Question 1

I'm starting today – what should I do to prepare?

Accepted Answer

We see a lot of posts from people who are about to start taking weight loss medication, and are wondering what "you wish you knew when you started." First off, take a deep breath. You got this. And here are a few tips to help you out as you begin your journey.

Worried about the needle? It's normal to be freaked out by the idea of injecting yourself, but I swear it's easy, painless, and you'll quickly get used to it. Follow the instructions from your provider, and watch a video about how to self-administer a subcutaneous injection. Here's a good one from the VA that also has some good pointers (no pun intended) like letting the vial to come up to room temperature before injecting:

VA Self-Injection Tutorial
Drink lots of water. These medications can be dehydrating, water is your friend...it will help the weight come off and help stave off fatigue. Google for guidelines, but I have a big 40oz hydroflask and I try to have 2-3 of those a day. It's also recommended to replenish your electrolytes; I personally have one of these LMNT packets a day in my water bottle.

LMNT Electrolyte Powder Packets
Make sure you are getting enough protein. Again, like water, search online for guidelines for your own height and weight/target weight. This is more of an ongoing thing than a "just starting" thing, but not getting enough protein (and calories in general) can get in the way of progress and mean you lose more lean body mass than you’d like. I supplement with 12oz of almond milk mixed with a scoop of this protein powder most days.
Avoid big, heavy meals the day before and the day of injecting. You'll get a feel for what your body can handle once you get into the swing of things, but to start, best to lean on lighter meals.
You might not feel anything on the starter 2.5mg dose, and that’s okay. It’s really just meant to get your body acclimated to the drug. You’ll read lots of accounts of people feeling the food noise disappear immediately and having very dramatic effects, but this is not as common as the subreddits would make it seem.
Be prepared for potential mild side effects (though many people have none!):
- Nausea: Have some ginger tea or ginger chews/candy -- I really like these organic ginger Tummydrops. I also like this chewable Emetrol, it tastes good and works for when you might need a little more than a tummydrop. Personally, I've never felt more than a tiny bit queasy, nothing too bad.
- Tiredness: Plan to take it easy on your first injection day. This is the biggest side effect I face, and it hits me pretty much every week the day or two after injection. As mentioned above, drinking lots of water and replenishing electrolytes can help. If anyone has any other suggestions, let me know and I can share them!
- Constipation: Things can, um, slow down a bit down there. Make sure you have Miralax or another gentle laxative available. People swear by MagO7 -- a magnesium supplement that has a laxative effect, but I haven't tried it, as I haven't experienced this, thankfully.
Organic Ginger Tummydrops

Chewable Emetrol

MagO7 Magnesium Supplement

And remember, most people have very mild side effects, or none at all, so don't sweat it too much.
If you have questions, come find us on Reddit! You'll find a super helpful community on Reddit. I mostly frequent r/tirzepatidecompound, but there's a bunch to check out, depending on your particular stripe. Before posting, though, try searching -- a lot of questions come up again and again (hence this FAQ!,) and a lot of the answers are all already there; you just need to find them. If you are still confused or have something new to ask or say, please do post! You’ll find most people are helpful and happy to engage.
You're going to do great. Congrats on taking this step to improve your health and your life!

Full Disclosure -- Some of these product links use affiliate links which give me a small commission for any purchases you make. (Your cost isn't affected.) I do personally use these products regularly (except the MagO7, which is still sitting unopened in my cabinet) and recommend them, regardless of any commission!

Question 2

Help! I can't understand my prescription label. What's my concentration?

Accepted Answer

Medication labels can look confusing with all their numbers and text, but there's one key piece of information you need: the concentration.

Think of concentration as the strength of your medication. Just like a strong cup of coffee has more caffeine per ounce than weak coffee, a higher concentration medication has more medicine packed into each milliliter of liquid.

What you're looking for: A number followed by either mg/mL or mg/0.5mL (like 10mg/mL or 5mg/0.5mL). Our calculators support both via a unit toggle above the concentration field, so you can enter what you see on the label and we'll convert as needed.

Simple example: If your label says "15mg/mL", that means:

Every 1mL (which equals 100 units on your syringe) contains 15mg of medicine
So for a 15mg dose, you'd inject exactly 1mL (100 units)
For a 7.5mg dose, you'd inject 0.5mL (50 units)

The examples below show you exactly where to find this concentration number on different types of labels.

Standard Format

Most common format showing concentration as X mg/mL:

COMPOUNDED MEDICATION Tirzepatide 20 mg/mL For subcutaneous injection only Qty: 5mL Rx#: 12345 Exp: 03/24/2025 Store refrigerated (2-8°C/36-46°F)

In this format, the concentration is clearly stated as mg per mL. This is the easiest format to read as no calculation is needed.

