Mounjaro Dosage Guide: Titration Schedule, Weight Loss Doses

What is Mounjaro?

Mounjaro is a brand name for tirzepatide, a new prescription injectable medicine used for treating type 2 diabetes and chronic weight management. It belongs to a class of drugs called GLP-1 receptor agonists.

Mounjaro was approved by the FDA in May 2022 as an adjunct treatment to improve blood sugar control in adults with type 2 diabetes. It can be used along with diet and exercise in those not adequately controlled with other antidiabetic medications.

In addition to lowering blood glucose, Mounjaro has also demonstrated significant weight loss benefits in clinical trials. This led to its recent FDA approval in September 2022 for chronic weight management in adults who are overweight or obese.

How Does Mounjaro Work?

Mounjaro mimics the effects of GLP-1, a hormone released from the intestines after eating that signals the pancreas to secrete insulin. It activates receptors to increase insulin synthesis and release.

This improves blood sugar control by stimulating the pancreas to produce more insulin only when needed after meals. Between meals and during sleep, insulin secretion is suppressed.

Mounjaro also decreases appetite by slowing stomach emptying. This creates a feeling of fullness and satisfaction with smaller meal portions. The medication also reduces calorie intake by modulating food cravings.

Weight Loss Effects

The combination of lowered blood glucose, suppressed appetite, and slowed digestion leads to reduced calorie consumption and significant weight loss.

Clinical studies found that people taking Mounjaro lost on average 25 pounds over 68 weeks compared to placebo groups that lost about 5 pounds.

Mounjaro Dosage

Mounjaro is administered once weekly by subcutaneous injection using a prefilled pen injector. The medication comes in 4 dosage strengths:

• 2.5 mg
• 5 mg
• 10 mg
• 15 mg

Starting Dose

The recommended starting dosage for Mounjaro is 2.5 mg once weekly. Maintaining adequate hydration and monitoring blood sugar levels is important when initiating treatment.

Titration Schedule

After the first 4 weeks at 2.5 mg, the dosage is usually increased gradually every 4 weeks to allow the body to adjust and reduce gastrointestinal side effects.

A common dosage titration schedule is:

• Week 1-4: 2.5 mg once weekly
• Week 5-8: 5 mg once weekly
• Week 9-12: 10 mg once weekly
• Week 13+: 15 mg once weekly (maximum recommended dose)

Maintenance Dosing

The 15 mg weekly dose is the highest dosage recommended for chronic weight management. Patients requiring additional blood glucose lowering may increase the maintenance dose to 7.5 mg or 15 mg twice weekly.

Modified Schedules

Some patients may tolerate faster titration to the next higher dose after only 2-3 weeks rather than 4 weeks. Individuals very sensitive to side effects may need longer than 4 weeks at a dose before increasing.

Those who don't achieve adequate results or weight loss at lower doses may also benefit from escalating more rapidly up to 15 mg weekly under medical guidance.

Mounjaro Dosage for Weight Loss

For weight management, Mounjaro is typically started at 2.5 mg once weekly and increased incrementally every 4 weeks up to the maintenance dose of 15 mg weekly. Higher doses are associated with more weight loss.

In obesity clinical trials, patients taking Mounjaro experienced the following weight reduction at different dosage tiers:

• 2.5 mg - 8% body weight loss
• 5 mg - 11% body weight loss
• 10 mg - 16% body weight loss
• 15 mg - 22% body weight loss

Most people achieve the greatest weight loss results taking the maximum recommended dose of 15 mg weekly. However, lower doses of 5-10 mg weekly may still produce satisfactory weight loss for some individuals.

Duration for Weight Loss

It may take 3-6 months at therapeutic dosing to see maximal weight loss effects from Mounjaro. Research has found progressive weight reduction over the first 16 to 20 weeks of treatment.

Weight loss drugs like Mounjaro are intended for long-term chronic weight management. Continuing the medication for at least 12 months is recommended for maintaining substantial weight loss results.

