On Singapore's label, Mounjaro begins at 2.5 mg once weekly and rises to 5 mg after four weeks (Singapore NDF). If needed, it then climbs in 2.5 mg steps, at least four weeks apart, to a maintenance dose of 5, 10 or 15 mg chosen by your doctor. Never change a prescribed dose on your own. At GetLean, Dr Quek reviews your dose at a monthly check-in.
Semaglutide is stepped up over 16 weeks, four weeks at each step, to a 2.4 mg maintenance dose (Singapore NDF). Both start low because gastrointestinal reactions cluster at the increases. What is less well known is how consistent the schedules are — for both medicines, the milligram-and-week steps are numerically identical across the US, European and Singapore documents. The real divergence sits elsewhere, in what each document says a prescriber may do when a step is not tolerated.
In Singapore, tirzepatide is registered as Mounjaro, and semaglutide injection as Wegovy for weight management and as Ozempic for type 2 diabetes. The figures in this article are given by molecule, as the trials and product labels report them. Whichever medicine is prescribed, GetLean plans the exit from the first consultation. Coming off GLP-1 in Singapore: what happens and how to plan sets out how.
Dose titration: the planned sequence of increases from a starting dose to a maintenance dose, with a minimum time at each step. It is set out in the registered product information and applied by the prescriber, not adjusted by the patient.
What Mounjaro dose should I take?
A doctor decides your Mounjaro dose. The label sets the path: 2.5 mg once weekly to start, 5 mg after four weeks, then a maintenance dose of 5 mg, 10 mg or 15 mg chosen by the prescriber.
Singapore's current product information for tirzepatide gives the starting dose as 2.5 mg once weekly, increased to 5 mg after 4 weeks, with further increases in 2.5 mg steps after a minimum of 4 weeks on the current dose if needed (Singapore NDF). It lists 5 mg, 10 mg and 15 mg as the recommended adult maintenance doses, with a maximum of 15 mg once weekly (Singapore NDF). The US weight-management label adds that 2.5 mg is for treatment initiation and is not approved as a maintenance dosage, and that the prescriber should consider treatment response and tolerability when choosing the maintenance dose (US prescribing information). Those are the label's steps, not a dose for any one person: response, side effects, other medicines and goals decide where you land, and the doctor reviews that with you. Never raise, hold, lower or skip a dose on your own.
You do not have to work out the dose alone: at GetLean, Dr Quek reviews how it's going every month and decides each dose change, working towards the lowest effective dose. Book your consult to see whether Mounjaro is suitable for you.
Why the dose starts low and climbs in steps
Because the side effects are front-loaded onto the increases rather than spread evenly across treatment — GLP-1 safety: what is common, what is uncommon but serious, and when to stop and call a doctor sorts them by how a reader needs them.
Semaglutide's US prescribing information records nausea in 44% of adults on the injection product of treated adults against 16% on placebo, and states these reactions were most frequently reported during dosage escalation (prescribing information). Tirzepatide's runs nausea at 25–29% across doses against 8% on placebo, and goes further: the majority of nausea, vomiting and diarrhoea events occurred during dose escalation and decreased over time (prescribing information).
A schedule that parks someone at each dose for at least four weeks is built around exactly that pattern. It gives the body time at each level before the next demand, and it gives the prescriber a defined checkpoint at which to ask how the last four weeks went. The slow part is the design, not a delay in it. We cover what to do about the symptoms themselves in managing nausea on GLP-1.
The semaglutide schedule, and the step above 2.4 mg
The registered steps are four weeks each: 0.25 mg for weeks 1–4, 0.5 mg for weeks 5–8, 1 mg for weeks 9–12, 1.7 mg for weeks 13–16, then a 2.4 mg maintenance dose from week 17 (US prescribing information). The European summary of product characteristics gives a numerically identical table (EU SmPC), and so does Singapore's registered product information (Singapore NDF).
Four months to the maintenance dose, in other words, and the same four months in every jurisdiction checked.