The concentration is 20 mg/mL, so you would enter "20" in the calculator.

Partial mL Format (mg/0.5mL)

Sometimes pharmacies list concentration per 0.5mL instead of per full mL. You can now use the unit toggle to select mg/0.5mL and enter the number exactly as shown on your label.

COMPOUNDED MEDICATION Semaglutide 2mg/0.5mL Total Volume: 2.5mL For subcutaneous injection only Rx#: 67890 Lot#: TZ0224A Exp: 04/15/2026 Keep Refrigerated

Easy mode: Select mg/0.5mL in the calculator and enter the number from your label. We'll convert to mg/mL automatically.

Manual conversion (optional):

Label shows: 2mg/0.5mL
Since 0.5mL = half of 1mL, double the mg value
2mg × 2 = 4mg → 4mg/mL

Best practice: Use the mg/0.5mL toggle and enter "2" to avoid mistakes — the calculator will show both mg/mL and mg/0.5mL in results.

Format with Additives

Many pharmacies add extra ingredients like B12, niacinamide, or glycine:

COMPOUNDED MEDICATION Tirzepatide/Niacinamide 8/2 mg/mL Volume: 5mL Rx#: 13579 Exp: 11/30/2026 Lot#: TZN0224B Store in refrigerator Discard after: 28 days from first use

Key rule: Only the tirzepatide or semaglutide concentration matters for dosing. Ignore all the other ingredients and their numbers.

How to find the right number:

Look for "Tirzepatide" or "Semaglutide" in the ingredient list
Find which position it's in (first, second, etc.)
Use the concentration number in that same position
In this example: Tirzepatide is listed first, so use the first number (8 mg/mL)

The tirzepatide concentration is 8 mg/mL, so you would enter "8" in the calculator.
(Ignore the niacinamide and its concentration—it doesn't affect your dosing)

Want to Learn More?

This is just a quick overview of reading medication labels. Get the complete guide with more examples, common pitfalls, and detailed explanations, or test your understanding with our interactive quiz. If you received a lyophilized (powder) vial and need to calculate your concentration after mixing with BAC water, use our reconstitution calculator.

📖 Read the Complete Guide 🧠 Take the Label Reading Quiz 🧪 Reconstitution Calculator

Question 3

These vials look small! Did my pharmacy send me the right amount?

Accepted Answer

We hear this one a lot on Reddit. The vials are tiny, and often less than half full (if that!), and you might be thinking – "Hold on a sec, how is this really going to last me 4 weeks, or more?!"

It's common for vials of injectable medication to appear smaller than you might expect, especially because these medications are often highly concentrated. The amount in the vial may seem small, but it's typically enough for the prescribed number of doses based on your current treatment plan.

Remember: 5ml is just about a teaspoon, and most of these vials are 2 to 4mL, so it's not a lot of liquid at all. It's potent stuff!

Question 4

How long will my medication last?

Accepted Answer

There are two scenarios here -- a sealed, never used vial, and a vial once it's first used. Let's look at each separately.

Sealed Vial

For an unopened, never-punctured vial: with proper refrigeration, the medication will last at least until the "Beyond-Use Date" (BUD) printed on the vial. This date can range from one month to one year from the compounding date.

The BUD is the date beyond which the safety and effectiveness of a compounded drug can no longer be guaranteed. However, these dates aren't based on testing of your specific medication, but rather on USP United States Pharmacopeia guidelines, state regulations, and published studies. This means a pharmacy might set a BUD one year out while another sets it just one month out - this difference often reflects state regulations rather than the actual medication inside.

Many people report successfully using their properly refrigerated compounded GLP-1s beyond the listed BUD without issues, but this is done at your own risk. The main risks are:

Loss of effectiveness - the medication may not work as well
Contamination - which could be dangerous

Warning signs to watch for: If your medication appears discolored, cloudy, or contains any particles, that's a sign that something has gone bad. Discard the vial (or check with your provider first).

Opened/punctured vial

Once the vial has been opened and used for the first time, with the rubber cap punctured by your syringe, a different "timer" begins.

The standard recommendation is that once punctured, a vial should be used within 28 days. This is a conservative safety guideline designed to minimize the risk of contamination.

However, many people successfully use their vials for up to two months (8 weeks) without issues, provided they follow proper handling protocols:

Always wipe the top of the vial with an alcohol swab before and after each puncture - always!
Keep the vial refrigerated between uses - in a closed container to avoid contamination
Never reuse needles - use a fresh, sterile syringe for each injection
Avoid touching the rubber stopper with your fingers

The primary risk of using a vial beyond the 28-day guideline is contamination - bacteria or other microorganisms could potentially enter the vial through the puncture site, even with proper handling. While many people report no problems extending use to two months, going much beyond that increases the contamination risk significantly.

