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Weeks Tirzepatide dose Notes 1–4 2.5 mg Initiation only (not for glucose/weight effect) 5–8 5 mg First maintenance option 9–12 7.5 mg Increase as tolerated 13–16 10 mg Maintenance option 17–20 12.5 mg Increase as tolerated 21+ 15 mg (max) Maximum maintenance dose These steps follow the Mounjaro FDA label and Zepbound FDA label

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During acute inflammation, pro-inflammatory M1-like macrophages accumulate in the liver, characterized by elevated expression of the NAD +—degrading enzyme CD38 and increased CD38-dependent NADase activity, leading to reduced tissue NAD + levels (Stahl et al