Tirzepatide Dosing Protocol: 10 mg Vial — Week-by-Week Titration & Supplies
Reconstitution guide, titration table, and supplies checklist for the 10 mg compounded tirzepatide vial.
Quickstart highlights
Tirzepatide is a dual GIP/GLP-1 receptor agonist (Eli Lilly LY3298176) that produced mean 20.9% body weight reduction at 15 mg weekly in the SURMOUNT-1 trial (NCT04184622, n=2,539).
- Concentration: 5 mg/mL (10 mg vial + 2 mL bacteriostatic water).
- At 5 mg/mL: 2.5 mg = 50 units, 5 mg = 100 units, 7.5 mg = 150 units, 10 mg = 200 units.
- One 10 mg vial provides 4 doses at 2.5 mg, or 2 doses at 5 mg, or 1 dose at 10 mg.
- SURMOUNT-1 trial: 10 mg dose achieved 19.5% mean body weight reduction at 72 weeks.
- Refrigerate reconstituted solution; use within 28 days.
Dosing table
For educational reference only. Your prescribing provider may adjust doses based on your clinical profile and response.
| Week | Dose (µg) | Units | Frequency | Notes |
|---|---|---|---|---|
| 1-4 | 2500 | 50 | Once weekly | Starting dose — 10 mg vial provides 4 injections at 2.5 mg |
| 5-8 | 5000 | 100 | Once weekly | 5 mg dose — each vial provides 2 full injections |
| 9-12 | 7500 | 150 | Once weekly | 7.5 mg dose — 1.5 mL per injection from a fresh vial |
| 13+ | 10000 | 200 | Once weekly | 10 mg maintenance — 2 mL per injection (full vial) |
Gradual approach
| Week | Dose (µg) | Units | Notes |
|---|---|---|---|
| 1-8 | 2500 | 50 | Slow ramp — 2.5 mg x 8 weeks |
| 9-16 | 5000 | 100 | 5 mg x 8 weeks before advancing |
Reconstitution steps
- Draw 2 mL bacteriostatic water into a 3 mL syringe; inject slowly down the vial wall.
- Gently swirl until lyophilized powder is fully dissolved; do not shake.
- Final concentration: 5 mg/mL (10 mg / 2 mL). Label and date the vial.
- Refrigerate immediately at 2–8 °C; do not freeze.
Supplies needed
8-week plan
- 1 vial
- 8 syringes
- 2 mL bac water
- 8 alcohol swabs
12-week plan
- 2 vials
- 12 syringes
- 4 mL bac water
- 12 alcohol swabs
16-week plan
- 2 vials
- 16 syringes
- 4 mL bac water
- 16 alcohol swabs
Protocol overview & cycle notes
Achieve sustained weight reduction using the full FDA-approved titration schedule, leveraging the 10 mg vial for efficient mid-to-high dose coverage in weeks 5–10 before advancing to higher dose vials if needed.
Cycle length: 16 weeks on.
Off-cycle: 8–12 weeks off; monitor weight and appetite during off-cycle.
Storage & handling
Injection & tracking tips
- Rotate injection sites weekly: abdomen, outer thigh, upper arm.
- The 10 mg vial at 5 mg/mL holds exactly 2 mL — a full vial equals one 10 mg maintenance dose.
- Use a 100-unit U-100 insulin syringe; mark 50 units for 2.5 mg, 100 units for 5 mg, 150 units for 7.5 mg, 200 units for 10 mg.
Tracking
Logging helps you and your provider spot patterns and adjust dose or timing.
- Record weekly body weight and waist circumference.
- Log GI side effects (nausea, vomiting) severity 0–10 for the first 12 weeks.
- Track energy levels and hunger scores to assess dose adequacy.
How this works & references
Frequently asked questions
How many vials do I need for a 16-week titration?
Is the 10 mg vial more cost-effective than the 5 mg vial?
What should I do if I can't reach the 10 mg maintenance dose?
Can tirzepatide cause low blood sugar?
How do I store unused reconstituted solution between weekly doses?
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