Ultimately, this is a personal risk tolerance decision. If you choose to extend beyond 28 days, pay close attention to any changes in the medication's appearance (cloudiness, discoloration, particles) or unusual side effects, and discard the vial (or check with your provider) if you notice anything that looks off.

Question 5

What can I do to minimize side effects?

Accepted Answer

To minimize side effects, start by following your doctor's instructions closely regarding dosage and timing. Eating smaller, more frequent meals can help reduce gastrointestinal discomfort. Avoiding rich, fatty, or spicy foods can also help manage nausea.

Staying hydrated is key — drinking water throughout the day can help alleviate headaches and constipation. If side effects persist or become unmanageable, contact your healthcare provider to discuss potential solutions, such as adjusting your dosage.

Question 6

How do I store my medication correctly?

Accepted Answer

Injectable medications like tirzepatide or semaglutide need to be stored in the refrigerator. Make sure the medication is kept at a temperature between 36°F and 46°F (2°C to 8°C) (that's standard refrigerator temperature.) Be careful -- the back of the fridge can sometimes get down to freezing temps, which you want to avoid.

Key storage points:

Keep it refrigerated, but look out for the very back of the fridge which might get too cold
Do not freeze the medication (note: there's some debate about this point, but everyone agrees that the freeze/thaw cycle is bad, so if you decide to freeze, make sure it stays frozen until you are ready to use.)
Avoid keeping in direct sunlight or extreme heat
Can be left at room temperature (under 86°F) for up to a week or so if needed
Keep the vial in a closed container to protect from light and help avoid contamination

If you are traveling, use an insulated cooler to keep your medication at the proper temperature:

FRIO Insulin Cooling Case - Large

Always check the medication label for specific storage instructions, and reach out to your provider or pharmacist if you have any questions.

Question 7

How long does it take to see results?

Accepted Answer

Results can vary significantly from person to person. Remember that the starter dose is not generally considered to be "therapeutic" -- it's more about getting used to the medication. Some people may start to notice changes within the first few days or weeks, while others may take longer to respond to the medication. Weight loss and improved blood sugar levels often happen gradually, and it's important to be patient and consistent. Also remember that social media tends to emphasize the most dramatic results, and that for most people, the results are more modest. **Comparison is the thief of joy** -- it's important to focus on your own journey, and not get discouraged by others' results.

Also remember that the medication isn't magic -- lifestyle factors like diet and exercise will still play a big role in their effectiveness. Regular check-ins with your healthcare provider can help track your progress and make any necessary adjustments to your treatment plan.

Question 8

How do tirzepatide and semaglutide work for weight loss?

Accepted Answer

Tirzepatide and semaglutide are GLP-1 (Glucagon-like peptide-1) receptor agonists, which means they mimic the action of a hormone called GLP-1 that helps regulate blood sugar and appetite. Tirzepatide is also a GIP (Glucose-dependent insulinotropic peptide) agonist, which promotes insulin release, and can help manage blood sugar levels. By slowing down gastric emptying and increasing feelings of fullness, these medications can help reduce overall food intake.

The combination of reduced appetite and better blood sugar control can lead to weight loss over time. However, these medications are most effective when combined with a healthy diet and regular physical activity.

Question 9

Is there a pill form of tirzepatide or semaglutide?

Accepted Answer

Short answer: Yes - there's now a real oral GLP-1 for weight loss (as of January 2026).

Oral Wegovy (semaglutide) is FDA-approved for weight loss. It was approved on December 22, 2025, and became available in early January 2026. It's the first oral GLP-1 actually approved for weight loss, not just diabetes.

The results are solid: in the OASIS 4 trial, people who stuck with it lost about 16.6% of their body weight at 64 weeks (about 13.6% on average when you count everyone who started). That's close to what you see with injectable Wegovy. The dose is 25mg once daily, and the introductory price is $149/month.

The downside: you still have to take it on an empty stomach and wait 30 minutes before eating or drinking anything. Same routine as Rybelsus. If you were hoping for a pill you could just pop with breakfast, this isn't quite it yet.

What about Rybelsus? It's still around, but it's only approved for diabetes, not weight loss. And now that oral Wegovy exists, there's really no reason to mess with Rybelsus for weight loss anymore.

What about oral tirzepatide (Mounjaro/Zepbound)? Eli Lilly is not developing an oral version of tirzepatide. Any company selling "oral" or "sublingual" tirzepatide is selling a compounded product that's not FDA-approved. Personally, I would avoid it.