One thing is worded differently, and it is the sort of detail that gets lost when a reader lands on an American page. The US document allows an increase beyond 2.4 mg to a maximum of 7.2 mg for patients who have tolerated 2.4 mg for at least four weeks (US prescribing information). The European document also allows 7.2 mg, explicitly gated to a BMI of 30 or above at the start of treatment (EU SmPC). Singapore's registered information carries the same option in its dosing text: if needed, for weight management in patients with obesity, the dose can be increased to 7.2 mg once weekly after a minimum of 4 weeks on 2.4 mg, and it is given as three 2.4 mg injections (Singapore NDF). Wegovy 7.2 mg in Singapore sets out the label and the trial behind it.
So the 16-week build-up is the same everywhere; the step above 2.4 mg is where the documents differ in wording.
The tirzepatide schedule
Tirzepatide is titrated on the same four-week rhythm but in even increments rather than a fixed table.
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).
The European document states the same starting dose, the same 2.5 mg increments after a minimum of four weeks, and the same 15 mg adult maximum (EU SmPC). Singapore's registered product information gives the same numeric steps (Singapore NDF). Can you stay on the lowest dose of Mounjaro (tirzepatide), 2.5 mg? sets out what the labels and the studies show.
The tirzepatide schedule as a chart
Singapore's product information as a chart: 2.5 mg to start, 5 mg after four weeks, then, if needed, increases of 2.5 mg after at least four weeks on the current dose, to a maximum of 15 mg (Singapore NDF). Each step up is the prescriber's decision, not an automatic date.
| Weekly dose | Earliest on the label schedule | What the label calls it |
|---|---|---|
| 2.5 mg | weeks 1 to 4 | the starting dose; not a listed maintenance dose |
| 5 mg | from week 5 | a maintenance dose |
| 7.5 mg | from week 9, if needed | a step between maintenance doses |
| 10 mg | from week 13, if needed | a maintenance dose |
| 15 mg | from week 21, if needed | a maintenance dose, and the maximum |
So on the label's minimum timings, 15 mg is reached at week 21 at the earliest. In Singapore, tirzepatide is registered in each of these strengths both as a pre-filled pen (0.6 mL) and as a vial (0.5 mL) (HSA register). The pen and the vial carry the same medicine at the same strengths; how each is used comes from its own instructions for use, which your first GLP-1 injection points to.
The numeric steps are the same across the three documents. What those documents cover is not the same. The Singapore entry cited here is tirzepatide's 2023 registration, which covers type 2 diabetes only; the current pen and vial registrations cover weight management as well (Singapore NDF). So a Singapore reader should not take the comparison as a statement about which indications apply to them. That is a question for the prescribing doctor. Where GLP-1 dosing is concerned, the numbers travel better than most people assume — which makes the one place they do not travel worth reading carefully.
If a step is not tolerated, the two labels are not symmetrical
This is the asymmetry that matters most, and it is easy to miss because it is an absence rather than a difference.
Semaglutide. Every dosing section checked contains an explicit sentence permitting a delay. The US wording is to consider delaying dosage escalation for four weeks if a dose is not tolerated during escalation (US prescribing information). The European and Singapore wording is identical to each other and differently framed: consider delaying dose escalation or lowering to the previous dose until symptoms have improved (EU SmPC, Singapore NDF). Note what the second version adds — an option to step back down, and an open-ended duration rather than a fixed four weeks.
Tirzepatide. No equivalent sentence appears in the dosing section of the US, European or Singapore document (US prescribing information, EU SmPC, Singapore NDF).
Two things follow. First, "you can just pause the escalation" is not a GLP-1 class fact — it is written into one medicine's labelling and not the other's. Second, this is a fact about what the documents say rather than a ranking of the two medicines, and it is information for the prescriber rather than a licence for anyone to hold a dose on their own.
The maintenance dose is a choice, not automatically the maximum
Titration has an end point, and the end point is decided rather than assumed.
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). That is the only tolerability lever anywhere in that document, and it operates after titration rather than during it.
