Understanding Dosing Principles: Start Low, Go Slow & Consistency
GLP-1 RA therapy follows one overriding rule: start low, go slow. Beginning with a small weekly dose lets the body adapt and reduces the odds of nausea, vomiting, or diarrhea that are more common at higher levels.
- Tirzepatide
- Semaglutide
- Retatrutide
Initiation phase (first 4 weeks)
2.5 mg subcutaneous once weekly.
Note: These starter doses mainly condition the gut and rarely deliver full glucose or weight benefits.
Titration (dose escalation)
After week 4 the dose usually rises to 5 mg (first therapeutic level).
Note: Further increases are made in 4-week steps if the patient tolerates the current dose and still needs stronger effect.
Maximum Labeled Doses
Mounjaro®: up to 15 mg weekly.
Note: Not every patient needs—or can tolerate—these ceiling doses.
Adjusting for side effects
If troublesome symptoms appear during titration, a clinician may hold the dose longer or step it back until side effects settle.
Initiation phase (first 4 weeks)
0.25 mg subcutaneous once weekly.
Note: These starter doses mainly condition the gut and rarely deliver full glucose or weight benefits.
Titration (dose escalation)
After week 4 the dose usually rises to 0.5 mg (first therapeutic level).
Note: Further increases are made in 4-week steps if the patient tolerates the current dose and still needs stronger effect.
Maximum Labeled Doses
For diabetes (Ozempic®): up to 2 mg weekly.
For weight management (Wegovy®): up to 2.4 mg weekly.
Note: Not every patient needs—or can tolerate—these ceiling doses.
Adjusting for side effects
If troublesome symptoms appear during titration, a clinician may hold the dose longer or step it back until side effects settle.
Initiation phase (first 4 weeks)
1-2 mg subcutaneous once weekly (extrapolated from clinical trials).
Note: Starting doses are based on extrapolation from phase 2 clinical trial data. Individual response may vary significantly.
Titration (dose escalation)
Increase by 1-2 mg every 4 weeks based on tolerance and effect.
Note: Slower titration may be necessary due to the triple agonist mechanism. Monitor for increased side effects compared to dual or single agonists.
Therapeutic Range
5-15 mg weekly based on available clinical data.
Note: Most clinical trial participants achieved significant results within this range.
Maximum Gray Market Dose
Up to 30 mg weekly available through gray market vendors.
⚠️ WARNING: Doses above 15 mg exceed those tested in published clinical trials. Higher doses carry unknown risks and should be approached with extreme caution. The triple agonist mechanism may produce more severe side effects at high doses compared to single or dual agonists.
Critical Safety Considerations
🚨 EXTREME CAUTION: Retatrutide's triple receptor activation (GLP-1, GIP, and glucagon) creates a more complex side effect profile. Users may experience:
- More pronounced gastrointestinal effects
- Increased heart rate (glucagon effect)
- Greater risk of hypoglycemia when combined with other medications
- Unknown long-term effects from gray market use
Note: Consider starting at the lowest possible dose and titrating very slowly. Medical supervision is especially critical with this experimental medication.
CRITICAL CAVEAT: Medical Supervision Is Essential​
Only a qualified healthcare provider should decide when to start, raise, hold, or lower your dose. The numbers above come from standard product labels and are not a do-it-yourself schedule. Self-setting doses is dangerous, especially with products of uncertain potency (Path C).
Consistency​
Inject on the same day each week to keep drug levels steady. If you must change your injection day, follow the product instructions or ask your provider first.