What's coming next: Eli Lilly has a different drug called orforglipron that's expected to get FDA approval in Q2 2026 (around April-June) after receiving a priority review voucher. The Phase 3 ATTAIN trials showed about 11% weight loss at the highest dose (36mg).

The appeal of orforglipron: you can take it any time, no empty stomach requirement, no waiting period. Take it with your morning coffee or with dinner. That's a real convenience advantage over oral Wegovy or Rybelsus.

The tradeoff is it's not quite as powerful as the injectable GLP-1s. But the ATTAIN-MAINTAIN trial showed it can help maintain weight loss after switching from injectables. So one option is using a shot to lose the weight, then switching to orforglipron to maintain it without the needles.

What about Pfizer's danuglipron? They discontinued it in April 2025 due to liver toxicity concerns.

Bottom line: If you want an oral GLP-1 right now and you're okay with the empty stomach routine, oral Wegovy is your best bet - it actually works and it's FDA-approved for weight loss. If you can wait until mid-2026, orforglipron might give you something even better: a pill with no food restrictions that you can take whenever. And if you want the absolute best results regardless of how you take it? The injections are still king. But the pill options are finally getting interesting.

Stay tuned, we'll keep this article updated as things develop!

Question 10

When should I move up to the next dose?

Accepted Answer

The short answer: When your current dose stops working effectively for appetite suppression and weight loss, it's usually time to consider moving up.

But let's break this down a bit more.

What the name-brand schedules look like

The FDA-approved titration schedules are pretty standard across the board:

For semaglutide (Ozempic/Wegovy): Start at 0.25 mg per week and gradually increase to 2.4 mg per week for weight loss, titrating every four weeks. So you'd typically go 0.25mg → 0.5mg → 1mg → 1.7mg → 2.4mg, spending about a month at each dose.

For tirzepatide (Mounjaro/Zepbound): Start at 2.5 mg, then increase to 5 mg once a week for 4 weeks, followed by increases to 7.5 mg once a week. The full schedule is usually 2.5mg → 5mg → 7.5mg → 10mg → 12.5mg → 15mg, again with about 4 weeks between increases.

These schedules are designed to minimize side effects while your body adjusts to the medication, while getting up to a maximum dose relatively quickly.

Here's where compounding gets interesting

One of the biggest advantages of working with a compounding pharmacy is that you're not locked into those rigid manufacturer schedules. You and your doctor can create a custom titration plan that works for YOUR body and YOUR goals.

Maybe you need to go slower because you're sensitive to side effects. Maybe you want to micro-dose increases by going up in smaller increments. Or maybe you're responding well and want to move a bit faster. With compounding, you have that flexibility.

The "stay low as long as possible" approach

A lot of people try to ride out lower doses for as long as they can, and that's totally understandable. For tirzepatide especially, we see folks wanting to stay at 2.5mg or 5mg forever because they're seeing results and don't want to deal with increased side effects or higher costs.

If you're still losing weight consistently, feeling good, and your appetite is well-controlled, there's nothing wrong with staying put. Some people genuinely do great on lower doses long-term.

But many people need higher doses to see full benefits

Here's the reality though: this isn't going to work for everybody. Many people won't see the full weight loss potential of these medications until they reach higher doses. If you've been stuck at the same weight for several weeks, your appetite is creeping back, or you're finding it harder to stick to your eating plan, it might be time to consider moving up in dose. There's no shame in that!

Signs it might be time to increase

Weight loss has stalled for 4+ weeks (a week or two is not a stall)
Your appetite is returning to pre-medication levels
You're having more food noise and cravings
You're not feeling satisfied after meals like you used to
You're having to white-knuckle it through your eating plan again

The bottom line

Work with your doctor to find the right balance for you. There's no shame in needing higher doses — these medications are dose-dependent, meaning more medication often equals better results. The goal is finding your own personal sweet spot where you're getting maximum benefit with manageable side effects.

And remember, with compounding, you have way more flexibility to fine-tune your dosing than you would with the name-brand pens. Take advantage of that flexibility to create a plan that actually works for you.

Question 11

What is split dosing, and what are its benefits?

Accepted Answer

We recently launched a split dose calculator here on Fat Scientist, so wanted to provide a little primer on what split dosing is, and why you might consider it.

Split dosing is exactly what it sounds like: taking your weekly dose of semaglutide or tirzepatide and dividing it into smaller, more frequent injections throughout the week instead of one big shot. Think of it as spreading out your medication rather than getting it all at once.

While the FDA-approved protocols call for once-weekly injections, many people find that splitting their dose works better for their body and lifestyle. And with compounded medications, you have the flexibility to experiment with different dosing schedules under your doctor's guidance.

Why would you want to split your dose?

The main reasons people consider split dosing usually come down to managing side effects and maintaining more consistent levels of the medication in their system.

