On the Singapore and EU labels, 2.5 mg is the starting step for Mounjaro (tirzepatide), and the recommended maintenance doses are 5 mg, 10 mg and 15 mg once weekly (Singapore NDF; EU SmPC). Which dose suits a person is the prescribing doctor's decision. Staying below the labelled maintenance doses would be an off-label decision, one a doctor makes with a particular person and keeps under review. Never change a prescribed dose on your own; that is a conversation with the doctor who prescribed it. This article is not a recommendation to stay on any dose.
Availability in Singapore. This medicine is registered with Singapore's Health Sciences Authority, and its registered indication includes weight management. Which medicine suits a particular person, if any does, is decided by the doctor who assesses them.
What is the lowest dose of Mounjaro for?
The lowest dose is 2.5 mg once weekly, which Singapore's product information gives as the starting dose (Singapore NDF). For tirzepatide, it is 2.5 mg for four weeks, then 5 mg, then increases of 2.5 mg after a minimum of four weeks on the current dose (Singapore NDF). Your own pace is your prescriber's decision.
The US prescribing information for weight management gives 2.5 mg once weekly for four weeks as the starting dose, states that 2.5 mg is for initiation and is not approved as a maintenance dose, then increases to 5 mg, with further increases in 2.5 mg steps after at least four weeks on the current dose to a maximum of 15 mg (US prescribing information). None of the documents cited here lists 2.5 mg among the recommended maintenance doses. The words "for treatment initiation" and "not approved as a maintenance dosage" are in the US label for the weight-management product; Singapore's product information calls 2.5 mg the starting dose (Singapore NDF). How GLP-1 dose titration works sets out the step-up in full.
The US label for Mounjaro in type 2 diabetes changed in August 2026. Its April 2026 version said "The 2.5 mg dosage is for treatment initiation and is not intended for glycemic control." The version effective 27 August 2026 drops that sentence: it still starts at 2.5 mg once weekly, and says to increase the dose "If additional glycemic control is needed" (US diabetes label). That is a blood-sugar label for type 2 diabetes, not a weight-management one. The US weight-management label still calls 2.5 mg a starting dose that is not approved for maintenance (US prescribing information), and Singapore's product information still gives 2.5 mg as the starting dose and 5, 10 and 15 mg as the maintenance doses (Singapore NDF).
Why does the dose start so low?
Nausea, vomiting and the other stomach side effects are mostly a feature of starting and of dose increases; in SURMOUNT-MAINTAIN, gastrointestinal events mostly occurred during dose escalation (Horn 2026). Against that pattern, it is easy to see why people ask whether the climb can stop at the first step.
What do the labels say if a higher dose is not tolerated?
Tirzepatide's US weight-management label lists 5 mg, 10 mg and 15 mg as maintenance doses, instructs that treatment response and tolerability be considered when selecting one, and states that a lower maintenance dose should be considered if a patient does not tolerate the current one (prescribing information). The lowest maintenance dose it lists is 5 mg, so for someone on a higher dose a lower maintenance dose means 10 mg or 5 mg, and the label lists nothing lower. Singapore's registered product information has no tolerability or delay sentence in its dosing text (Singapore NDF).
Is staying below the labelled maintenance doses off-label?
A doctor may prescribe a medicine outside its registered indication. That is a recognised part of medical practice, it has a name — off-label prescribing — and it is a judgement made about one patient, with their history in front of the doctor, weighing what is known against what is not. It is not a general permission. The Singapore, EU and US weight-management labels cited here list 5 mg, 10 mg and 15 mg as the recommended adult maintenance doses, so staying at 2.5 mg would sit outside that schedule and would be an off-label decision. It would be a decision a doctor makes with a particular person and keeps under review, not a registered use and not something to arrange on your own. Using less than the registered dose, or leaving longer gaps between injections, is a different question again, and micro-dosing and dose-stretching covers it.
What does the stepping-down evidence show?
One trial tested stepping down, and it stepped down to 5 mg. In SURMOUNT-MAINTAIN, people who had lost weight on 10 or 15 mg and then stepped down to 5 mg finished 16.6% below their starting weight at week 112, against 21.9% for those who stayed on the full dose and 9.9% for those switched to placebo (Horn 2026). On average, the lower dose held more of the loss than stopping did; individual results vary. That was a step down to 5 mg, the lowest labelled maintenance dose, after 60 weeks on 10 or 15 mg; the trial did not test 2.5 mg. The trial was run in the United States in adults with a mean BMI of 40, and it was funded by the manufacturer. Those are averages in a studied population, and individual results vary: one in four people on 5 mg regained enough to be given rescue treatment. Our maintenance dose article sets out what the labels and the one stepping-down trial show.
