GLP-1 dosing schedules, in plain language

What this guide covers

The FDA-label titration schedules for semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound), why every dose starts low and climbs slowly, the maximum doses, and what the label says about holding a dose or missing one. This is patient education, not a substitute for the prescriber who knows your case. Generic names sit next to brand names throughout: semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro, Zepbound).

Key points

• The one rule behind every GLP-1 dose. Start low, go slow. Every GLP-1 follows the same shape: a low starting dose that is not really meant to do much, then a step up every four weeks or so until you reach a dose that works and that you tolerate. The point of the slow climb is to limit the nausea, diarrhea, and other GI effects, which are always heaviest right after a dose change. The schedules below are the standard ones from the FDA prescribing information. They are a starting framework, not a personal prescription, your prescriber sets and adjusts your actual dose, and slowing the climb down is normal and common.
• Ozempic (semaglutide, type 2 diabetes). The FDA-approved Ozempic schedule starts at 0.25 mg once weekly for 4 weeks. That 0.25 mg dose is a tolerability dose, it is not considered effective for blood sugar on its own. At week 5 it goes to 0.5 mg weekly. If more glucose control is needed after at least 4 weeks, it can increase to 1 mg, and then to a maximum of 2 mg. So the ladder is 0.25, then 0.5, then 1, then 2 mg, each step held for at least four weeks before the next.
• Wegovy (semaglutide, weight management). Wegovy is the same molecule as Ozempic but titrates higher and on a fixed monthly schedule built for weight management. The FDA label steps it up roughly every 4 weeks: 0.25 mg, then 0.5, then 1.0, then 1.7, and finally the 2.4 mg maintenance dose, usually reached around week 16 to 20. If a step is not tolerated, the label allows delaying the increase. The 2.4 mg dose is the maintenance target the STEP trials used.
• Mounjaro (tirzepatide, type 2 diabetes). Tirzepatide climbs in 2.5 mg steps. The Mounjaro schedule starts at 2.5 mg once weekly for 4 weeks (again, a starter dose, not the working dose), then 5 mg. After that, the dose can increase by 2.5 mg at a time, no sooner than every 4 weeks, through 7.5, 10, 12.5, up to a maximum of 15 mg. Many people land and stay at 5, 10, or 15 mg depending on response and tolerance.
• Zepbound (tirzepatide, weight management). Zepbound is tirzepatide for weight management and uses the same 2.5 mg ladder as Mounjaro: start 2.5 mg weekly for 4 weeks, move to 5 mg, then increase by 2.5 mg every 4 weeks as needed. The FDA label lists 5 mg, 10 mg, and 15 mg as the maintenance doses, with 15 mg the maximum. As with the others, the right maintenance dose is the lowest one that gives you the result, not automatically the top of the ladder.

Frequently asked questions