Tirzepatide With Glycine: Dosage Chart, Titration, and Unit Conversions
The short version is that the glycine carrier changes nothing about how tirzepatide is dosed. What it changes is the vial concentration, and that is where people get confused, because a dose written in milligrams means a different number of syringe units depending on which vial is in front of you. This page gives both numbers.
8 min read · Updated August 26, 2026
Medically reviewed by Dr. Jonathan Snipes, MD and Kim Callender, NP, FNP-BC. Last reviewed August 26, 2026.Quick Answer
Compounded tirzepatide with B6 and glycine is dosed identically to the B12 formulation: a twice-weekly subcutaneous injection starting near 1.5mg, titrated up roughly every four weeks as tolerated. The carrier is inert and does not change the dose. It does change the unit conversion: the glycine vial is filled at 15mg per 0.5mL (30mg/mL), so 5 units delivers 1.5mg, where the same 1.5mg from a 6mg/mL B12 vial is 25 units. A 60mg vial holds 40 starting-dose injections and costs $225, which is $3.75 per milligram, the same per-milligram price as the B12 vial.
The carrier does not change the dose
Tirzepatide is a dual GIP and GLP-1 receptor agonist. That is the molecule doing the work, and it is the same molecule in both of our compounded formulations. What differs is what it is dissolved in.
The default formulation pairs it with cyanocobalamin, vitamin B12. The alternative pairs it with vitamin B6 and glycine, an amino acid that acts as a buffer. Neither carrier binds an incretin receptor. Neither affects gastric emptying, appetite signaling, or blood sugar. The dosing ladder, the injection schedule, and the titration rules are the same for both, and a patient moving between them carries their dose across rather than restarting.
The carrier exists to solve a tolerance problem, not a potency one. B12 is the default because it is stable, inexpensive, and supports energy levels during weight loss. The B6 and glycine version is reserved for patients with a known cyanocobalamin reaction, a methylation issue, or a histamine response. Requesting it without one of those indications buys nothing.
Tirzepatide glycine dosage chart
Doses below are per injection on a twice-weekly schedule, which is how our compounded vials are filled. Multiply by two for the weekly total. Every step is taken only if the previous step was tolerated, and the prescriber sets the actual ladder for the individual patient.
| Step | Dose per injection | Units (glycine vial, 30mg/mL) | Units (B12 vial, 6mg/mL) | Typical duration |
|---|---|---|---|---|
| Microdose entry | 0.3mg | 1 unit | 5 units | 4 weeks or longer |
| Standard start | 1.5mg | 5 units | 25 units | 4 weeks |
| Step 2 | 2.5mg | About 8 units | About 42 units | 4 weeks |
| Step 3 | 3mg | 10 units | 50 units | 4 weeks |
| Step 4 and beyond | 4mg and up | About 13 units | Higher-concentration vial usually issued | Prescriber directed |
The column that matters is the one matching the vial you were sent. Notice that a 1.5mg dose is 5 units from one vial and 25 units from the other. That is a fivefold difference in plunger position for an identical dose, and it is the single most likely place for a dosing error when someone switches formulations.
How to convert milligrams to syringe units
Every dosing page on the internet quotes tirzepatide in milligrams, and almost none of them convert to units, because they cannot: the conversion depends on a vial concentration that varies between pharmacies. Ours is published, so the arithmetic can be shown.
A U-100 insulin syringe has 100 units per millilitre, so one unit is 0.01mL. The glycine formulation is filled at 15mg of tirzepatide per 0.5mL, which is 30mg/mL, so each unit carries 0.3mg. The B12 formulation is filled at 6mg/mL, so each unit carries 0.06mg.
- Glycine vial: units = dose in mg ÷ 0.3. A 1.5mg dose is 5 units.
- B12 vial: units = dose in mg ÷ 0.06. A 1.5mg dose is 25 units.
Read the concentration printed on the vial in front of you rather than reusing a unit count from a prior prescription or from a forum post. A patient who moves to the glycine vial and keeps injecting 25 units out of habit would take 7.5mg instead of 1.5mg.
