Tirzepatide Dosing Interval
Tirzepatide should be administered once weekly, with doses separated by at least 7 days, though the next dose can be given as early as 3 days (72 hours) after the previous injection if a dose is missed and the regularly scheduled day cannot be maintained. 1
Standard Dosing Schedule
Tirzepatide is administered as a once-weekly subcutaneous injection, with each dose separated by approximately 7 days. 2, 3
The medication can be injected at any time of day, with or without meals, providing flexibility for patient scheduling. 3
Patients should establish a consistent weekly injection day to maintain therapeutic drug levels and optimize glycemic control. 4
Missed Dose Management
If a dose is missed and the next scheduled dose is more than 4 days (96 hours) away, the missed dose should be administered as soon as possible. 1
If a dose is missed and the next scheduled dose is within 4 days (96 hours), the missed dose should be skipped, and the next dose should be administered on the regularly scheduled day. 1
The minimum interval between two tirzepatide doses is 3 days (72 hours), which represents the earliest safe timeframe for administering consecutive doses. 1
Dose Escalation Timing
During the initial titration phase, tirzepatide is started at 2.5 mg weekly and escalated by 2.5 mg increments every 4 weeks until the target maintenance dose (5 mg, 10 mg, or 15 mg) is achieved. 3
This 4-week escalation interval between dose increases allows for assessment of tolerability, particularly gastrointestinal side effects, and should not be shortened. 3, 4
The gradual dose escalation strategy reduces the incidence of nausea and other gastrointestinal adverse events compared to more rapid titration. 4
Pharmacokinetic Considerations
Tirzepatide has a half-life of approximately 5 days, which supports once-weekly dosing and provides steady-state drug levels after 4 weeks of treatment. 5
Renal impairment does not significantly affect tirzepatide pharmacokinetics, so no dose adjustment or timing modification is required based on kidney function. 5
The 3-day minimum interval between doses is based on pharmacokinetic modeling to prevent excessive drug accumulation while allowing flexibility for missed dose management. 5
Common Pitfalls to Avoid
Do not administer tirzepatide doses less than 3 days (72 hours) apart, as this may increase the risk of gastrointestinal adverse events and hypoglycemia when combined with insulin or sulfonylureas. 1, 3
Avoid making up for multiple missed doses by administering them in rapid succession; instead, resume the regular weekly schedule. 1
Do not accelerate the 4-week dose escalation intervals during titration, as this significantly increases the risk of nausea, vomiting, and treatment discontinuation. 3, 4
When switching from other GLP-1 receptor agonists to tirzepatide, allow at least one week after the last dose of the previous medication before initiating tirzepatide to avoid overlapping drug effects. 6