Tirzepatide

• Weight management: 5 mg maintenancerecommended

  Label path to the lowest maintenance dose (5 mg). Your prescriber chooses the maintenance dose from response and tolerability.

• 10 mg maintenance (weight reduction or sleep apnea)

  Label steps 2.5, 5, 7.5, then 10 mg, each at least 4 weeks. 10 mg is a label maintenance option for sleep apnea too.

• 15 mg maintenance (maximum label dose)

  Label steps 2.5 to 15 mg in 2.5 mg increments. 15 mg is the label maximum and a maintenance option for sleep apnea.

• Start 2.5 mg once weekly for 4 weeks; this dose is not a maintenance dose (https://uspl.lilly.com/zepbound/zepbound.html).
• Then 5 mg; increase in 2.5 mg increments after at least 4 weeks on the current dose.
• Maintenance for weight reduction: 5, 10 or 15 mg weekly. Obstructive sleep apnea: 10 or 15 mg. Maximum 15 mg once weekly.
• Missed dose: give as soon as possible within 4 days (96 hours); if more than 4 days have passed, skip it.

Route: Subcutaneous, once weekly (abdomen, thigh or upper arm are the label's sites; check the instructions for use).

Timing: Same day each week, any time of day.

• Zepbound vials and pens are supplied ready to inject: no reconstitution. Single-dose vials are 2.5, 5, 7.5, 10, 12.5 or 15 mg per 0.5 mL; multi-dose vials/KwikPen hold 4 doses (10 mg/2.4 mL up to 60 mg/2.4 mL, giving 2.5 to 15 mg per 0.6 mL dose).
• In this app 'water' = the label's 2.4 mL volume of the 60 mg multi-dose strength (25 mg/mL): 15 mg = 0.6 mL = 60 units, 2.5 mg = 10 units. Real titration switches to a stronger vial each step; the app models one vial for planning only.
• No sourced reconstitution figures exist for lyophilized or compounded tirzepatide: No reliable figure found in the sources; ask your prescriber or supplier.

KwikPen: discard 30 days after first use and after 4 weekly doses (label). Single-dose vial: use one vial per week, discard unused portion (carton text). Multi-dose vial in-use window: not found in sources.

None: continuous therapy.

Why:

• The label describes ongoing weekly maintenance; changes are made with your prescriber, guided by response and tolerability.

• Never draw into the same syringe as another compound; use separate syringes and distinct injection sites.
• Hypoglycemia risk rises with insulin or sulfonylureas; dose reduction of those may be needed (label).

Prescription-only (FDA-approved as Zepbound/Mounjaro). Compounded or 'research' tirzepatide is not FDA-approved.

Common side effects:

• Most common (Zepbound label, 5/10/15 mg): nausea 25-29%, diarrhea 19-23%, vomiting 8-13%, constipation 11-17%, abdominal pain 9-10%, dyspepsia 9-10%, injection-site reactions 6-8%, fatigue 5-7%, hypersensitivity 5%, hair loss 4-5%, GERD 4-5%.

Stop and call your prescriber if:

• Boxed warning: thyroid C-cell tumor risk. Report a neck mass, trouble swallowing, shortness of breath or persistent hoarseness. Contraindicated with personal or family history of medullary thyroid carcinoma or MEN 2.
• Severe abdominal pain (possible pancreatitis; the label says to discontinue if suspected) or suspected gallbladder disease.
• Signs of allergic reaction/anaphylaxis or angioedema: seek medical attention promptly.
• Dehydration from vomiting or diarrhea (risk of acute kidney injury).

Labs and monitoring:

• Renal function if volume depleted by GI effects.
• Eye exam follow-up if diabetic retinopathy history.
• Glucose if on insulin or sulfonylureas (hypoglycemia risk).

What sources report this compound changes, or say to check. A record of the evidence, not targets or advice.

• Body weightReported changeDrug label

  Mean change at week 72 vs placebo -3.1%: -15.0% (5 mg), -19.5% (10 mg), -20.9% (15 mg) in the adults-with-obesity study

  Zepbound label on DailyMed
• Blood pressureReported changeDrug label

  Systolic fell 6.6 to 7.7 mmHg and diastolic 4.5 to 5.0 mmHg vs about 1 mmHg with placebo (study 1); hypotension reported in 1.6% vs 0.1% placebo

  Zepbound label on DailyMed
• Heart rateReported changeDrug label

  Mean increase of 1 to 3 beats per minute, none with placebo

  Zepbound label on DailyMed
• Lipase and amylaseCheck itDrug label

  Pooled weight-reduction trials: amylase rose 20-25% and lipase 28-35% vs 2.1% and 5.8% with placebo; adjudicated acute pancreatitis 0.2% in both arms

  Zepbound label on DailyMed
• Total cholesterolReported changeDrug label

  Fell 3.8-6.3% (5-15 mg) vs 1.8% with placebo in study 1

  Zepbound label on DailyMed
• Serum creatinine / kidney functionCheck itDrug label

  Acute kidney injury reported in 0.5% vs 0.2% placebo; label says to monitor kidney function when nausea, vomiting or diarrhoea could cause dehydration

  Zepbound label on DailyMed

• Zepbound US prescribing information (Lilly)
• Zepbound label on DailyMed
• Healthline: Zepbound out of the fridge (secondary, vial room-temperature window)