When should I increase my Mounjaro dose?

Key Takeaways

Information

Mounjaro (tirzepatide), a dual GIP and GLP-1 receptor agonist, is approved for the treatment of type 2 diabetes and is gaining traction for weight management. The manufacturer, Eli Lilly, recommends a starting dose of 2.5 mg once weekly, increasing in 2.5 mg increments every 4 weeks based on tolerance, up to a maximum of 15 mg per week.

According to the SURMOUNT-1 trial, patients on tirzepatide experienced significant weight loss over 72 weeks. Here’s a quick look at the trial’s findings:

• 10mg dose: ~21.1% average weight loss

• 15mg dose: ~26% average weight loss

Dose increases in the trial were pre-scheduled and uniform across participants, but clinical practice often takes a more tailored approach.

Facts

Manufacturer's stepwise dosing guide

This stepwise approach is meant to balance efficacy with tolerability, giving the body time to adapt to potential gastrointestinal side effects such as nausea, vomiting, or constipation.

Real-World Patterns

In real-life clinical practice and patient communities:

• Not everyone escalates on schedule. Many patients remain on a lower dose longer to manage side effects.

• Dose escalation is often delayed if significant weight loss continues or if side effects are intolerable.

• Some patients plateau on lower doses and choose to increase only when progress stalls.

Opinions

Increasing the Mounjaro dose should be a personalised decision, made in collaboration with your healthcare provider. Here’s a framework many real-world users follow:

1. Side Effect Tolerance:

   1. If nausea, fatigue, or bloating are significant at your current dose, delay escalation. You can spend more time at a lower dose or even reduce the dose temporarily.

2. Weight Loss Progress:

   1. Compare your weight trajectory to the clinical trial benchmark. If you’re on 5mg at week 12 and seeing less than 5–7% weight loss, your provider might suggest a bump to 7.5mg or 10mg.

3. Metabolic Goals:

   1. Those with type 2 diabetes may prioritise HbA1c reduction over weight loss. Dose changes may reflect this emphasis.

4. Quality of Life:

   1. Some patients on 15mg report greater side effects with marginal weight benefit compared to 10mg. Staying on 10mg might be a wise choice for those who value stability.

Final Thoughts

While trial data offers a compelling story of progressive weight loss with higher doses, your own journey with Mounjaro may differ. Use side effects, your current weight loss percentage, and your overall well-being as guideposts rather than rigid timelines.

As with any medication, speak to your healthcare provider before making changes—and remember, weight loss is a marathon, not a sprint.