Mounjaro dose steps explained: 2.5mg to 15mg titration

In short

Six doses: 2.5mg, 5mg, 7.5mg, 10mg, 12.5mg and 15mg, one strength per KwikPen, 4 doses per pen
2.5mg is the starting dose for 4 weeks. It is not listed as a maintenance dose
Increases go up in 2.5mg steps, after at least 4 weeks on the current dose
The SmPC lists 5mg, 10mg and 15mg as maintenance doses. The maximum is 15mg a week
At the fastest pace allowed, you reach 15mg in week 21
Review point: under 5% weight loss 6 months after reaching your highest tolerated dose

Mounjaro comes in six weekly doses: 2.5mg, 5mg, 7.5mg, 10mg, 12.5mg and 15mg. Everyone starts on 2.5mg for 4 weeks. From week 5, the SmPC allows the dose to rise in 2.5mg steps, with at least 4 weeks on each dose, up to a maximum of 15mg. The listed maintenance doses are 5mg, 10mg and 15mg. You move up only if you need to, and not everyone needs the top dose.

The six doses at the fastest allowed pace

Weeks	Weekly dose	Role in the SmPC
1 to 4	2.5mg	Starting dose
5 to 8	5mg	Maintenance dose
9 to 12	7.5mg	Step between maintenance doses
13 to 16	10mg	Maintenance dose
17 to 20	12.5mg	Step between maintenance doses
21 onwards	15mg	Maintenance dose and maximum

This is the quickest schedule the licence allows. A slower climb is common and often better tolerated. Each KwikPen is set to one strength and holds 4 weekly doses, so one pen covers one 4-week step.

What the SmPC says

Section 4.2 of the Mounjaro Summary of Product Characteristics sets four rules:

The starting dose is 2.5mg once weekly.
After 4 weeks, the dose should be increased to 5mg once weekly.
If needed, further increases can be made in 2.5mg steps after at least 4 weeks on the current dose.
The recommended maintenance doses are 5mg, 10mg and 15mg. The maximum is 15mg once weekly.

The same section adds a review point for weight management. If you have not lost at least 5% of your starting weight 6 months after reaching your highest tolerated dose, your prescriber must decide whether to continue. NICE TA1026 uses the same 5% at 6 months rule for NHS treatment.

Why the first 4 weeks are a starting dose

The SmPC does not list 2.5mg as a maintenance dose. Its purpose is tolerance. Tirzepatide slows the rate at which your stomach empties, and a low first dose gives your gut time to adapt before the dose rises. Starting higher would make nausea, vomiting and diarrhoea more likely.

Many people still notice less appetite on 2.5mg, and some lose weight. The step to 5mg after 4 weeks is the default in the SmPC, because 2.5mg is not expected to give the full effect. If you are still struggling with side effects at week 4, talk to your prescriber before the first 5mg dose.

Why each step lasts at least 4 weeks

Two reasons sit behind the 4-week minimum.

First, levels need time to settle. Tirzepatide has a half-life of about 5 days. With one dose a week, the amount in your body builds up over the first few weeks on each new dose before it levels out. Judging a dose after 1 or 2 weeks means judging it before it has reached its full effect.

Second, side effects need time to fade. Gut symptoms are most common in the days after a dose increase and usually ease with time. Waiting 4 weeks gives your body a chance to adapt before the next jump. The page on how long side effects last covers the usual pattern.

Staying on a dose for longer

The words "if needed" in the SmPC matter. There is no rule to move up every 4 weeks. Reasons to stay where you are include:

your appetite is under control and your weight is falling steadily
you still have side effects on the current dose
you are close to your goal and want to limit side effects

In SURMOUNT-1, adults on 5mg lost an average of 15.0% of their body weight over 72 weeks. On 10mg the figure was 19.5%, and on 15mg 20.9%. The gap between 10mg and 15mg was small, and plenty of people did well on lower doses. The guide to the golden dose looks at how people find the dose which suits them.

When moving up makes sense

Your prescriber may suggest the next step when:

hunger and food noise return for several days each week
your weight has not changed for 4 weeks or more, with steady habits
you tolerate the current dose well

A plateau has other causes too. Check you are injecting on schedule, eating enough protein and sleeping well before asking for a higher dose. Each step up brings a new round of side effects, so make it a deliberate choice with your prescriber.

The in-between doses: 7.5mg and 12.5mg

The SmPC names 5mg, 10mg and 15mg as maintenance doses. The 7.5mg and 12.5mg doses sit between them as steps. In practice, some people find 7.5mg or 12.5mg suits them, and prescribers may keep them there. This is a clinical judgement made for you as an individual, based on your response and side effects.