What do the studies of 2.5 mg show?
Two 2026 studies report weight change at 2.5 mg, and both are observational. The first followed 112 adults without diabetes in Japan who all began on 2.5 mg; after four weeks the dose was kept at 2.5 mg (58 people) or raised to 5 mg (54 people), by shared decision-making (Amioka 2026). At six months, average weight loss was 15.3% on 2.5 mg and 16.1% on 5 mg (p = 0.563), and adverse events were more frequent on 5 mg, 50% against 35%, mostly gastrointestinal (Amioka 2026). It was not randomised, so the two groups did not get their dose by chance; it lasted six months; it enrolled adults aged 18 to 65 with a mean BMI of 30.8; both groups also had dietary and exercise counselling; and individual results vary.
The second used routine health records. It took at least three separate 2.5 mg tirzepatide prescriptions spanning six months or more as a stand-in for staying on the lowest dose, and found 1,016 such people among 322,442 treated (Murugadoss 2026). In a matched comparison, average weight change at 12 months was −5.5% for those records, against −2.2% for matched records of sustained 0.25 mg semaglutide; individual results vary (Murugadoss 2026). The authors note that many patients in routine care do not reach a recommended maintenance dose because of tolerability, access, cost, supply or individualised goals (Murugadoss 2026). Records show what was prescribed, not what was injected, and they include only people who kept being prescribed 2.5 mg; the authors say the pattern may overlap with, but does not establish, intentional microdosing.
Neither study is a randomised trial of staying at 2.5 mg, so neither shows what would happen to a particular person.
What does a prescriber look at?
A prescriber can see how someone has responded so far, what side effects they have had, what else they take, what the goal is, and whether a smaller dose would be the lowest effective dose for them or simply less medicine. The principle is the lowest effective dose — the smallest dose that still achieves the clinical goal, rather than the highest dose a person can tolerate. The principle does not change Singapore's label: the lowest recommended maintenance dose is 5 mg, and whether a person stays below it is the off-label decision described above, for the prescriber. Every part of this is your prescriber's decision: never raise, hold, lower or skip a dose on your own, and take a schedule from the person who wrote your prescription rather than from an article.
How GetLean approaches dose changes
At GetLean, dose changes are made at the monthly check-in with Dr Quek, and the dose reviews work towards the lowest effective dose. When a patient asks to stay on 2.5 mg, Dr Quek reviews how their weight, eating and exercise have been going, which GetLean tracks through its daily WhatsApp coaching, and advises from there. The programme is designed to end: habits are built with daily WhatsApp coaching while the medication is working, and Dr Quek steps the dose down at monthly reviews towards the lowest effective dose, rather than stopping overnight. That describes stepping down from the dose a person has reached on the labelled schedule; it does not make the starting step a maintenance dose. Weaning off GLP-1 covers how a planned taper works.
Common questions
Can you stay on the lowest dose of Mounjaro (tirzepatide)?
On the Singapore and EU labels, 2.5 mg is the starting step for Mounjaro (tirzepatide), and the recommended maintenance doses are 5 mg, 10 mg and 15 mg once weekly (Singapore NDF; EU SmPC). None of the documents cited here lists 2.5 mg among the recommended maintenance doses. Which dose suits a person is the prescribing doctor's decision. Staying below the labelled maintenance doses would be an off-label decision, one a doctor makes with a particular person and keeps under review.
Is staying below the labelled maintenance doses off-label?
A doctor may prescribe a medicine outside its registered indication. That is a recognised part of medical practice, it has a name — off-label prescribing — and it is a judgement made about one patient, with their history in front of the doctor, weighing what is known against what is not. It is not a general permission. The Singapore, EU and US weight-management labels cited here list 5 mg, 10 mg and 15 mg as the recommended adult maintenance doses, so staying at 2.5 mg would sit outside that schedule and would be an off-label decision.
Is there a big difference between 2.5 mg and 5 mg of Mounjaro?
One non-randomised 2026 study of 112 Japanese adults found average weight loss at six months of 15.3% on 2.5 mg and 16.1% on 5 mg (p = 0.563), with adverse events in 35% and 50% of the two groups, mostly gastrointestinal (Amioka 2026). The study was small, lasted six months, and the doses were chosen by patient and doctor rather than by chance, and individual results vary.