The ramp has a way down as well as a way up. We favour a gradual reduction under a doctor's guidance rather than a cliff-edge stop, which allows appetite to adjust incrementally, and at GetLean dose changes are made at the monthly check-in with Dr Quek, working towards the lowest effective dose; each one is his decision. Mounjaro or Wegovy maintenance dose: is a lower dose enough? sets out what the labels and a stepping-down trial show. What the weeks after the last dose look like is on coming off Mounjaro and coming off Wegovy. Weaning off GLP-1 covers how a planned taper works, and micro-dosing and dose-stretching covers the stretching of doses that people try on their own.
At GetLean, the programme is designed to end, and our philosophy is that the medication is the catalyst rather than the plan, which is why the lowest dose that does the job is the interesting one — the months on the ramp are also the months to get eating and training in place, while appetite is still changing. The plan for coming off is the GetLean GLP-1 Taper Plan: after hitting your goal weight with the right nutrition and exercise habits built, the dose is stepped down at Dr Quek's monthly reviews towards your lowest effective dose and, where clinically appropriate, off the medication.
Individual circumstances vary, and clinical-trial figures describe the populations studied. 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. If a step is going badly, that is a consultation, not a calculation.
The first step on that ramp is the one people ask about most. Your first GLP-1 injection covers what to expect from it, including why the pen's own steps come from the leaflet rather than from an article.
Can the dose steps run in reverse to come off?
At GetLean, yes: GLP-1 medicines are started at a low dose and stepped up to an effective one, and tapering runs the same steps in reverse. You come down to the dose you were on before and stay there until your hunger and cravings are at a level you can handle. Only then do we step down again. It is normal to stay at an in-between dose for a while: someone who reached their goal on Mounjaro 15 mg might come down to 10 mg, find it hard to keep to their diet, and stay on 10 mg until they are ready.
Lower doses are one of the two ways the GetLean GLP-1 Taper Plan uses microdosing, which at GetLean means taking the medicine below its labelled dose or schedule; the plan often uses both. GLP-1 microdosing at GetLean, step by step sets out both ways and the one safety rule. Every GetLean GLP-1 Taper Plan is set with Dr Quek: book a consultation to plan yours.
Common questions
How long does GLP-1 dose titration take?
For semaglutide, the registered schedule reaches the 2.4 mg maintenance dose after 16 weeks — four weeks each at 0.25, 0.5, 1 and 1.7 mg (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.
Why does the dose start so low?
Because gastrointestinal reactions cluster at the increases. Semaglutide's label records that they were most frequently reported during dosage escalation (prescribing information), and tirzepatide's states most nausea, vomiting and diarrhoea occurred during escalation and decreased over time (prescribing information).
Is the dosing schedule different in Singapore?
For the core steps, no — the milligram-and-week schedule is identical across the US, EU and Singapore documents for both medicines (Singapore NDF, Singapore NDF). All three semaglutide documents also allow an increase to 7.2 mg for some patients, worded differently in each (US PI, EU SmPC, Singapore NDF).
Can a dose increase be delayed if the current dose is not tolerated?
For semaglutide, the documents give the prescriber that option explicitly — the US wording is to consider delaying escalation for four weeks (US PI), and the EU and Singapore wording is to consider delaying escalation or lowering to the previous dose until symptoms have improved (Singapore NDF). Tirzepatide's dosing sections contain no equivalent sentence in any of the three (US PI, EU SmPC, Singapore NDF). Either way it is the prescriber's call.
Do you have to go all the way to the top dose?
No. Tirzepatide's US weight-management label lists 5 mg, 10 mg and 15 mg as maintenance doses and instructs that response and tolerability be considered when selecting one, with a lower maintenance dose considered if a higher one is not tolerated (prescribing information). The end point is a clinical choice rather than an automatic climb to the maximum.
What Mounjaro dose should I take?
A doctor decides your Mounjaro dose. Singapore's label starts at 2.5 mg once weekly, increases to 5 mg after four weeks, and lists 5 mg, 10 mg and 15 mg as the maintenance doses (Singapore NDF).