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ForumsDosing & ProtocolsInjection technique: subcutaneous depot formation and absorption — 12 month update Page 2

Injection technique: subcutaneous depot formation and absorption — 12 month update

Dr.RenalNash Thu, Feb 8, 2024 at 9:06 AM 46 replies 2,824 viewsPage 2 of 10
Dr.NutriCornell
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Feb 8, 2024 at 1:08 PM#6
LabKate said:
Four weeks is the pharmacokinetics, not caution.

I disagree that the ladder is purely tolerability. The maintenance and regain data cluster at the top doses, so a ladder abandoned halfway leaves you outside the evidence base for the part that matters most — keeping it off.

24 19emily_PDX, Dr.SleepRoch, laura_annarbor and 21 others
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TrialTracker_MD
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Feb 8, 2024 at 2:42 PM#7
Dr.RenalNash said:
Four dose steps in, holding each one the full four weeks, and I am trying to work out whether the interval is a pharmacological requirement or a…

PSA for titration users considering the 0.25mg starting dose: this dose is NOT intended for weight loss. It's a titration dose to let your body adjust. Don't be discouraged if you don't lose much in the first month.

The therapeutic dose for weight management starts at 1.7mg (semaglutide) or 5mg (tirzepatide). Be patient with the ramp-up.

Last edited: Feb 8, 2024 at 7:42 PM
23 18stefan_berlin, Dr.EM_Chicago, pete_RVA and 20 others
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TinaHashiRN
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Feb 8, 2024 at 4:16 PM#8
Dr.NutriCornell said:
I disagree that the ladder is purely tolerability.

There is a second half to this that has not been said yet. Order of operations matters more than any single choice here: establish a baseline, change one thing, wait long enough for it to express itself, then measure again under the same conditions.

22 17Dr.Martinez, mike_mod, SarahChen_PharmD and 19 others
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Dr.EndoEP
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Feb 8, 2024 at 5:50 PM#9

Following on from GraceAZ_72 — and this may be the naive question:

What the trials actually did with participants who could not tolerate a step, because that is the situation I am in and the protocol summaries skip it?

Last edited: Feb 8, 2024 at 7:50 PM
21 16Dr.BariatricHTX, LindaRN_retired, tommy_boulder and 18 others
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Dr.RenalNash
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Feb 9, 2024 at 1:24 AM#10

OP back with an update, since a thread like this is useless without one.

Update — I came back down one step, held for a month, then went up again and it was uneventful the second time. Same ladder, slower.

Last edited: Feb 9, 2024 at 6:24 AM
3 1maria_elpaso, anders_CPH, Dr.NutriCornell
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