HealthcountHealthcount

GLP-1 titration and pen life planner

The dose ladder for your weekly injection with real dates on it, plus what is actually left in the pen you're holding. Free, no sign-up, and the working is shown.

The short answer: the labels ask for a minimum of 4 weeks on your current dose before a step up. Tirzepatide starts at 2.5 mg and climbs in 2.5 mg steps to a maximum of 15 mg, with 5, 10 and 15 mg all named as maintenance doses. Semaglutide runs a 16-week escalation from 0.25 mg to a 2.4 mg maintenance dose. A multi-dose pen holds 4 injections and has a fixed life once it has been opened: 30 days for a tirzepatide KwikPen, 6 weeks for a semaglutide FlexTouch pen in the UK and EU. Four weeks is a minimum, not a deadline, and your prescriber decides when or whether you move.

Where you are now

Three things, and the ladder below fills in.

Both are weekly injections. The name in brackets is the active ingredient, which is what the SmPC figures are attached to.

The milligrams you are on this week. If you have just moved up, pick the new one and use its start date below.

Every date on this page is counted from here, because the label's 4-week minimum runs from your first injection at the dose, not from your first ever injection.

The next rung on the ladder

Add the date you started 2.5 mg and the dates appear. The ladder below works without it.

The standard ladder for Mounjaro

Straight from the SmPC. Dates show the earliest each rung could begin if every 4-week minimum were met exactly, with nothing held back.

DoseWhat the label calls itEarliest start
2.5 mgYou are hereStarting doseEveryone starts here. The SmPC has 4 weeks at 2.5 mg, then 5 mg.Add a date
5 mgMaintenance doseOne of the three doses the SmPC names as maintenance (5, 10 and 15 mg).Add a date
7.5 mgStep between maintenance dosesA 2.5 mg increment on the way up, rather than a named maintenance dose.Add a date
10 mgMaintenance doseA named maintenance dose in the SmPC.Add a date
12.5 mgStep between maintenance dosesA 2.5 mg increment on the way up, rather than a named maintenance dose.Add a date
15 mgMaintenance dose, and the maximum15 mg once weekly is the maximum dose in the SmPC. There is no rung above it.Add a date

Rungs behind you show no date because this page has no record of when you were on them. It only knows the date you typed in. Figures are from the UK Summary of Product Characteristics on emc.

What is left in your pen

Two questions about the box in your fridge. They are what decide how many injections are left and the date it runs out, so it is worth getting them off the carton rather than guessing.

The milligrams on the carton or the pen label, not the amount you inject. It usually matches your dose above, so it is already filled in. Change it if the box says something else, which happens when you have been asked to hold a lower dose out of the pen you already had.

2. How many doses does one device hold?

The box says which one you have. A single-dose device is one injection and then it goes in the sharps bin. A multi-dose pen is the one you keep in the fridge and use four times.

So you have: 2.5 mg KwikPen (4 doses of 2.5 mg, 10 mg in total).

Why this matters: a single-dose device is one injection and no arithmetic. Unopened, it keeps to the printed expiry date in the fridge. Left at room temperature it has 30 days.

Unless you change something in the panel below, the figures use the labelled 2.5 mg every 7 days from a device you have not injected from yet.

I inject a smaller amount, space my injections out, or I am part way through this one

Leave it blank and it uses your dose above (2.5 mg). Only different if you have been told to hold a smaller amount than the device is labelled for.

7 is the licensed weekly schedule. Longer gaps are counted properly here, because a device on a stretched schedule hits its discard date long before it runs dry.

Out of this device only, not the total you have ever had. Two injections from a four-dose pen is 2.

The discard clock starts at the first injection, not at the day the box came out of the pharmacy bag. Leave it blank and the dates use the date you started this dose.

Injections this device gives you

4

The smallest of the three limits below, at 2.5 mg every 7 days.

Injections left

4

After the 0 you said you have already taken.

Label says discard by

Not set

The SmPC says the KwikPen must be discarded 30 days after first use

Three separate limits, and the smallest one wins
LimitInjectionsWhere the number comes from
Milligrams in the deviceBites first410 mg deliverable, divided by 2.5 mg an injection.
Days after first use530 days once the device is opened, at 7 days between injections.
Doses the label licensesBites first4The label says to dispose of the KwikPen after its 4 weekly doses. A little solution is left in it on purpose, and trying to inject that gives an incomplete dose.

A little liquid is always left after the last dose. It is there so the final press delivers a full amount, the label says to discard it, and none of the counts above include it. Figures are from the UK Summary of Product Characteristics on emc.

Last injection this device covers

Not set

Add a date above to see this.

First injection it cannot cover

Not set

Add a date above and the dates fill in. The injection counts work without one.

If you miss an injection

Take it as soon as possible within 4 days of the missed dose. After 4 days, skip it and take the next one on the usual day. The SmPC also asks for at least 3 days between any two doses.

Straight from the missed-dose section of the Mounjaro SmPC. If you are not sure where you are in the week, ring your prescriber or pharmacist instead of working it out from a website.

When to get help urgently

  • Severe tummy pain that will not go away. Both labels name this as a symptom of acute pancreatitis and say to seek medical attention straight away.
  • Vomiting or diarrhoea you cannot keep on top of. Both labels warn this can dehydrate you enough to affect your kidneys.
  • Signs of an allergic reaction: swelling of the face, lips or throat, or trouble breathing.
  • Anything you are not sure about. Your GP or pharmacist can answer it faster than a website can.