Side effect management: Many people find that taking a smaller dose more frequently reduces those unpleasant GI side effects like nausea, vomiting, and stomach upset. This stepwise approach may help reduce gastrointestinal symptoms such as nausea or bloating, which may be common with GLP-1 receptor agonists. Instead of getting hit with a big wave of medication all at once, you're giving your body smaller, more manageable amounts to process.

More consistent appetite control: Some people notice that their appetite suppression starts to wear off toward the end of the week with once-weekly dosing. Split dosing can help maintain more steady levels of appetite control throughout the week.

Better energy levels: Many patients do better with a half-dose of Ozempic taken twice a week. This approach reduces side effects and helps maintain more consistent energy. Some folks report feeling more energetic and less "medication hangover" with split dosing.

Flexibility around life events: If you have a big dinner planned or know you'll be traveling, split dosing can give you more control over timing your injections around your schedule.

Common split dosing schedules

Twice weekly (every 3-4 days): This is probably the most popular split dosing approach. You take half your weekly dose, wait 3-4 days, then take the other half. Doses can also be split throughout the week. Inject half of dose, wait 3-4 days, and inject the other half. So if you're normally on 5mg of tirzepatide weekly, you could simply do 2.5mg twice per week.

If you want more precise dosing to account for the specific timing you choose, the split dose calculator can help with that.

Every other day or every 2-3 days: Some people prefer even more frequent, smaller doses. This might mean taking 1/3 of your weekly dose every 2-3 days, or even smaller amounts every other day. This requires more injections but can provide very smooth, consistent levels.

Things to keep in mind

It's not officially studied: While many healthcare providers are comfortable with split dosing, it's important to know that there is no medical or scientific evidence supporting a twice-weekly injection schedule of Ozempic, and doing so could lead to unpredictable results. The clinical trials that got these medications approved were all done with once-weekly dosing.

Work with your provider: This isn't something to try on your own. Your doctor needs to be involved in planning any changes to your dosing schedule, especially since everyone's body responds differently.

More injections means more work: Obviously, split dosing means more frequent injections, which some people find annoying or inconvenient. You'll also go through your medication supply faster in terms of actual injection events, even though you're using the same total amount.

Compounding gives you options: With name-brand pens, split dosing can be tricky because you're stuck with pre-filled amounts. With compounded medications, you have much more flexibility to create custom split dosing schedules that work for your specific needs.

Is split dosing right for you?

Split dosing might be worth considering if you're dealing with significant side effects that seem to peak right after your weekly injection, if you notice your appetite control waning toward the end of the week, or if you just want more consistent day-to-day effects from your medication.

The best way to find out is to have an honest conversation with your provider about your experience on your current dosing schedule. They can help you weigh the pros and cons and determine if split dosing might be a good fit for your situation.

Remember, the goal is finding what works best for your body and your life—and that might be different from what works for someone else.

Question 12

Is it vial or vile?

Accepted Answer

It's vial. The word you are looking for is vial.

Question 13

Tirzepatide Dosing Chart: Standard, Slow, and Microdosing Schedules

Accepted Answer

Whether you're starting tirzepatide for the first time or adjusting your dose, having a clear dosing chart makes everything easier. This page covers the standard FDA-approved titration schedule for Mounjaro and Zepbound, as well as the slower and microdosing approaches commonly used with compounded tirzepatide. Looking for Zepbound doses? It's the same molecule — same chart, same schedule.

Important: This page is for informational purposes only and is not medical advice. Always follow your prescriber's instructions for dosing.

Standard Tirzepatide Titration Schedule (FDA-Approved)

This is the official titration schedule from the Mounjaro and Zepbound prescribing information. Each dose level lasts a minimum of 4 weeks before increasing.

Weeks Dose Notes 1–4 2.5 mg Starting dose only (not a maintenance dose) 5–8 5 mg First approved maintenance dose 9–12 7.5 mg Titration dose (transitional) 13–16 10 mg Maintenance dose 17–20 12.5 mg Titration dose (transitional) 21+ 15 mg Maximum approved dose

Key guidelines:

Increase by no more than 2.5 mg at a time
Wait at least 4 weeks before each increase
You don't have to keep going up if you are at a dose that's working for you
Maximum dose is 15 mg per week
If you can't tolerate a dose, you can drop back to the previous one

At the fastest pace, you'd reach 15 mg in about 20 weeks (5 months). Many people stay at 5 mg or 10 mg long-term if they're seeing good results and tolerating it well.

Slow Titration Schedule

Some prescribers recommend a slower titration, staying at each dose for 6–8 weeks instead of 4. This is especially common with compounded tirzepatide and for people who are sensitive to GI side effects.

