What is the GLP-1 titration schedule?

When you start taking a glucagon-like peptide-1 receptor agonist (GLP-1) like Wegovy or Ozempic, your doctor will determine your dosage. You’ll usually start on the lowest possible dose, which is then gradually increased over time. This is a process known as titration.

GLP-1s are often tough on your digestive system, associated with side effects like nausea, vomiting, and diarrhea. Starting at a low dose and slowly increasing it can help your body adjust to the medication over time, without the side effects becoming unmanageable.

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What is GLP-1 titration?

Titration is a standard part of a GLP-1 journey, designed to help you find a dose of the medication that has the maximum effectiveness without too many severe side effects.

You will usually start by taking the lowest dosage. You might not notice any changes in your weight or blood sugar at first, as the initial dosage is intended to help your body get used to the medication. You will likely notice gastrointestinal side effects at first that go away over the course of the first few weeks.

Your doctor will then increase your dosage regularly, typically every 4 weeks, until the desired effect is reached. This may be at the maximum dosage, but if you experience severe side effects at the highest dosage, your doctor may decide to keep you at a lower level.

Learn more about what to expect in the first month of GLP-1 treatment.

Example titration schedules

While every person is different, most GLP-1s for weight loss follow a structured step-up dosing schedule.

• Wegovy:
  • Usually, Wegovy injections start at 0.25 milligrams (mg) given once weekly, increasing every 4 weeks through doses of 0.5 mg, 1.0 mg, and 1.7 mg, and eventually reaching a maintenance dose of 2.4 mg.
  • For the oral tablet form of Wegovy, the starting dose is 1.5 mg once per day for 30 days. Then it increases to 4 mg once daily for 30 days, to 9 mg once daily for 30 days, and finally to a maintenance dose of 25 mg once daily.
• Zepbound: Generally begins at 2.5 mg once weekly, with the potential to increase by 2.5 mg every 4 weeks until reaching an effective maintenance dose of 5 to 15 mg.

Next steps

If you have any concerns about your GLP-1 titration schedule, you can speak with the prescribing doctor. Consider keeping track of your side effects so that you know whether you’re ready to increase to the next dose.

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