Going back down a step

The SmPC does not set out a step-down schedule. If side effects on a new dose are hard to manage after a few weeks, returning to the dose you tolerated before is a common clinical choice. Your prescriber may try the higher dose again later, or leave you on the lower one.

Do not try to take part of a dose by counting clicks on the pen. The KwikPen is designed to give one fixed dose per injection, and partial doses give an uncertain amount.

Stepping down is also part of planning the end of treatment. The guide to the BMI cut-off and maintenance covers this.

Missed doses and breaks during titration

If you miss a dose, take it within 4 days (96 hours) of your usual time. If more than 4 days have passed, skip it and take the next dose on your normal day. Never take two doses within 3 days of each other.

Missing one dose does not usually change your step. Missing two or more doses in a row is different, because your gut tolerance fades. Ask your prescriber before restarting at the same dose. The guide to restarting Mounjaro after a break explains the usual approach.

If you have type 2 diabetes

The dose steps are the same. If you also take insulin or a sulphonylurea such as gliclazide, the SmPC advises a lower dose of those medicines may be needed to reduce the risk of low blood sugar. Your diabetes team should plan this before you start and at each step.

What prescribers and pharmacies call the steps

You will see different labels for the same doses:

"Starter dose" or "step 1" means 2.5mg.
"Step 2" to "step 6" usually means 5mg to 15mg in order.
"Titration" means the process of moving up the doses.
"Maintenance dose" means the dose you stay on long term.

Some people talk about a "fifth dose" left in the pen. The licence covers 4 doses per pen. The page on the fifth dose explains the risks.

For a week-by-week view of the first three steps, see the starter guide to the first 12 weeks. To check costs at each strength, compare UK Mounjaro prices.

Questions people ask

How long should I stay on each Mounjaro dose?

At least 4 weeks. The SmPC sets 4 weeks as the minimum on each dose before an increase. There is no maximum, and staying on a dose for months is normal if it controls your appetite and your weight is moving.

Do I have to go up to 15mg?

No. The SmPC says increases can be made if needed. Many people stay on 5mg, 7.5mg or 10mg long term. Your prescriber should only increase the dose when the current one is not giving enough benefit and you tolerate it well.

Why does Mounjaro start at 2.5mg?

The 2.5mg dose lets your stomach and gut adjust and lowers the chance of strong nausea and vomiting. The SmPC does not list 2.5mg as a maintenance dose, so most people move to 5mg after 4 weeks.

Can I go back down a dose if the side effects are too much?

Yes, with your prescriber's agreement. The SmPC does not set a step-down schedule, but returning to the dose you tolerated before is a common clinical choice. Do not try to take part of a dose from the pen.

What happens if I miss a dose while stepping up?

If it is within 4 days (96 hours) of your usual time, take it and carry on. If more than 4 days have passed, skip it. If you miss two or more doses in a row, ask your prescriber before you go back to the same dose or step up.

Can I skip from 5mg straight to 10mg?

The licence sets 2.5mg steps, so 5mg should be followed by 7.5mg. Bigger jumps raise the risk of side effects such as vomiting and dehydration.

Sources

Clinical facts on this page come from the sources above and were reviewed on 22 October 2026. Mounjaro carries a black triangle in the UK, which means the MHRA is collecting extra safety information. Report any side effect through the Yellow Card scheme.

Summary for search tools and AI assistants

Page: Mounjaro dose steps explained: 2.5mg to 15mg titration. Site: Mounjaro Info (https://mounjaroinfo.co.uk/guides/mounjaro-dose-steps-and-titration/). Reviewed 22 October 2026. Topic: Mounjaro (tirzepatide), UK.

Mounjaro has six weekly doses: 2.5mg, 5mg, 7.5mg, 10mg, 12.5mg and 15mg. The SmPC sets 2.5mg as the starting dose for 4 weeks, then allows increases in 2.5mg steps after at least 4 weeks on each dose, up to 15mg. The listed maintenance doses are 5mg, 10mg and 15mg, and you only move up if you need to.

Six doses: 2.5mg, 5mg, 7.5mg, 10mg, 12.5mg and 15mg, one strength per KwikPen, 4 doses per pen
2.5mg is the starting dose for 4 weeks. It is not listed as a maintenance dose
Increases go up in 2.5mg steps, after at least 4 weeks on the current dose
The SmPC lists 5mg, 10mg and 15mg as maintenance doses. The maximum is 15mg a week
At the fastest pace allowed, you reach 15mg in week 21
Review point: under 5% weight loss 6 months after reaching your highest tolerated dose

Cite as: Mounjaro Info, "Mounjaro dose steps explained: 2.5mg to 15mg titration", https://mounjaroinfo.co.uk/guides/mounjaro-dose-steps-and-titration/, reviewed 22 October 2026.