Weeks Dose Time at Dose 1–8 2.5 mg 8 weeks 9–16 5 mg 8 weeks 17–24 7.5 mg 8 weeks 25–32 10 mg 8 weeks 33–40 12.5 mg 8 weeks 41+ 15 mg Ongoing

At this pace, reaching 15 mg takes about 40 weeks (10 months). The tradeoff is fewer side effects for most people, with results that are more gradual but often more sustainable.

When to consider slow titration:

You experienced significant nausea or GI issues at a previous dose
You're seeing good results at a lower dose and there's no rush to increase
Your prescriber recommends it based on your response

Microdosing Tirzepatide Schedule (Compounded Only)

Microdosing uses sub-standard doses (below 2.5 mg) during the initial weeks, then gradually works up to the standard titration. This requires a compounded formulation — branded pens can't deliver doses this small.

Weeks Dose Notes 1–2 0.25–0.5 mg Getting your body used to the medication 3–4 0.5–1.0 mg Still below standard starting dose 5–8 1.0–1.5 mg Gradual increase 9–12 1.5–2.5 mg Approaching standard starting dose 13+ 2.5 mg Transition to standard or slow titration

After the microdosing phase, most people continue with either the standard or slow titration schedule above, starting at 2.5 mg.

Who tends to microdose:

People who are especially sensitive to medications or have a history of GI issues
Those who want to start as gently as possible
People whose prescribers recommend a conservative approach

Important context: Microdosing is not clinically studied. There are no published trials testing tirzepatide at doses below 2.5 mg. The schedules above come from prescriber protocols and community experience, not clinical data.

Compounded Tirzepatide Concentrations

With compounded tirzepatide, your vial will have a specific concentration (mg/mL). The concentration determines how many units you draw in your syringe to get your target dose. This is where mistakes happen most often — always double-check your math, or use our Tirzepatide Dose Calculator to be sure.

Common concentrations and the units needed for each dose:

At 5 mg/mL

Dose Units to Draw 0.5 mg 10 units 1.0 mg 20 units 2.5 mg 50 units 5.0 mg 100 units 7.5 mg 150 units* 10 mg 200 units*

*Requires a larger than normal syringe or multiple injections

At 10 mg/mL

Dose Units to Draw 0.5 mg 5 units 1.0 mg 10 units 2.5 mg 25 units 5.0 mg 50 units 7.5 mg 75 units 10 mg 100 units 12.5 mg 125 units* 15 mg 150 units*

*Requires a larger than normal syringe or multiple injections

At 20 mg/mL

Dose Units to Draw 2.5 mg 13 units 5.0 mg 25 units 7.5 mg 38 units 10 mg 50 units 12.5 mg 63 units 15 mg 75 units

Not sure about your concentration? Check our guide on finding your medication concentration.

Want to calculate your exact dose? Use the Tirzepatide Dose Calculator — enter your concentration and target dose, and it tells you exactly how many units to draw.

Zepbound vs. Mounjaro: Is the Dosing Different?

The active ingredient is the same (tirzepatide), and the titration schedule is identical. The difference is what they're approved for:

Mounjaro Zepbound Approved for Type 2 diabetes Weight management; obstructive sleep apnea Starting dose 2.5 mg weekly 2.5 mg weekly Max dose 15 mg weekly 15 mg weekly Maintenance doses Any dose based on A1C response 5 mg, 10 mg, or 15 mg (weight); 10 mg or 15 mg (sleep apnea) Titration schedule Same Same

How Long to Stay at Each Dose

There's no single right answer, and at the risk of repeating myself, your medical provider is the best-positioned to work with you to determine your titration schedule. But here are some general guidelines:

Consider moving up when:

You've been at your current dose for at least 4 weeks
Side effects from the current dose have settled
Weight loss has stalled or slowed significantly
Your prescriber recommends it

You can probably stay where you are when:

You're still losing weight at a steady pace
You're tolerating the current dose well
Side effects are manageable but still present (they may resolve with more time)

Consider dropping back when:

Side effects are severe or not improving after several weeks
You're losing weight too quickly (more than 1% of body weight per week sustained)
Your prescriber recommends it

Missed Dose

If you miss your weekly injection:

Within 4 days: Take it as soon as you remember, then resume your regular schedule
More than 4 days late: Skip the missed dose and take your next dose on the regularly scheduled day

Don't double up to make up for a missed dose, and if you are at all unsure, check in with your medical provider.

Split Dosing

Some people split their weekly dose into two or more smaller injections throughout the week. This can help with side effects by keeping medication levels more stable. If you're interested, check out our Split Dose Calculator.

