Mounjaro dosage: how the dose schedule works

What is the Mounjaro dosage schedule for weight loss?

The Mounjaro dosage schedule is a titration ladder: treatment starts at 2.5 mg once weekly for four weeks, then rises in 2.5 mg steps through 5 mg, 7.5 mg, 10 mg and 12.5 mg to a maximum of 15 mg. Each step is held for at least four weeks before the next increase is considered.

This table is the standard Mounjaro dosage chart, taken from the South African professional information.

It shows the fastest pace the registration allows, not a target. Four weeks per step is a minimum, and many doctors hold a dose for longer when it is working well or when side effects need more time to settle.

In South Africa each strength comes as its own Mounjaro KwikPen holding four weekly doses, so one pen covers one four-week step. Single-dose vials of the same strengths also exist here; the differences are covered in Mounjaro vial vs pen.

What doses does Mounjaro come in?

Mounjaro comes in six strengths: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg and 15 mg. In South Africa each strength is registered as its own KwikPen holding four weekly doses, and the same strengths exist as single-dose vials. There is no strength above 15 mg.

The pen delivers one fixed dose. You dial to the single stop and inject; there is no setting 3 mg on a 2.5 mg pen and no taking half a dose. Moving up the schedule means collecting a different pen, which is why the strength printed on the box must match your treatment plan exactly.

Strength is not volume. Every weekly injection is the same 0.6 ml; what changes between strengths is the concentration of tirzepatide in that volume. A 15 mg injection feels no different from a 2.5 mg one, and the technique never changes as your dose climbs.

How often do you take Mounjaro?

Once a week, every week, on the same day. The injection goes under the skin of the stomach, thigh or upper arm, at any time of day, with or without food. Meals, mornings and evenings make no difference to the dose; the seven-day rhythm is the part that matters.

Pick a slot you will actually keep. Many people anchor the injection to a fixed point in the week, Sunday evening after supper or Monday morning before work, and set a phone reminder for the first few months until the habit holds.

The weekly interval comes from tirzepatide's long half-life. The level in your body falls slowly across the week, so one injection covers seven days without daily top-ups, and a dose taken a few hours late changes nothing. How much flexibility you have beyond that is covered in the missed-dose rules below.

Why does Mounjaro start at 2.5 mg?

The 2.5 mg starting dose is not a treatment dose. It exists purely to let your digestive system get used to the medicine before the dose reaches levels that drive weight loss.

Tirzepatide slows how quickly the stomach empties. Started too high, that effect commonly causes nausea, vomiting and diarrhoea. Started low and raised slowly, the same effect arrives gently, and most people tolerate each step with mild or no symptoms.

This is why skipping ahead is a bad idea even when the first weeks feel underwhelming. Appetite effects are often modest at 2.5 mg, and that is expected; the schedule is designed around tolerance first, results second.

The same logic applies after a long break. If treatment stops for several weeks, restarting at the old maintenance dose can trigger the full set of digestive side effects again, so doctors often restart lower and rebuild. If you have paused for any reason, ask your doctor where to resume rather than picking up where you left off.

How long do you stay on each dose?

At least four weeks, and often longer. Four weeks is the shortest interval the registration allows between increases, because it takes roughly that long for tirzepatide levels to stabilise and for side effects at a new dose to show their true pattern.

Your doctor decides the pace based on three things: how your weight is responding, how you are tolerating the current dose, and your overall health picture. If nausea or reflux flares after a step up, the usual response is to hold the dose longer, sometimes to step back down for a cycle, then try again.

There is no penalty for moving slowly. The trials that support the registration allowed slower escalation for tolerability, and a dose you can stay on comfortably beats a higher dose you have to abandon.

What is a maintenance dose of Mounjaro?

A maintenance dose is the level you settle at once weight is responding and side effects are manageable. For weight management the recommended maintenance doses are 5 mg, 10 mg or 15 mg weekly; 7.5 mg and 12.5 mg act as stepping stones, though some people hold there too.

Not everyone needs the maximum. In the SURMOUNT-1 trial, average weight loss over 72 weeks was 15% of body weight on 5 mg, 19.5% on 10 mg and 20.9% on 15 mg. Individual results vary. The higher doses did more on average, but 5 mg alone produced a substantial result for many participants.

The practical takeaway: the right maintenance dose is the lowest one that gives you steady progress with acceptable side effects. That judgement call belongs to your doctor at your follow-up reviews, which is why ongoing monitoring is built into treatment.

What happens if you miss a Mounjaro dose?

If you remember within four days (96 hours) of your usual injection time, take the missed dose as soon as you can, then carry on with your normal weekly day. If more than four days have passed, skip the missed dose entirely and take the next one on schedule.

