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ForumsDosing & ProtocolsTirzepatide titration: 2.5→5→7.5→10→12.5→15mg guide

Tirzepatide titration: 2.5→5→7.5→10→12.5→15mg guide

Dr.Martinez Mon, Feb 19, 2024 at 5:20 PM 181 replies 34,127 viewsPage 1 of 20
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Dr.Martinez
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Feb 19, 2024 at 5:20 PM#1

Tirzepatide titration: 2.5→5→7.5→10→12.5→15mg guide

Pinned because it affects plans people have already made, not because it is dramatic. Everything below is what is confirmed as of today.

This post is the record, and it will be edited as things change — with the change noted rather than substituted. If you have something firmer than what is here, a document or a date or a first-hand account, post it and it goes in with credit.

Read it this way:

  • What is stated is confirmed; what is uncertain is marked as uncertain
  • Anything time-sensitive is worth verifying yourself before you act on it
  • The replies below carry the corrections, so read them before asking

Nothing here is advice about your situation, and the situation is still moving.

— Dr.Martinez · Dosing & Protocols
6 1AttorneyGrant, DebRD_ATL, KristenIndy and 3 others
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COA_Karl
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Feb 19, 2024 at 6:15 PM#2
Dr.Martinez said:
Tirzepatide titration: 2.5→5→7.5→10→12.5→15mg guide Pinned because it affects plans people have already made, not because it is dramatic.

Agreed on the mechanism, with the caveat that the head-to-head used semaglutide 1mg, not 2.4mg. It is still the best direct evidence available, but it is not the comparison most people think they are citing.

5 0jim_asheville, matt_MKE, Dr.ReproEndo and 2 others
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Dr.GastroMayo
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Feb 19, 2024 at 7:10 PM#3
Dr.Martinez said:
Tirzepatide titration: 2.5→5→7.5→10→12.5→15mg guide Pinned because it affects plans people have already made, not because it is dramatic.

Pushing back on Dr.Martinez here. The "tirzepatide is simply better" summary irritates me. It is better on mean weight loss, and the cardiovascular outcome evidence is far thinner than semaglutide's. If the reason for treating is cardiovascular risk rather than weight, the evidence base points the other way.

Correct me if the detail matters more than I have assumed.

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jim_asheville
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Feb 19, 2024 at 8:05 PM#4

Taking the question as asked, rather than the general version of it. Steady state is faster than people expect: half-life about five days, so you are at plateau in roughly three to four weeks rather than five. That matters when you are deciding whether a dose step has finished expressing itself.

3 23wanda_boise, NurseAsh_DET, BenResearch_OR
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quinn_sf
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Feb 20, 2024 at 1:15 AM#5
COA_Karl said:
Agreed on the mechanism, with the caveat that the head-to-head used semaglutide 1mg, not 2.4mg.

Same position here, arrived at the long way round. SURMOUNT-1 landed around 20.9% mean weight loss at 15mg over 72 weeks, against roughly 15% for semaglutide 2.4mg in STEP 1. Different trials, different populations, so the comparison is indicative rather than decisive — but SURPASS-2 was a genuine head-to-head and it pointed the same way.

Last edited: Feb 20, 2024 at 7:15 AM
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