses <10 mg, indicating gradual titration is common 4.
Approximately 69.6% of patients have at least one dose escalation during the first 6 months of therapy 4.
Clinical Rationale for Starting Dose
Gradual dose titration from 2.5 mg helps mitigate gastrointestinal adverse effects (nausea, diarrhea, vomiting, decreased appetite), which are the most common side effects of GLP-1-based therapies 1, 3.
The starting dose approach is consistent with other GLP-1 receptor agonists (such as liraglutide and semaglutide), where lower initial doses reduce treatment discontinuation due to GI intolerance 5.
Terminology Clarification
The appropriate term is "starting dose" or "initial dose" rather than "introductory dose." This reflects that 2.5 mg is the mandatory first step in a structured titration schedule, not an optional or exploratory dose 1, 2, 3.