Related Tools

Tirzepatide Dose Calculator — Calculate exactly how many units to draw based on your concentration and dose
Reconstitution Calculator — Figure out your concentration after mixing a lyophilized vial with BAC water
Split Dose Calculator — Convert your weekly dose into a custom schedule
Reverse Calculator — Figure out how much you took based on units drawn
How to find your concentration — Guide to reading your vial label
How to store your medication — Proper storage guidelines
Minimizing side effects — Tips for managing common GI side effects

This page was last updated in February 2026. Dosing information is based on FDA prescribing information for Mounjaro and Zepbound. Compounded dosing protocols are based on common prescriber practices and are not FDA-approved. Always follow your healthcare provider's instructions.

Question 14

Orforglipron: What to Know About the First Oral GLP-1 for Weight Loss

Accepted Answer

For years, the biggest complaint about GLP-1 drugs has been simple: nobody likes needles. Orforglipron is Eli Lilly's answer to that — a once-daily pill that works through the same core mechanism as semaglutide (Ozempic, Wegovy), but you just swallow it with a glass of water. No injections, no refrigeration, no food restrictions. If it clears the FDA, it'll be the first oral GLP-1 approved specifically for weight loss in the US.

This page covers what we know about orforglipron based on the Phase 3 trial data and Lilly's FDA filing. It will be updated after the FDA issues its decision, currently expected around April 10, 2026.

Important: This page is for informational purposes only and is not medical advice. Always follow your prescriber's instructions.

How Does Orforglipron Work?

Orforglipron is a GLP-1 receptor agonist — the same basic mechanism as semaglutide. It binds to GLP-1 receptors in your brain and gut, suppressing appetite, slowing digestion, and helping regulate blood sugar. If you're familiar with how Wegovy or Ozempic works, you already understand most of what orforglipron does.

The key difference is how it's made. Semaglutide and tirzepatide are peptides — large, complex molecules that have to be injected because stomach acid would destroy them before they could be absorbed. Orforglipron is a small molecule, which means it's more like a traditional drug in pill form. Your gut can absorb it intact.

A few practical advantages that come from this:

No food restrictions. Oral semaglutide (Rybelsus) requires a 30-minute fasting window before and after taking it, which is awkward for a lot of people. Orforglipron has no such requirement — take it whenever.
No refrigeration. Small molecules are typically more stable at room temperature, which matters for travel and storage.
No injection anxiety. For some people, this is genuinely a big deal.

What it is not: a dual agonist. Tirzepatide hits both GLP-1 and GIP receptors, which is why it tends to produce stronger weight loss results. Orforglipron is GLP-1 only, so it's more comparable to semaglutide than to tirzepatide in terms of mechanism.

Expected Dosing Schedule

Based on the Phase 3 trials, orforglipron uses a gradual titration starting at 1 mg and working up over several months. The final FDA-approved label may differ slightly, but this is what the trials used:

Weeks Daily Dose Notes 1–4 1 mg Starting dose 5–8 3 mg 9–12 6 mg Lowest maintenance dose tested 13–16 12 mg Mid-range maintenance dose 17–20 24 mg Titration step (not a primary maintenance) 21+ 36 mg Maximum dose tested; best efficacy

A few things worth noting:

Each step is 4 weeks, so it takes about 20 weeks (5 months) to reach 36 mg at full pace.
The trials tested 6 mg, 12 mg, and 36 mg as maintenance doses. The 24 mg dose appears to be primarily a stepping stone to 36 mg, not a long-term target.
Not everyone needs to reach 36 mg. As with tirzepatide and semaglutide, some people see good results at lower doses.
This is a daily pill, not a weekly injection — consistency matters more. Missing a dose here and there isn't the same as skipping a weekly shot, but building the habit is important.

How Does It Compare to Injectables?

This is the honest answer most people want: orforglipron is less effective for weight loss than the leading injectables, but it closes the gap meaningfully — and it's a pill.

Metric Orforglipron 36 mg Semaglutide 2.4 mg (Wegovy) Tirzepatide 15 mg (Zepbound) Route Daily pill Weekly injection Weekly injection Weight loss (trial avg.) ~11–12% body weight ~15% body weight ~20% body weight Duration 72 weeks 68 weeks 72 weeks Mechanism GLP-1 only GLP-1 only GLP-1 + GIP dual agonist Nausea rate 13–16% ~44% ~18–33% Discontinuation (side effects) 5–10% ~5–7% ~4–7%

What this means practically:

If you're currently on tirzepatide (Zepbound or compounded), orforglipron would likely be a step down in efficacy. It's not a direct swap.
If you're on semaglutide (Wegovy or compounded), the efficacy is closer — orforglipron loses some weight loss effectiveness but wins on convenience and, notably, lower nausea rates.
The nausea difference is real. GLP-1s are notorious for nausea, especially early in titration. Orforglipron's GI profile skews more toward diarrhea and indigestion rather than nausea, which some people will find much easier to tolerate.

