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GLP-1 Dosing Guide: Tirzepatide & Semaglutide Charts

You have your vial. Your provider gave you a starting dose. And now you are staring at a syringe trying to figure out whether 0.25mg means 10 units or 25 units, and whether the escalation chart you found online applies to what is actually in the vial sitting in front of you.

This is one of the most common points of confusion in GLP-1 treatment, and it is entirely understandable. Brand-name auto-injectors are pre-filled and pre-dosed. Compounded vials are not. The milligram dose your provider prescribed has to be converted to a unit volume based on the specific concentration of your particular vial, and those concentrations vary.

This page covers the standard dose escalation schedules for both tirzepatide and semaglutide (based on FDA-approved branded versions), how to convert milligram doses to units for compounded vials, why compounded dosing may differ from the charts you find elsewhere, and where to go for specific medication breakdowns.

One rule before reading any chart on this page: Always follow the dosing instructions your provider gave you. The schedules below are standard reference schedules based on clinical trial protocols and FDA-approved labeled dosing. Your provider may adjust timing, dose amounts, or escalation pace based on your health profile, tolerance, and response.

How dosing works with GLP-1 medications

GLP-1 medications for weight management are started at a low dose and increased gradually over several months. This approach, called dose escalation, serves two purposes. First, it allows your body to adjust to the medication and reduces gastrointestinal side effects like nausea. Second, it lets your provider and care team assess your response at each level before moving higher.

Neither semaglutide nor tirzepatide reaches its full weight management dose in the first few weeks. Patients who expect significant appetite suppression at the starting dose are often disappointed, and patients who rush the escalation trying to speed up results may experience more nausea. The slow start is the protocol, not a limitation.

Tirzepatide standard dose escalation

The table below reflects the dose escalation schedule for the FDA-approved branded version of tirzepatide as labeled for weight management in adults without type 2 diabetes. Compounded tirzepatide dosing follows similar milligram amounts, but your provider will specify the unit volume based on your vial’s concentration.

Week Dose Notes
Weeks 1-4 2.5 mg once weekly Starting dose. Most patients tolerate this well.
Weeks 5-8 5 mg once weekly First increase. Some patients notice appetite suppression beginning here.
Weeks 9-12 7.5 mg once weekly Mid-range dose. Nausea risk increases if escalation was rushed.
Weeks 13-16 10 mg once weekly Higher therapeutic range.
Weeks 17-20 12.5 mg once weekly Near-maximum dose.
Week 21+ 15 mg once weekly Maximum labeled dose. Not all patients require or tolerate 15mg.

Your provider may recommend stopping escalation at an intermediate dose if you are responding well and tolerating the medication. The goal is the lowest effective dose, not the highest tolerable one.

How tirzepatide units work in a compounded vial

Compounded tirzepatide is typically prepared in concentrations of 5mg/mL or 10mg/mL, though your pharmacy may prepare other concentrations based on your provider’s prescription.

To calculate units from milligrams:

  • At 5mg/mL: 1mg = 0.2mL = 20 units on a standard U-100 insulin syringe
  • At 10mg/mL: 1mg = 0.1mL = 10 units on a standard U-100 insulin syringe

Example: A 2.5mg starting dose from a 5mg/mL vial = 0.5mL = 50 units.

These are reference calculations only. Your provider will specify the exact volume to draw for your vial. If the calculation on your provider instructions does not match what you see here, follow your provider instructions. Vial concentrations vary.

For a detailed unit-by-unit reference chart specific to tirzepatide, see Tirzepatide Dosing for Weight Loss in Units.

Semaglutide standard dose escalation

The table below reflects the dose escalation schedule for the FDA-approved branded injectable version of semaglutide as labeled for weight management in adults. Compounded semaglutide dosing follows similar milligram amounts, but your provider will specify the unit volume based on your vial’s concentration.

Week Dose Notes
Weeks 1-4 0.25 mg once weekly Starting dose. Below therapeutic range. Tolerability focus only.
Weeks 5-8 0.5 mg once weekly First increase. Still sub-therapeutic for most patients.
Weeks 9-12 1 mg once weekly Enters therapeutic range. Appetite effects often noticeable here.
Weeks 13-16 1.7 mg once weekly Higher therapeutic dose.
Week 17+ 2.4 mg once weekly Maximum labeled dose for weight management.