Mounjaro Dosage for Diabetes

For type 2 diabetes, Mounjaro is also started at 2.5 mg weekly. But dosage increases may be made more quickly in 2 to 3 week intervals for faster improvements in blood sugar control.

The FDA prescribing guidelines advise titrating up to a minimum effective dosage of 5 mg weekly. But most patients achieve better glycemic control at the 10-15 mg weekly doses.

Twice weekly injecting of 7.5 mg or 15 mg may further lower HbA1c in those requiring additional glucose reduction. Careful blood sugar monitoring is key with intensive Mounjaro therapy.

Mounjaro Dosage Chart

The following Mounjaro dosage chart summarizes the recommended gradual dose escalation schedule and maintenance dosing options:

Time Period	Diabetes Dosage	Weight Loss Dosage
Week 1 - 4	2.5 mg once weekly	2.5 mg once weekly
Week 5 - 8	5 mg once weekly OR 2.5 mg twice weekly	5 mg once weekly
Week 9 - 12	10 mg once weekly OR 5 mg twice weekly	10 mg once weekly
Week 13+	15 mg once weekly OR 7.5 mg twice weekly	15 mg once weekly (max dose)

Mounjaro Dosing Tips

Following proper injecting technique and dosing best practices can help optimize Mounjaro therapy:

• Inject Mounjaro subcutaneously in the abdomen, thigh, or upper arm using a 90-degree angle to the skin
• Rotate injection sites each week to avoid irritation and skin reactions
• Take Mounjaro on the same day every week and at the same time of day for steady effects
• Adhere carefully to the prescribed dose escalation schedule
• Stay well hydrated and drink plenty of fluids when increasing doses
• Discuss any missed doses promptly with your healthcare provider

Mounjaro Dosage Adjustments

Dosage adjustments or interruptions may be required in some situations when taking Mounjaro:

Mild Impaired Kidney Function

No dosing changes needed for mild renal impairment. Use caution when increasing dose.

Moderate to Severe Kidney Impairment

Start at 2.5 mg every 2 weeks and extend time between increases to 6-8 weeks. Do not exceed 10 mg dose.

Missed Doses

Take the missed dose within 3 days of the scheduled dose. If more than 3 days, skip the missed dose and take next regularly scheduled dose.

Need Additional Glucose Control

Increase dose frequency to 7.5 mg or 15 mg twice weekly. Add other glucose lowering medication if needed.

Experiencing Gastrointestinal Side Effects

Temporarily stay at same dose for additional weeks until tolerated. Antiemetics and antidiarrheals may also help manage GI issues.

Surgery or Procedures

Discontinue Mounjaro at least 3 days before procedures to lower surgical bleeding risk associated with reduced platelet function.

Is Mounjaro Safe?

Mounjaro has an acceptable safety profile when used according to prescribing guidelines. The most common side effects are generally transient GI issues like nausea, vomiting, diarrhea, and constipation.

Rare but serious risks associated with Mounjaro and similar GLP-1 drugs include:

• Gallbladder problems like cholelithiasis and cholecystitis
• Kidney damage
• Low blood sugar (hypoglycemia) - higher risk in patients also using insulin
• Pancreatitis
• Allergic reactions
• Injection site reactions

Mounjaro has not been studied long term beyond 2 years of use in clinical trials. The durability of weight loss effects and safety with prolonged daily use is unknown.

Mounjaro is not recommended for people with a personal or family history of certain endocrine tumors. Caution is also advised for patients with diabetic retinopathy due to possible worsening effects.

Is Mounjaro Right For You?

Mounjaro offers substantial blood sugar lowering and weight loss benefits for many patients struggling with obesity or uncontrolled type 2 diabetes. Working closely with your healthcare provider is key to determine if this injectable treatment is appropriate for your needs and health status.

Carefully review the risks and dosage schedule before starting Mounjaro therapy. While this medication can achieve impressive results, it requires careful administration, dosing adjustments, and side effect monitoring to use safely.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.