Everyone wants to know the "best" tirzepatide dose. The clinical trial data is clear: higher doses produce more weight loss, but also more side effects. Most patients find their sweet spot between 10-15mg. Here's how to navigate the dosing journey.
Key finding: In SURMOUNT-1, participants on 15mg tirzepatide lost an average of 22.5% of body weight at 72 weeks. Those on 10mg lost 21.4%. The 5mg dose achieved 15% average weight loss.
Weight Loss by Dose: The Data
Here's what the SURMOUNT clinical trials showed:
| Dose | Avg Weight Loss | % Achieving ≥5% | % Achieving ≥20% |
|---|---|---|---|
| 5mg | 15.0% | 85% | 35% |
| 10mg | 19.5-21.4% | 89% | 50% |
| 15mg (maximum) | 20.9-22.5% | 91% | 57% |
| Placebo | 2.4% | 35% | 3% |
The takeaway: 10mg and 15mg produce similar results (within ~1-2% weight loss difference), but 10mg generally has fewer side effects. Many patients do well maintaining at 10mg rather than pushing to 15mg.
Standard Titration Schedule
Tirzepatide uses a gradual titration to minimize side effects:
| Week | Dose | Purpose | What to Expect |
|---|---|---|---|
| 1-4 | 2.5mg | Acclimation | Mild appetite suppression, possible nausea |
| 5-8 | 5mg | First maintenance dose | Stronger appetite reduction, early weight loss |
| 9-12 | 7.5mg | Optional increase | Continued weight loss acceleration |
| 13-16 | 10mg | Target maintenance | Near-optimal results for most patients |
| 17-20 | 12.5mg | Optional increase | Additional appetite suppression |
| 21+ | 15mg | Maximum dose | Peak efficacy, highest side effect potential |
Important: 2.5mg is only a starter dose—it's not approved for maintenance. Don't stay at 2.5mg expecting full results; this dose is designed to let your body adjust before therapeutic dosing begins.
Side Effects by Dose
Higher doses mean more efficacy but also more side effects. Here's the pattern from clinical trials:
Common Side Effects (All Doses)
Nausea
18-33%
Diarrhea
12-23%
Constipation
6-11%
Vomiting
5-12%
5-7.5mg: Lower Side Effect Profile
Nausea in ~18-24% of patients. Most side effects mild and transient. Good balance of efficacy and tolerability.
10-12.5mg: Moderate Side Effects
Nausea in ~24-28% of patients. GI symptoms more common but usually manageable. Most patients tolerate well after adjustment.
15mg: Highest Side Effect Potential
Nausea in ~28-33% of patients. Higher discontinuation rates due to side effects. Consider if 10-12.5mg isn't producing adequate results.
What's the "Best" Dose for You?
There's no universal answer. The best dose depends on your response:
Stay at 5mg if:
You're losing 1-2 lbs/week, appetite is well-controlled, side effects minimal, and you're happy with progress.
Increase to 10mg if:
Weight loss has stalled, appetite suppression is wearing off before next dose, and you tolerated lower doses well.
Consider 15mg if:
You need maximum efficacy (e.g., preparing for surgery), 10-12.5mg hasn't produced adequate results, and you can manage increased side effects.
Pricing by Dose
Cost considerations may influence your target dose:
| Dose | LillyDirect (Brand) | Compounded (Typical) | Savings |
|---|---|---|---|
| 5mg | $399 | $179-$300 | $99-$220/mo |
| 10mg | $449 | $199-$300 | $149-$250/mo |
| 15mg | $449 | $199-$300 | $149-$250/mo |
Many compounding providers offer flat or near-flat pricing regardless of dose, making higher doses more cost-effective. LillyDirect charges the same for 10mg and 15mg ($449).
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