One surprisingly interesting data point: The ATTAIN-MAINTAIN trial specifically looked at people who switched from injectable GLP-1s to orforglipron. People who switched from Wegovy maintained about 95% of their prior weight loss. People who switched from Zepbound maintained about 80%. So if you're stabilized on an injectable and switch to the pill, you're likely to hold most of your progress — you're not starting from scratch.

What About Side Effects?

The same general GI side effects you'd expect from any GLP-1: nausea, diarrhea, constipation, indigestion. The profile is similar to other GLP-1s, with a few differences worth knowing:

Less nausea than semaglutide. The 13–16% nausea rate compares favorably to Wegovy's ~44%. This is one of the more appealing aspects of orforglipron for people who struggled with nausea on semaglutide.
More diarrhea than you might expect. The trade-off seems to be that diarrhea and dyspepsia are a bit more prominent with orforglipron. Not severe for most people, but worth knowing going in.
Discontinuation rates are slightly higher at the maximum dose. At 36 mg, somewhere in the 5–10% range of trial participants stopped due to side effects. This is in line with or slightly above the injectables, and some of this is expected — the 36 mg dose is the highest and least-tolerated.
The standard advice applies: go slow, stay hydrated, eat smaller meals, and give your body time to adjust at each dose before moving up.

FDA Approval and Availability

Lilly submitted orforglipron to the FDA under Priority Review, which means the agency committed to a faster-than-standard review timeline. The PDUFA date (the FDA's target decision date) is April 10, 2026.

No Advisory Committee meeting was scheduled, which is generally read as a positive sign — the FDA typically convenes an AdCom when there are significant questions about safety or efficacy that benefit from outside expert input. Not needing one suggests the data came in clean.

Approval isn't guaranteed, but the probability is estimated high (around 84%) based on the strength of the trial data and Lilly's track record with the FDA.

On pricing (if approved):

Lilly has been fairly transparent about their intended pricing through LillyDirect, their direct-to-patient platform:

Starting doses: approximately $149/month
Highest dose (36 mg): approximately $399/month
Medicare patients: capped at $50/month under the Inflation Reduction Act

That $399 list price for the max dose is competitive with Wegovy and Zepbound, which run $1,000+ per month at list price before insurance or GoodRx-type discounts.

On supply: One of the bigger logistical stories here is that Lilly has reportedly stockpiled $1.5 billion of orforglipron inventory ahead of the launch. The GLP-1 shortages that plagued semaglutide and tirzepatide in 2023–2024 were a massive headache for patients and a PR problem for the whole category. Lilly is clearly trying to avoid a repeat.

What This Means If You're on Compounded GLP-1s

This is the practical question for a lot of people on this site.

First: orforglipron is almost certainly not compoundable. It's a patented small molecule, not a peptide. Compounding pharmacies have made compounded semaglutide and tirzepatide available partly because the FDA's shortage list created a legal pathway. Orforglipron isn't on any shortage list (it hasn't even launched), it's not a peptide, and Lilly has clearly planned for adequate supply. There is no realistic compounding pathway here.

Second: it's not a replacement for compounded tirzepatide. If you're getting 15–20% weight loss on tirzepatide, switching to orforglipron would likely mean accepting meaningfully less weight loss (11–12%). Plus you lose the GIP agonist effect. If tirzepatide is working well for you, this isn't an upgrade or even a lateral move.

Where orforglipron could make sense:

You're currently on compounded semaglutide and losing access (due to shortage list changes, pharmacy closures, etc.). The efficacy profiles are closer, and orforglipron has the pill convenience advantage.
You haven't started a GLP-1 yet and hate injections. If a pill gets you to actually start treatment vs. avoiding injections indefinitely, that's a real benefit.
You've had significant nausea issues on semaglutide and the lower nausea rate of orforglipron might make it more tolerable.
You travel frequently or have storage constraints that make injectable medications annoying.

On cost vs. compounded: Compounded semaglutide and tirzepatide are typically $100–$200/month from telehealth providers, often less. Orforglipron at $149–$399/month list price is more expensive than most compounded options — but it may be more accessible than branded injectables for people without insurance coverage.

If you want to compare your current semaglutide dosing to what orforglipron might mean for you, the Semaglutide Calculator can help you think through your current protocol. For tirzepatide context, the Tirzepatide Dose Calculator is the place to start.

This page was last updated March 2026 and will be updated after the FDA issues its decision. Information is based on published Phase 3 trial data and publicly available FDA filing information. Nothing here is medical advice — talk to your prescriber about what's right for you.

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