GLP-1 maintenance dose protocols by drug 2026

Maintenance is the lowest dose that holds your loss. That is 2.4 mg a week on Wegovy, 5, 10 or 15 mg on Zepbound, 0.5, 1 or 2 mg on Ozempic and up to 15 mg on Mounjaro. Most people reach it between week 16 and week 24. We read the four current FDA labels on Monday, August 17, 2026, and we reprice every program on this page every Monday. Nothing here is medical advice, and no dose change should happen without the person who wrote your prescription.

Maintenance doses by drug

A patient at target on Zepbound 5 mg stays on 5 mg. The 7.2 mg ceiling comes from STEP UP, which measured 18.7 percent body weight loss at 72 weeks against 15.6 percent on 2.4 mg. That extra loss costs more side effects: gastrointestinal events ran 70.8 percent against 61.2 percent, and altered skin sensation 22.9 percent against 6.0 percent. The 7.2 mg pen also runs $50 a month more.

What happens when you stop

Three clinical trials measured it. All found regain.

Among people who kept taking tirzepatide in SURMOUNT-4, 89.5 percent still held at least 80 percent of their lead-in loss at week 88. Among those switched to placebo, 16.6 percent did. The STEP 1 extension is the closest to real life, because everyone stopped: a year out, participants sat 5.6 percent below their start, having regained two-thirds of the loss. The likely driver is metabolic adaptation, the body defending the higher weight once appetite suppression ends.

What happens when you stop a GLP-1 prices year one and year two on each drug.

What the loss looks like over time

STEP 1 reported a mean 14.9 percent loss at week 68, but behind that mean 50.5 percent of people lost at least 15 percent and 13.6 percent did not reach 5 percent. Loss is front-loaded. STEP 5 held semaglutide 2.4 mg to a 15.2 percent mean at week 104. SELECT, the longest randomized follow-up at 17,604 adults, measured 10.2 percent below baseline at week 208, four years in. Past four years there is no randomized evidence, so any five-year figure, including the cost totals below, is an extrapolation. The 2026 ADA Standards of Care treat obesity as a chronic disease needing ongoing therapy.

Muscle at maintenance

The SURMOUNT-1 DXA substudy scanned 160 people at 72 weeks. About 25 percent of the weight lost was lean tissue, and the placebo group that lost weight through diet lost the same proportion. Protein around 1.2 to 1.6 grams per kilogram of body weight and resistance training two or three times a week are associated with holding more lean tissue, though neither has been shown to prevent regain.

What the dose does to the bill

The program moves the five-year cost far more than the dose does. NovoCare sells the Wegovy injection at $349 a month at both 1.7 mg and 2.4 mg, cut from $499 in November 2025, and the 7.2 mg pen at $399. The Wegovy pill runs $149 at the 1.5 mg and 4 mg starter strengths (4 mg rises to $199 on September 1, 2026) and $299 at the 9 mg and 25 mg maintenance strengths. LillyDirect charges $299 at Zepbound 2.5 mg, $399 at 5 mg and $449 at 7.5 mg and up, so a step down from 7.5 mg to 5 mg saves $50 a month. The Wegovy injection is $349 at both its doses, so the same step saves nothing there. The $449 Zepbound price holds only when your refill lands within 45 days. Miss that window and Lilly bills its regular $699 at 10 mg and above. For insured patients the copay tier is usually flat across doses.

Compounded semaglutide and tirzepatide come from a compounding pharmacy under a different regulatory route than an FDA-approved product, so the cheapest five-year total and the most expensive are not quotes for the same thing.

Cheapest to start is often not cheapest to stay

Introductory pricing is normal here. A reader who compares first months pays for it over five years, often for the same molecule, which is why the chart's headline price has been the maintenance price since June 2026.

Prices move

Maintenance is indefinite, and prices change. Every change we have recorded is at the price index.

Maintenance runs for years, so you will miss a dose at some point. Each label sets a different window. The missed-dose rule for each drug puts them in one table.

How much does it cost to stay on a GLP-1 for five years?

It depends far more on the program than the dose, and on whether the drug is compounded or branded. Multiply a program's verified all-in monthly price by sixty for the five-year total at today's price.

Two situations can justify tapering off: planning a pregnancy, where the Wegovy label says to stop at least two months ahead because semaglutide has a long half-life, and a precipitating condition like type 2 diabetes that has resolved and no longer needs treatment. For weight management without one of those, the evidence supports staying on the lowest effective dose.

The program you buy through decides the five-year bill. See Shed's flat all-in maintenance price and full score on the Shed review page.