Quick answer: the tirzepatide maintenance dose on the Zepbound label is 5 mg, 10 mg or 15 mg once a week, chosen by your prescriber based on response and side effects.[1] Trials show that stopping leads to substantial regain: people switched to placebo regained 14% of their body weight within a year.[2] A 2026 trial found that stepping down to 5 mg kept off more weight than stopping, but less than staying on the full dose.[3]
This guide covers the approved maintenance doses, what happened when people stopped or reduced tirzepatide, and the questions to raise with your prescriber. For the full drug background, see our tirzepatide profile.
What the label says about maintenance doses
Zepbound is approved “to reduce excess body weight and maintain weight reduction long term” in adults with obesity, or overweight plus a weight-related condition.[1]
| Use | Maintenance dose | Notes |
|---|---|---|
| Weight reduction and long-term maintenance | 5, 10 or 15 mg weekly | Lower dose can be considered if a higher one is not tolerated[1] |
| Obstructive sleep apnea | 10 or 15 mg weekly | 5 mg is not a maintenance option[1] |
| Type 2 diabetes (Mounjaro) | Dose that controls blood sugar, up to 15 mg | Up to 10 mg in children 10 and older[6] |
The label does not set a time limit and does not say when to stop. The 2.5 mg dose is only for the first 4 weeks and is not approved for maintenance.[1] To see how people get to a maintenance dose, see the tirzepatide dosage chart.
What happens if you stop: SURMOUNT-4
SURMOUNT-4 is the main study of stopping tirzepatide.[2]
- Design: 783 adults without diabetes took their highest tolerated dose (10 or 15 mg) for 36 weeks. The 670 who completed this period were then randomly assigned to keep taking tirzepatide or switch to placebo for 52 more weeks.[2]
- First 36 weeks: average weight loss was 20.9%.[2]
- Next 52 weeks: the placebo group regained 14.0% of their body weight, while the tirzepatide group lost a further 5.5%.[2]
- Keeping most of the loss: 89.5% of those who stayed on tirzepatide kept at least 80% of their earlier weight loss, versus 16.6% on placebo.[2]
- Overall: from the start of the trial to week 88, weight fell 25.3% with continued tirzepatide and 9.9% in the group switched to placebo.[2]
The placebo group had not regained everything by week 88, but weight was still rising when the trial ended. The authors concluded that withdrawal led to substantial regain, while continued treatment maintained and added to the loss.[2]
Can you take a lower dose? SURMOUNT-MAINTAIN (2026)
SURMOUNT-MAINTAIN, published in The Lancet in June 2026, is the first randomized trial to test stepping down the dose after weight loss.[3]
- Design: 441 US adults with obesity took tirzepatide at their highest tolerated dose for 60 weeks. At week 60, 378 were randomly assigned to stay on that dose (140), drop to 5 mg (144) or switch to placebo (94) for 52 weeks.[3]
- Result at week 112: compared with where they started, weight was down 21.9% in the full-dose group, 16.6% in the 5 mg group and 9.9% in the placebo group.[3]
- Regain: the share of people who regained at least half their lost weight and were given rescue treatment was 8% on the full dose, 25% on 5 mg and 67% on placebo.[3]
- Safety: side effects were mostly mild to moderate gastrointestinal events, mainly during dose escalation.[3]
| Group (weeks 60 to 112) | Weight change from start at week 112 |
|---|---|
| Stayed on highest tolerated dose | −21.9%[3] |
| Reduced to 5 mg | −16.6%[3] |
| Switched to placebo | −9.9%[3] |
The authors wrote that reducing to 5 mg “might provide a valuable alternative to discontinuation,” while noting that individual responses vary.[3] In plain terms, a lower dose kept off a good share of the weight for many people, but not as much as staying on the full dose.
Long-term treatment: the 3-year SURMOUNT-1 data
The longest placebo-controlled data come from people with obesity and prediabetes who stayed in SURMOUNT-1 for 176 weeks, about 3.4 years.[4]
- Weight: average loss was 12.3% on 5 mg, 18.7% on 10 mg and 19.7% on 15 mg, versus 1.3% on placebo.[4]
- Diabetes: 1.3% developed type 2 diabetes on tirzepatide versus 13.3% on placebo.[4]
- After stopping: 17 weeks after treatment ended, the share with diabetes had risen to 2.4% in the tirzepatide groups, compared with 13.7% for placebo.[4]
These results suggest the effect holds as long as treatment continues, and starts to fade once it stops. No new safety signals were found over three years.[4]
How prescribers choose a maintenance dose
There is no single maintenance dose for everyone. The label asks prescribers to weigh treatment response and tolerability.[1] Common considerations include:
- How much effect you need. Higher doses produced more weight loss in SURMOUNT-1: 15.0% on 5 mg, 19.5% on 10 mg and 20.9% on 15 mg at 72 weeks.[5] SURMOUNT-MAINTAIN suggests some people keep much of their loss on a lower dose, though on average less than on the full dose.[3]
- Whether you are still losing weight or have stabilized. A dose that keeps weight steady may be enough once active weight loss is over.
- Side effects. If nausea or other effects persist, the label allows a lower maintenance dose.[1]
- Other conditions. Sleep apnea requires 10 or 15 mg.[1] People with type 2 diabetes take Mounjaro at the dose that controls blood sugar.[6]
- Cost and access. Coverage and price can differ by dose and format. Our Zepbound vs Mounjaro guide explains the differences.
If you are thinking about stopping, see what to expect in our guide to how long tirzepatide stays in your system. For weight loss by dose and week, see tirzepatide weight loss results.
What has not been studied well
- Spacing out doses (for example every 10 or 14 days) has not been tested in a randomized trial, and it is not in the label.[1]
- Doses between the approved strengths, sometimes called microdosing, have not been tested in randomized maintenance trials.
- Stopping and restarting in cycles has not been formally studied.