Some patients reach their maintenance dose at 1mg or 1.7mg and do not need to escalate to 2.4mg. Your provider will guide this decision based on your response and tolerance.

How semaglutide units work in a compounded vial

Compounded semaglutide is typically prepared in concentrations of 2.5mg/mL or 5mg/mL, though other concentrations exist.

To calculate units from milligrams:

  • At 2.5mg/mL: 1mg = 0.4mL = 40 units on a standard U-100 insulin syringe
  • At 5mg/mL: 1mg = 0.2mL = 20 units on a standard U-100 insulin syringe

Example: A 0.25mg starting dose from a 2.5mg/mL vial = 0.1mL = 10 units.

For a detailed unit-by-unit reference chart specific to semaglutide, see Semaglutide Dosage in Units.

Why compounded dosing may differ from brand-name charts

This is the source of most dosing confusion online, and it is worth explaining directly.

Brand-name semaglutide auto-injectors are pre-filled devices that deliver a precise, pre-set dose each time. The dose is the dose. There is no math involved.

Compounded vials are different. They are prepared by licensed US-based compounding pharmacies at concentrations specified by the prescribing provider. The concentration determines how many units of liquid you draw to deliver a given milligram amount. Two patients on the same milligram dose of compounded semaglutide may draw completely different unit volumes if their vials have different concentrations.

This is why generic online dosing charts can be dangerous to follow without confirmation from your provider. If you see a chart that says “draw 10 units for your first dose” and your vial is a different concentration from what that chart assumed, you may be drawing more or less medication than intended.

Three things to always verify with your provider before injecting:

  1. The concentration of your specific vial (mg/mL)
  2. The milligram dose prescribed
  3. The unit volume to draw (mL and/or units on syringe)

Safety note on dose escalation

Compounded GLP-1 medications should only be dosed as directed by your prescribing provider. Do not increase your dose ahead of schedule, share your medication, or use dosing protocols from sources other than your provider. If you have questions about your dose, contact your care team before making any change.

Comparing tirzepatide and semaglutide dosing

Tirzepatide and semaglutide are not directly dose-comparable. They act on different receptors (or in tirzepatide’s case, two receptors), they are measured in different milligram amounts at equivalent escalation stages, and the clinical trials that established their efficacy used different protocols and patient populations.

A side-by-side dosing comparison for patients trying to understand the differences is available at Tirzepatide vs Semaglutide Dosage Chart.

What’s in this section

This hub covers reference dosing information for GLP-1 medications used in weight management. The supporting pages go deeper on specific dosing topics:

Tirzepatide Dosing for Weight Loss in Units - A complete unit-by-unit reference chart for tirzepatide at standard compounded vial concentrations, with provider instructions on how to draw each dose. Highest priority page in this section.

Semaglutide Dosage in Units - Unit conversion reference for semaglutide at 2.5mg/mL and 5mg/mL concentrations, with the full escalation schedule broken down by injection volume.

Tirzepatide Dosage Schedule - The complete tirzepatide dose escalation timeline from 2.5mg to 15mg, with guidance on what to expect at each stage and when to contact your provider.

Compounded Semaglutide Dosage Chart - Dosing reference specific to compounded semaglutide vials, including common concentrations, unit calculations, and how compounded dosing differs from the branded auto-injector protocol.

Compounded Tirzepatide Dosage Chart - Dosing reference specific to compounded tirzepatide vials, including concentration-based unit calculations and escalation guidance.

Tirzepatide vs Semaglutide Dosage Chart - A side-by-side comparison of the two medications’ escalation schedules, dose ranges, and how they are measured, for patients trying to understand the practical differences.

For a complete overview of GLP-1 programs including eligibility, pricing, and how to get started, see our GLP-1 Weight Loss guide.

Important: Compounded medications are not FDA-approved products. They are prepared by US-based, state-licensed compounding pharmacies and have not been independently evaluated by the FDA for safety, efficacy, or quality. All prescriptions require evaluation by an independent, licensed healthcare provider. Not all patients will qualify. Results vary by individual.