Contact NHS 111 for advice, or call 999 if someone is seriously unwell.

This page is information, not medical advice, and it is not prescribing anything. Nothing here tells you to change a dose, start one, stop one or stretch one out. Your GP or prescriber decides your dose and your schedule, and the leaflet in your box is the version that applies to the device in your hand. Keep a record of what you actually inject and when, and you can track it free.

Why the ladder exists at all

Nobody starts on a full dose of these medicines. The step-up schedule is there because the sickness, reflux and bowel upset that put people off are heavily loaded into the weeks after a dose goes up. The tirzepatide label puts it plainly: nausea, diarrhoea and vomiting happened mainly during dose escalation and settled over time. Climbing slowly gives your gut time to catch up.

That is also why the label asks for a minimum of 4 weeks rather than exactly 4 weeks. Staying put for six weeks, or three months, or indefinitely, is a normal clinical decision and not a sign that anything has gone wrong. The semaglutide labels go further and say escalation can be delayed, or the dose dropped back to the previous step, when a dose is not tolerated.

The two ladders, side by side

Tirzepatide starts at 2.5 mg once weekly. After 4 weeks it goes to 5 mg, and after that increases are in 2.5 mg steps with a minimum of 4 weeks on the current dose. The maximum is 15 mg once weekly. Worth knowing: 5, 10 and 15 mg are all named maintenance doses, so 7.5 and 12.5 mg are steps between them rather than places most people settle. The US label adds that 2.5 mg is for starting treatment only and is not approved as a maintenance dosage.

The weekly semaglutide injection runs a fixed 16-week table: 0.25 mg for weeks 1 to 4, 0.5 mg for weeks 5 to 8, 1 mg for weeks 9 to 12, 1.7 mg for weeks 13 to 16, then 2.4 mg as maintenance. A 7.2 mg dose exists for weight management if it is needed, and only after at least 4 weeks at 2.4 mg. One real difference between regions: the US label names 1.7 mg as one of the two maintenance dosages for weight reduction in adults, where the EU label treats it purely as a step on the way up. The tool above shows whichever applies where you are.

If you are thinking about moving between the two, the ladders do not convert. There is no published mg-for-mg equivalence, only positions on two different schedules. That is what the dose switch planner is for.

How the pen maths works

A tirzepatide KwikPen holds 2.4 mL as 4 doses of 0.6 mL, so the deliverable amount is four times the strength on the box. A 2.5 mg pen delivers 10 mg in total, a 10 mg pen delivers 40 mg, a 15 mg pen delivers 60 mg. Semaglutide FlexTouch pens also hold four doses each: in the UK and EU the 0.25 mg pen holds 1 mg, the 0.5 mg pen 2 mg, the 1 mg pen 4 mg, the 1.7 mg pen 6.8 mg and the 2.4 mg pen 9.6 mg. Single-dose pens are one injection and no arithmetic, and the 7.2 mg strength is only made that way.

There is liquid left after the last dose. It is overfill, there so the final press delivers a full amount, and the label tells you to discard the pen rather than chase it. The planner never counts it.

The bit that catches people out

A pen has three separate limits, and only the smallest one matters. The first is supply: how many injections the milligrams inside will cover. The second is the in-use limit, which starts the moment the pen is first used and does not care how much is left. Once a tirzepatide KwikPen has been opened it has 30 days. A semaglutide FlexTouch pen has 6 weeks in the UK and EU, and 56 days on the US label. The third is the number of injections the label licenses at all: dispose of the pen after its 4 weekly doses, and in the FDA's words, even if there is medicine left in it.

At the pen's own labelled dose those three never really disagree, because four weekly injections take 21 days from first to last. Set a smaller amount per injection, or a longer gap between them, and they come apart fast. Take a 15 mg KwikPen, which delivers 60 mg. At 2.5 mg an injection the arithmetic gives 24 injections, only 5 of those land inside the 30 days the label allows, and the label licenses 4. The planner shows all three numbers, tells you which one bites first, and uses that one for the dates.

One more thing worth saying out loud, because a lot of tools get it wrong: this is not a monthly subscription. A pack can sit in the fridge for months, and a person on a held or stretched schedule does not reorder on a calendar rhythm. Nothing here assumes you buy a pen every four weeks, and nothing here guesses your interval. It uses the one you type in.

What this page will not do

  • Tell you to go up. The ladder is information. The decision belongs to your prescriber.
  • Tell you to stretch a dose out or split a pen. It shows the arithmetic because people ask for it, and it flags every point where that arithmetic goes past what the label describes.
  • Score your progress, predict your weight, or tell you whether you are doing well.
  • Replace the leaflet in your box. Pens get relabelled, presentations change, and the paper that came with yours is the version that applies to it.

If you want the syringe-unit conversions for these pens instead, that lives on the printable dose chart.

Sources

Every dose, interval and pen figure comes from the label for that exact presentation: the EU Summary of Product Characteristics and emc for the UK and Ireland, and the FDA prescribing information on DailyMed for the US. Last reviewed 25 July 2026. Australian presentations are registered separately by the TGA, so if you are in Australia, treat the figures as the EU ones and check the Consumer Medicine Information in your box.