Practice · Dosing & titration

Dose numbers across compounds are not on the same scale

Practice › Dosing & titration titration worked example tirzepatide missed dose semaglutide

baseline_peakTL2Member7 Jul 2025#1

Dose numbers across compounds are not on the same scale — setting out what I have, and where I think it stops being reliable.

I have read the maintained page on this and I still have a gap, so I am asking rather than guessing.

Context: semaglutide, 5 weeks in, currently at a dose I reached by the standard four-week steps. Everything below is my own record rather than anything a clinician told me.

The specific question is the one in the title. What I have already checked: the labelling summary on the relevant documentation page, the two most-linked topics in this subcategory, and my own notes from the last 9 weeks. What I could not find is whether the answer changes at higher doses or whether it is the same arithmetic throughout.

If the answer is "it depends", I would rather know what it depends on than be given a number.

0 likes 13mo

IRenaudinTL2Member14 Sep 2025#2

Stepping down deliberately: the withdrawal trials show that stopping is followed by regain. The step-down literature is thinner. The conservative assumption is that stepping down is followed by some regain, with the magnitude unknown.

32 likes 10mo

s.chowdhuryTL3Regular2 Nov 2025#3

On the opening post — agreed on the reasoning, with one qualification.

Holding a dose indefinitely: the trials did not study indefinite holding at a non-maximum dose. The trials escalated to a target and then held that. What happens if you stay at an intermediate dose for years is not formally studied and extrapolation is the best available reasoning.

16 likes 9mo

This topic was referenced in

Splitting a weekly dose in two: the pharmacokinetic argument against — the long versionPractice › Dosing & titration · 148 replies
Reaching a dose and staying there for a year: a longitudinal note — does this still hold?Practice › Dosing & titration · 39 replies

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