FAQ

Frequently Asked Questions

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What is the standard starting dose for tirzepatide?
The standard starting dose for the FDA-approved branded version of tirzepatide is 2.5mg once weekly for the first four weeks. Compounded tirzepatide is dosed by a licensed provider based on your health profile. The concentration of your compounded vial determines how many units correspond to each milligram dose. Your provider will specify both the milligram dose and the unit volume to draw.
What is the standard starting dose for semaglutide?
The standard starting dose for the FDA-approved branded injectable semaglutide is 0.25mg once weekly for the first four weeks. Compounded semaglutide vials vary in concentration, so your provider will specify both the milligram amount and the unit volume to inject. Do not adjust your dose or escalation schedule without provider guidance.
How long do dose increases typically take?
The standard escalation for both tirzepatide and semaglutide involves holding each dose for approximately four weeks before increasing. Escalation is slower than many patients expect. Rushing the schedule significantly increases the risk of nausea and other gastrointestinal side effects. Your provider may recommend a slower escalation if you are sensitive to the medication.
Why does my compounded vial dose look different from what I see in online charts?
Compounded vials are prepared in concentrations that differ from brand-name auto-injectors. A compounded semaglutide vial might be prepared at 2.5mg/mL or 5mg/mL, which changes how many units you draw for a given milligram dose. Always follow the specific instructions your provider gives you, not a generic online chart. The charts on this page show standard brand-name escalation schedules for reference only.
Can I self-adjust my dose if I am not seeing results?
No. Dose adjustments should only be made under provider guidance. Increasing your dose too quickly increases the risk of side effects including nausea, vomiting, and in rare cases, pancreatitis. If you feel your current dose is not effective, contact your care team to discuss whether an adjustment is appropriate.

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Medical Disclaimer: All medical services are provided by independent, U.S.-licensed healthcare providers. Compounded medications are not FDA-approved. Results vary by individual and are not guaranteed. Our providers only prescribe when clinically appropriate. For residents of AR, DC, DE, MS, NM, RI, and WV, state regulations require an initial live video consultation before a prescription can be written.

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All medical services are provided by independent, U.S.-licensed healthcare providers. These dedicated professionals are responsible for all clinical decisions, including diagnosis, treatment, and prescribing. Your confidential doctor-patient relationship is established directly with your independent provider to ensure your care is compliant, personalized, and focused on your unique health goals.

Understanding Your Medication: Compounded Formulations

The medications available through this platform are prepared by U.S.-based, state-licensed compounding pharmacies. These facilities are highly regulated and must adhere to standards set by their respective State Boards of Pharmacy.

Compounding allows pharmacists to create personalized medication formulations to meet specific patient needs, such as providing an alternative for a medication that is in shortage or creating a formulation without an ingredient a patient is allergic to.

It is important to understand that, as is the case with all compounded medications, these specific formulations are not FDA-approved. The FDA-approval process is designed for mass-produced, branded drugs. Compounded medications (which may utilize salt forms like semaglutide sodium/acetate) are prepared for individual patients and do not undergo the same large-scale FDA review for safety and efficacy. Your licensed provider will determine if this type of medication is the appropriate treatment for you. Transformation Health is not affiliated with, nor endorsed by, the manufacturers of any brand-name medications mentioned (e.g., Ozempic®, Wegovy®, Mounjaro®).

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We are passionate about providing helpful, informative content on our website. Please note that this information is intended for educational purposes only and does not constitute professional medical advice, diagnosis, or treatment. Your health journey is unique, so we encourage you to always consult your personal physician or another qualified health provider with any questions about a medical condition or before starting any new treatment program.

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You may see references to brand-name medications like Wegovy®, Ozempic®, Mounjaro®, and Zepbound®. These are registered trademarks of their respective owners (Novo Nordisk A/S and Eli Lilly and Company) and are FDA-approved medications. The compounded medications available through this platform are not affiliated with or endorsed by the owners of these trademarks. They are alternative formulations prescribed by your provider to meet your specific clinical needs.