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Research library

Tirzepatide

LY3298176 · Mounjaro · Zepbound
Evidence A · Strong human evidenceApproved medicine
In one line. One of the best-studied weight loss medicines, with large human trials behind its doses.

What it is

Tirzepatide is a man-made peptide that acts like two gut hormones, GIP and GLP-1. These hormones help release insulin after meals and make you feel full. It is injected under the skin once a week.

What is actually known

It has strong human evidence. Large trials tested 5, 10 and 15 mg weekly in thousands of people.

Approved in the US for type 2 diabetes (2022, Mounjaro) and chronic weight management (2023, Zepbound)

At a glance

RouteUnder the skin
How oftenOnce a week
Half-lifeabout 5 days
Peakabout 1 to 2 days
Mix withBacteriostatic water
After mixingRefrigerate 2-8 C, use within 28 days, never freeze

Dose schedule

Product label

Source: Mounjaro and Zepbound prescribing information, section 2 (Dosage and Administration)

WeeksDoseHow often
1 to 42.5 mgOnce a week
5 to 85 mgOnce a week
9 to 127.5 mgOnce a week
13 to 1610 mgOnce a week
17 to 2012.5 mgOnce a week
21 onwards15 mgOnce a week

The label starts at 2.5 mg for 4 weeks, then raises the dose by 2.5 mg no sooner than every 4 weeks. Usual maintenance is 5, 10 or 15 mg. Many people stay on a lower step if it works.

Mixing and drawing up

Pick your vial size. Water is chosen so every step reads between 2 and 100 units on a U-100 insulin syringe. Every number below is calculated, not typed.

Vial5 mg
Add water1 mL
Strength5 mg/mL
1 unit50 mcg
DoseDrawUnitsDoses in vialUsed within 28 days
2.5 mg0.5 mL50 U22
5 mg1 mL100 U11
7.5 mgNot from this vial: more than the vial holds
10 mgNot from this vial: more than the vial holds
12.5 mgNot from this vial: more than the vial holds
15 mgNot from this vial: more than the vial holds
Vial10 mg
Add water1 mL
Strength10 mg/mL
1 unit100 mcg
DoseDrawUnitsDoses in vialUsed within 28 days
2.5 mg0.25 mL25 U44
5 mg0.5 mL50 U22
7.5 mg0.75 mL75 U11
10 mg1 mL100 U11
12.5 mgNot from this vial: more than the vial holds
15 mgNot from this vial: more than the vial holds
Vial15 mg
Add water1 mL
Strength15 mg/mL
1 unit150 mcg
DoseDrawUnitsDoses in vialUsed within 28 days
2.5 mg0.167 mL16.7 U64 (2 left over: choose a smaller vial)
5 mg0.333 mL33.3 U33
7.5 mg0.5 mL50 U22
10 mg0.667 mL66.7 U11
12.5 mg0.833 mL83.3 U11
15 mg1 mL100 U11
Vial20 mg
Add water1 mL
Strength20 mg/mL
1 unit200 mcg
DoseDrawUnitsDoses in vialUsed within 28 days
2.5 mg0.125 mL12.5 U84 (4 left over: choose a smaller vial)
5 mg0.25 mL25 U44
7.5 mg0.375 mL37.5 U22
10 mg0.5 mL50 U22
12.5 mg0.625 mL62.5 U11
15 mg0.75 mL75 U11
Vial30 mg
Add water1.5 mL
Strength20 mg/mL
1 unit200 mcg
DoseDrawUnitsDoses in vialUsed within 28 days
2.5 mg0.125 mL12.5 U124 (8 left over: choose a smaller vial)
5 mg0.25 mL25 U64 (2 left over: choose a smaller vial)
7.5 mg0.375 mL37.5 U44
10 mg0.5 mL50 U33
12.5 mg0.625 mL62.5 U22
15 mg0.75 mL75 U22
Vial40 mg
Add water2 mL
Strength20 mg/mL
1 unit200 mcg
DoseDrawUnitsDoses in vialUsed within 28 days
2.5 mg0.125 mL12.5 U164 (12 left over: choose a smaller vial)
5 mg0.25 mL25 U84 (4 left over: choose a smaller vial)
7.5 mg0.375 mL37.5 U54 (1 left over: choose a smaller vial)
10 mg0.5 mL50 U44
12.5 mg0.625 mL62.5 U33
15 mg0.75 mL75 U22
Vial50 mg
Add water2 mL
Strength25 mg/mL
1 unit250 mcg
DoseDrawUnitsDoses in vialUsed within 28 days
2.5 mg0.1 mL10 U204 (16 left over: choose a smaller vial)
5 mg0.2 mL20 U104 (6 left over: choose a smaller vial)
7.5 mg0.3 mL30 U64 (2 left over: choose a smaller vial)
10 mg0.4 mL40 U54 (1 left over: choose a smaller vial)
12.5 mg0.5 mL50 U44
15 mg0.6 mL60 U33
Vial60 mg
Add water3 mL
Strength20 mg/mL
1 unit200 mcg
DoseDrawUnitsDoses in vialUsed within 28 days
2.5 mg0.125 mL12.5 U244 (20 left over: choose a smaller vial)
5 mg0.25 mL25 U124 (8 left over: choose a smaller vial)
7.5 mg0.375 mL37.5 U84 (4 left over: choose a smaller vial)
10 mg0.5 mL50 U64 (2 left over: choose a smaller vial)
12.5 mg0.625 mL62.5 U44
15 mg0.75 mL75 U44

Certificates, tools and where to buy

Certificates on file for Tirzepatide: the laboratory's original pages.

Work out the draw · Plan a schedule · Reading a syringe · Shop

Do not use if

  • Personal or family history of medullary thyroid carcinoma, or MEN 2
  • Known serious allergy to tirzepatide

Watch for

  • Nausea, diarrhoea, vomiting and constipation, mostly after a dose increase
  • Gallbladder problems (gallstones), especially with fast weight loss
  • Dehydration from stomach side effects, which can strain the kidneys
  • Low blood sugar when used with insulin or a sulfonylurea

Stop and get medical help if

  • Severe stomach pain that may go through to the back (possible pancreatitis)
  • Pain under the right ribs, fever, yellow eyes or skin (possible gallbladder problem)
  • Signs of a severe allergic reaction
  • Unable to keep fluids down

Interactions

  • Oral birth control pills may work less well for 4 weeks after starting and after each dose increase; the label advises a non-oral method or adding a barrier method in those weeks
  • Do not combine with another GLP-1 medicine (semaglutide, liraglutide)
  • Insulin or sulfonylureas: the dose of these may need lowering

A good vial

  • White to off-white dry cake
  • Clear, colourless solution after mixing

Do not use the vial if

  • Cloudy or particles after gentle swirling
  • Yellow or brown colour
  • Collapsed or melted cake

Combinations

WithStatusWhy, and on what basis
SemaglutideAvoidSame drug class; adds side effects without evidence of more benefit (label)

Evidence

Large randomised human trials at 5, 10 and 15 mg once a week, in obesity (SURMOUNT) and type 2 diabetes (SURPASS).

This page is research and education. It is not medical advice and not a personal dosing plan. Doses marked "Product label" come from the official prescribing information; doses marked "Market practice" show what is used in this market and are not a recommendation. Use prescription medicines only under the care of a licensed physician.