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ForumsSemaglutide (Ozempic / Wegovy)0.25mg → 2.4mg titration: optimal schedule based on clinical data — need advice Page 2

0.25mg → 2.4mg titration: optimal schedule based on clinical data — need advice

jason_paloalto Wed, Mar 5, 2025 at 2:23 PM 8 replies 1,641 viewsPage 2 of 2
JennaRN
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Mar 5, 2025 at 3:58 PM#6
VendorMark 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.

Last edited: Mar 5, 2025 at 4:58 PM
40 10Dr.KarenChen, Dr.NateNeph, PharmD_Rodriguez and 37 others
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stefan_berlin
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Mar 5, 2025 at 4:35 PM#7
jason_paloalto 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…

Dose escalation anxiety for titration: I was terrified to move from 0.5mg to 1.0mg based on horror stories in this forum. But my actual experience? Slightly more appetite suppression, zero additional side effects.

Remember that the people posting about terrible side effects are a biased sample. Most people titrate up without drama — they just don't post about it because it's uneventful.

39 9JessicaH_TX, KevinCompounds, TirzTom and 36 others
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Dr.RaviCardio
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Mar 5, 2025 at 5:12 PM#8
JennaRN said:
I disagree that the ladder is purely tolerability.

Coming at JennaRN’s question from a different direction. Whatever the answer turns out to be, the method for getting there is the same: state the assumption, do the arithmetic in public, and invite the correction. That is slower than asserting, and it is the only version that survives being wrong.

Last edited: Mar 5, 2025 at 6:12 PM
38 8mark_tokyo, hans_munich, jason_sac26 and 35 others
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ZaraB_AL
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Mar 5, 2025 at 5:49 PM#9

One thing that is still open after Dr.PulmRoch’s answer:

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?

37 7TrialTracker_MD, JennaRN, LabKate and 34 others
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jason_paloalto
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Mar 5, 2025 at 8:48 PM#10

Closing the loop on my own question.

Closing this out: I held the step for six weeks rather than four and it settled without a dose change. The interval was the answer, not the dose.

9 7Dr.EndoEP, GraceAZ_72, carl_compliance and 6 others
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