Vial sizes and how long they last
The glycine formulation is dispensed in two fills, both at the same 15mg-2.5mg per 0.5mL concentration. Prices are what Optimal Balance Pharmacy bills at wholesale, with no markup added by the clinic.
| Vial | Price | Per mg | Injections at 1.5mg | Beyond-use date |
|---|---|---|---|---|
| 60mg (2mL) | $225 | $3.75 | 40 (about 20 weeks) | 90 days from compounding |
| 180mg (6mL) | $675 | $3.75 | 120 (about 60 weeks) | 90 days from compounding |
The practical reading of that table: at a starting dose the 90-day beyond-use date runs out before the vial does. A 60mg vial holds 20 weeks of starting-dose injections but is only usable for about 13 weeks, so the larger fill is not the better value for a patient who is still titrating. It becomes the better value once you have climbed to a dose that consumes the vial inside its dating.
Why the glycine version looks more expensive and mostly is not
The headline comparison is $225 against $45, which reads like a five times markup, and it is the reason this question comes up constantly. The comparison is wrong because the two numbers describe different quantities of drug.
The $45 B12 vial holds 12mg of tirzepatide. The $225 glycine vial holds 60mg. Divide either one out and both land on $3.75 per milligram. The glycine formulation is not priced at a premium per unit of drug; it is simply not offered in a small starter fill, so the entry price is higher.
Where the glycine version genuinely costs more is in the smallest possible first order. A patient starting on B12 can buy a $45 vial. A patient who needs the glycine formulation starts at $225. Both then pay the same $39 medical visit and the pharmacy’s $15 flat overnight shipping.
The two titration rules that matter
The specific ladder is less important than how you climb it, and two rules account for most of the difference between patients who reach a therapeutic dose and patients who quit at week nine.
- Never step up while the last step is still unresolved. Nausea from a dose increase settles over two to three weeks as receptors adapt. Stacking a new increase on top of an unresolved one compounds the symptom instead of advancing the protocol.
- Hold or step back rather than stopping. Our dispensing protocol says this explicitly. Stepping back one rung and holding four extra weeks preserves the adaptation you have built. Stopping gives it back and means restarting from the bottom later.
If nausea is the thing limiting your titration, the other levers are worth trying before you conclude the dose is wrong. See how to stop GLP-1 nausea for the full protocol.
Who should not take it
The contraindications are identical to any other tirzepatide formulation, because they attach to the molecule rather than the carrier. Compounded tirzepatide is not appropriate for anyone with a personal or family history of medullary thyroid cancer, MEN2 syndrome, active pancreatitis, or severe gastroparesis, and it is not used during pregnancy. These are screened at intake.
Compounded tirzepatide is not an FDA-approved product. It is prepared by a state-licensed 503A pharmacy against an individual prescription, which is a distinct legal pathway rather than a shortcut around one.
Bottom line
Dose the glycine formulation exactly as you would dose the B12 one: twice weekly, starting near 1.5mg, stepping up about every four weeks if the current step is tolerated. Convert to units against the concentration on your own vial, which for the glycine fill is 30mg/mL, meaning 5 units per 1.5mg. Expect $225 for a 60mg vial, the same $3.75 per milligram as the B12 version, and pick the fill size against the 90-day beyond-use date rather than against the volume.
For the carrier decision itself, read glycine compared with the B-12 carrier, or see the tirzepatide with glycine product page for the current vial specification. When you are ready, start a $39 visit.
Common questions about tirzepatide glycine dosing
- What is the dosage for tirzepatide with glycine?
- The same as any other compounded tirzepatide: a twice-weekly subcutaneous injection, starting around 1.5mg per injection and titrated upward roughly every four weeks as tolerated. The B6 and glycine carrier is pharmacologically inert with respect to weight loss and does not change the dose. What does change is the unit conversion, because the glycine vial is filled at 15mg-2.5mg per 0.5mL, a different concentration from the 6mg/mL B12 vials, so the same milligram dose is a different number of syringe units.