A single skipped week is not a crisis. Tirzepatide has a long half-life, so levels fall gradually rather than dropping off a cliff, and one missed dose rarely undoes progress. Appetite may return somewhat toward the end of the gap; that is temporary and settles once the routine resumes.

Never inject two doses within three days of each other, and never double up to catch up. Doubling raises the medicine level sharply and brings on exactly the nausea and vomiting the schedule is designed to avoid.

You can also change your regular injection day if a different day suits your week better. The only rule: at least three days (72 hours) must pass between the last dose on the old day and the first dose on the new one. The injection routine itself is covered step by step in how to inject Mounjaro.

Side effects and dose changes

Side effects and the dose schedule are tightly linked. The common ones are digestive: nausea, diarrhoea, constipation, vomiting and indigestion. They cluster in the first week or two after each dose increase, then usually fade as the body adjusts.

That pattern is useful information for your doctor. Symptoms that settle within days of a step up are usually managed with smaller meals, slower eating and good hydration. Symptoms that persist for weeks suggest the dose moved too fast, and holding or lowering it often resolves the problem without stopping treatment.

Mounjaro is not suitable for everyone: it should not be used in pregnancy or while breastfeeding, or by people with a personal or family history of medullary thyroid cancer or MEN2 syndrome. Severe, persistent stomach pain can signal pancreatitis: seek medical care immediately. The full picture, including rare risks, is in our guide to Mounjaro side effects.

Do the different Mounjaro strengths cost different amounts?

Yes. Each KwikPen strength carries its own regulated price, and the price rises with the strength, so the monthly cost climbs as you move up the dosage schedule. A budget built on the starting pen understates what treatment costs once your dose settles at a higher level.

The national Medicine Price Registry, in its May 2026 update, listed the KwikPen range at roughly R3,600 to R8,200 per pen depending on strength, with each pen covering four weekly doses. We do not sell medicine. Prices vary by pharmacy and dose; confirm with your pharmacy.

The medicine price itself is uniform nationally under the Single Exit Price system, so the number does not improve by shopping between chains. What sits behind it, from dispensing fees to the annual price adjustment cycle, is broken down in our guide to the Mounjaro price in South Africa.

Can you compare Mounjaro doses with Ozempic doses?

Not milligram for milligram. Mounjaro runs from 2.5 mg to 15 mg weekly, while Ozempic runs from 0.25 mg to 1 mg locally, but the two contain different molecules with different potencies, so 5 mg of tirzepatide is not five times 1 mg of semaglutide.

What the schedules share is their shape: a non-treatment starting dose, stepped increases held for at least four weeks, and a maintenance level set on response and tolerability. That shape is the pattern across this class of medicine, and it is why switching between products is never a straight number swap.

If you move from one medicine to the other, the doctor chooses a fresh starting point on the new one rather than converting your old dose, then rebuilds from there. The full comparison, from mechanism to trial results, is in Mounjaro vs Ozempic; which option fits your situation is decided by a doctor on assessment.

What happens to your dose when you stop Mounjaro?

There is no registered step-down schedule. The Mounjaro dosage rules describe how to go up, not how to come down, so stopping is a decision to take with your doctor rather than a taper to improvise. Some doctors step patients down through lower strengths and watch the response; others stop outright.

The withdrawal data explains why the exit deserves planning. In the SURMOUNT-4 trial, people who stopped tirzepatide after 36 weeks regained an average of 14% of body weight over the following year, while those who continued lost a further 5.5%. Individual results vary, and the spread around those averages was wide.

Stretching injections to every ten or fourteen days as a do-it-yourself taper puts you on a schedule no trial has tested. If cost or side effects are pushing you toward stopping, raise it at a review; adjusting the plan is routine work for the doctor managing it.

Plan the exit with the same care as the climb. What protects the result once treatment ends, from strength training to structured follow-up, is covered in maintaining weight loss after GLP-1 medication.

Who decides your Mounjaro dose in South Africa?

Your doctor. Mounjaro is a Schedule 4 medicine in South Africa, so every dose, and every dose change, requires a doctor's assessment and authorisation. Pharmacies dispense the strength on your treatment plan; they cannot move you up or down the schedule.

This matters at a practical level. If your pharmacy is out of stock of your strength, the safe answer is a call to your doctor, not improvising with a different pen strength. The schedule can usually be adjusted safely, but that adjustment must come from the doctor managing your plan.

It also matters for results. Dose decisions work best with data: weight trend, side effects, blood pressure and any lab work your doctor requests. A doctor who reviews you regularly can time each step for you specifically, rather than marching to the calendar. The rhythm of those reviews in a structured programme is described on our what to expect page.

Frequently asked questions