Tirzepatide Dosing Protocol: 5 mg Vial — Week-by-Week Titration & Supplies
Quickstart highlights
Tirzepatide activates both the GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 receptors, producing synergistic effects on insulin secretion, glucagon suppression, gastric emptying delay, and hypothalamic satiety signaling.
- Concentration: 5 mg/mL (5 mg vial + 1 mL bacteriostatic water).
- At 5 mg/mL on a U-100 syringe: 2.5 mg = 50 units, 5 mg = 100 units.
- Starting dose: 2.5 mg (50 units) once weekly for 4 weeks; increase by 2.5 mg every 4 weeks.
- One 5 mg vial covers 2 injections at the starting 2.5 mg dose.
- Refrigerate reconstituted solution; use within 28 days.
Dosing table
For educational reference only. Your prescribing provider may adjust doses based on your clinical profile and response.
| Week | Dose (µg) | Units | Frequency | Notes |
|---|---|---|---|---|
| 1-4 | 2500 | 50 | Once weekly | Starting dose — use 100-unit U-100 syringe; inject subcutaneously |
| 5-8 | 5000 | 100 | Once weekly | First increase — 1 full vial dose; switch to new vial for week 5 |
| 9-12 | 7500 | 150 | Once weekly | 7.5 mg dose requires second vial; reconstitute fresh vial at week 9 |
| 13-16 | 10000 | 200 | Once weekly | 10 mg maintenance — assess tolerability before increasing |
| 17+ | 12500 | 250 | Once weekly | 12.5–15 mg optional maximum; titrate only if tolerating lower dose well |
Gradual approach
| Week | Dose (µg) | Units | Notes |
|---|---|---|---|
| 1-8 | 2500 | 50 | Slow ramp — hold 2.5 mg for 8 weeks to minimize GI side effects |
| 9-16 | 5000 | 100 | 5 mg plateau — reassess tolerability before advancing |
Your free Tirzepatide tracker
- Dose reminders
- Injection logging
- Cycle progress
Reconstitution steps
- Draw 1 mL bacteriostatic water into a 3 mL syringe; inject slowly down the vial wall to avoid foaming.
- Gently swirl — do not shake — until the lyophilized cake is fully dissolved (1–3 minutes).
- Solution should appear clear and colorless; discard if cloudy or particulate matter is visible.
- Label the vial with reconstitution date; refrigerate immediately at 2–8 °C.
Supplies needed
8-week plan
- 2 vials
- 8 syringes
- 2 mL bac water
- 8 alcohol swabs
12-week plan
- 3 vials
- 12 syringes
- 3 mL bac water
- 12 alcohol swabs
16-week plan
- 4 vials
- 16 syringes
- 4 mL bac water
- 16 alcohol swabs
Protocol overview & cycle notes
Support medically supervised weight management via dual GIP/GLP-1 receptor agonism with the slowest possible titration schedule to minimize GI adverse events. Target maintenance dose 10–15 mg weekly after 12–16 weeks.
Cycle length: 16 weeks on.
Off-cycle: 8–12 weeks off; monitor HbA1c, body weight, and appetite during off-cycle to assess need for re-initiation.
Storage & handling
Injection & tracking tips
- Inject subcutaneously in the abdomen (2 inches from navel), outer thigh, or upper arm; rotate sites each week.
- Use a 100-unit (1 mL) U-100 insulin syringe for all doses; the 2.5 mg starting dose is exactly 50 units.
- Inject at the same time each week (±24 hours acceptable); morning injection minimizes meal-timing conflicts.
Tracking
Logging helps you and your provider spot patterns and adjust dose or timing.
- Log body weight every Monday before eating; track weekly trend rather than daily fluctuation.
- Record GI symptoms (nausea, vomiting, diarrhea) severity (0–10) after each injection.
- Track fasting glucose weekly if diabetic or pre-diabetic; adjust hypoglycemic medications with your provider.
How this works & references
Sources
- Tirzepatide Once Weekly for the Treatment of Obesity. Jastreboff AM et al. — N Engl J Med — 2022
- Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. Garvey WT et al. — Lancet — 2023
- FDA — Zepbound (tirzepatide) Prescribing Information, 2023
Frequently asked questions
How many 5 mg vials do I need for a 16-week cycle?
What if I experience severe nausea at 5 mg?
Can I inject at any time of day?
What is the maximum dose for the 5 mg vial concentration?
How should I handle a missed dose?
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View protocolThis content is for informational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any peptide therapy. Dosing and protocols may vary by formulation and prescriber.