- How many units of tirzepatide glycine should I inject?
- It depends on the vial concentration, which is why the milligram figure alone is not enough. The glycine formulation is filled at 15mg of tirzepatide per 0.5mL, which works out to 30mg/mL, so on a standard U-100 insulin syringe 5 units delivers 1.5mg and 10 units delivers 3mg. The B12 formulation is filled at 6mg/mL, where 25 units delivers 1.5mg. Same dose, very different draw. Always read the concentration on the vial your pharmacy actually sent rather than reusing a unit count from a previous prescription.
- Is glycine or B12 better for tirzepatide?
- For weight loss they are equivalent, because neither carrier contributes to the mechanism. B12 (cyanocobalamin) is the default and is the less expensive of the two. The B6 and glycine formulation exists for patients who cannot take the B12 version: a known cyanocobalamin reaction, a methylation issue, or a histamine response. It is not an upgrade and there is no clinical reason to request it without one of those indications. See the carrier comparison for the full decision.
- Why is tirzepatide with glycine more expensive?
- The peptide is identical, so the difference is the preparation. The glycine version starts at $225 for a 60mg vial against $45 for a 12mg B12 vial, but those are different quantities and comparing the headline numbers is misleading. Per milligram the glycine vial is $3.75 and the B12 vial is $3.75, which is to say they cost the same per milligram of tirzepatide. The glycine vial simply arrives in a larger fill. Both are billed at Optimal Balance Pharmacy’s wholesale price with no clinic markup.
- How long does a tirzepatide glycine vial last?
- The 60mg vial holds 40 injections at a 1.5mg starting dose, which is 20 weeks on a twice-weekly schedule, and about 10 weeks once you have titrated to 3mg per injection. The 180mg vial holds three times that. In practice the beyond-use date of 90 days from compounding under USP <797> is the binding constraint at low doses rather than the volume, so most patients on a starting dose finish the vial on the calendar rather than on the plunger.
- What is the titration schedule for compounded tirzepatide?
- The conventional ladder is a step up roughly every four weeks, if and only if the current step is tolerated. A typical progression per injection runs 1.5mg, then 2.5mg, then 3mg, then 4mg, continuing under prescriber direction. Two rules matter more than the specific numbers. Never step up while nausea from the last step is unresolved, and hold rather than stop if a step is not tolerated, because stepping back one rung and holding four extra weeks reaches a higher final dose than pushing through and quitting.
- Can I switch from tirzepatide B12 to the glycine formulation?
- Yes, and you carry your dose across rather than restarting the titration, since the active ingredient and the milligram amount are unchanged. The one thing that must change is your unit count, because the concentrations differ: a patient injecting 25 units of the 6mg/mL B12 vial is taking 1.5mg, and the same 1.5mg from the glycine vial is 5 units. Injecting 25 units of the glycine vial by habit would deliver 7.5mg, which is five times the intended dose. Confirm the new unit count with your prescriber at the switch.
- Does tirzepatide with B6 and glycine work as well?
- Yes. The active molecule is the same dual GIP and GLP-1 receptor agonist in both formulations, at the same dose, on the same schedule. Glycine is a buffering amino acid and B6 is a vitamin cofactor; neither binds an incretin receptor and neither contributes to or detracts from appetite suppression, blood-sugar regulation, or weight loss. If results differ between the two, the cause is the dose or the adherence rather than the carrier.
- Is compounded tirzepatide with glycine FDA approved?
- No, and no compounded medication is. Compounded preparations are made by a state-licensed 503A pharmacy for an individual patient against a prescription, which is a separate legal pathway from FDA approval of a manufactured product. Tirzepatide as a molecule has an FDA approval history through the branded products, but the specific compounded formulation with B6 and glycine has not been through and does not require that process. See how 503A pharmacies work and whether compounded tirzepatide is legal.
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