GLP-1 Dosing Hub: Every Dose, Schedule, and Titration Protocol
Your complete reference for GLP-1 medication dosing. From starting doses through maintenance, including titration schedules, dose adjustments, and what to do when you miss a dose.
Medical Disclaimer: Dosing decisions should always be made by your healthcare provider. Do not adjust your dose without medical guidance. This information is for educational reference only.
Getting the dose right is one of the most important factors in GLP-1 treatment success. Too low and you will not see results; too high and side effects may become unbearable. This hub covers dosing for semaglutide, tirzepatide, and retatrutide.
Semaglutide Dosing (Ozempic / Wegovy)
Standard Titration Schedule
| Period | Dose | Duration | Purpose |
|---|---|---|---|
| Month 1 | 0.25mg | 4 weeks | Initial tolerance building |
| Month 2 | 0.5mg | 4 weeks | Continued adjustment |
| Month 3 | 1.0mg | 4 weeks | Therapeutic dose begins |
| Month 4 | 1.7mg | 4 weeks | Increased efficacy |
| Month 5+ | 2.4mg | Ongoing | Maximum approved dose (Wegovy) |
Key notes: Not all patients need to reach 2.4mg. If you are achieving target weight loss (1-2 lbs per week) at a lower dose with acceptable side effects, your provider may keep you there. The Ozempic dosing for diabetes maxes at 2.0mg.
Tirzepatide Dosing (Mounjaro / Zepbound)
Standard Titration Schedule
| Period | Dose | Duration | Purpose |
|---|---|---|---|
| Month 1 | 2.5mg | 4 weeks | Initial tolerance building |
| Month 2 | 5mg | 4 weeks | First therapeutic dose |
| Month 3 | 7.5mg | 4 weeks | Increased efficacy |
| Month 4 | 10mg | 4 weeks | Enhanced weight loss |
| Month 5 | 12.5mg | 4 weeks | Higher efficacy |
| Month 6+ | 15mg | Ongoing | Maximum approved dose |
Key notes: Tirzepatide has more dose steps than semaglutide, allowing finer adjustment. Many patients achieve excellent results at 5mg or 7.5mg without needing the maximum dose. At $125/mo through Trimi, the cost remains the same regardless of dose.
Retatrutide Dosing
Retatrutide is a triple agonist (GLP-1/GIP/glucagon receptor). Clinical trial dosing has used monthly titration starting at 1mg and increasing to 4mg, 8mg, or 12mg. As a newer medication, dosing protocols are still being refined. Your provider will follow the latest evidence-based protocols.
Titration Best Practices
Tips for Smooth Titration
- Do not rush: If side effects are significant at your current dose, stay at that dose for an additional 2-4 weeks before increasing
- Communicate with your provider: Report significant nausea, vomiting, or other side effects before the next dose increase
- Eat before your injection: Some patients tolerate injections better when they have eaten a small meal
- Inject at the same time: Consistency helps your body adjust. Many patients prefer evening or bedtime injection
- Track your response: Note weight, appetite, side effects, and energy each week to share with your provider
When to Adjust Your Dose
Reasons to Consider a Higher Dose
- Weight loss has stalled for 4+ weeks at current dose
- Appetite suppression is minimal
- You are tolerating the current dose well with few side effects
- You have not yet reached a therapeutic dose
Reasons to Consider a Lower Dose or Staying Put
- Persistent, significant side effects (especially nausea or vomiting)
- You are losing weight at a healthy pace (1-2 lbs/week)
- Difficulty eating enough to meet nutritional needs
- You have reached your goal weight and want to transition to maintenance
Missed Dose Protocols
Semaglutide
If your next scheduled dose is more than 2 days away, take the missed dose as soon as you remember. If it is within 2 days of your next dose, skip it and resume your regular schedule.
Tirzepatide
If within 4 days of the missed dose, take it right away. If more than 4 days have passed, skip it and take the next dose on your regular day.
Injection Technique
- Sites: Abdomen (2 inches from navel), front of thigh, or back of upper arm
- Rotation: Rotate sites each week to prevent lipodystrophy
- Temperature: Allow refrigerated medication to sit at room temperature for 15-30 minutes before injection
- Angle: 90-degree angle for subcutaneous injection
- Duration: Hold the pen in place for 10 seconds after injection to ensure full dose delivery
Maintenance Dosing
Once you reach your goal weight, your provider may recommend a lower maintenance dose. The goal is the minimum dose that prevents significant weight regain while minimizing side effects and cost. Not all patients need to stay on the maximum dose long-term.
Frequently Asked Questions
Why do GLP-1 medications require dose titration?
Gradual dose increases allow your body to adjust to the medication, significantly reducing gastrointestinal side effects like nausea and vomiting. Starting at a low dose and increasing every 4 weeks minimizes discomfort while building toward effective therapeutic levels.
What happens if I miss a dose of my GLP-1 medication?
For weekly injections: if you miss by fewer than 5 days (semaglutide) or 4 days (tirzepatide), take it as soon as you remember and resume your regular schedule. If more time has passed, skip the missed dose and take the next one on your regular day. Never double up doses.
Can I stay on a lower dose if it is working for me?
Yes. If you are losing weight steadily and tolerating a lower dose well, many providers will keep you there. The goal is the lowest effective dose that produces adequate results with manageable side effects. Higher doses are not always better.
Do compounded GLP-1 medications use the same doses as brand-name?
Compounded semaglutide and tirzepatide use the same active ingredients and follow similar titration schedules. Your Trimi provider will customize your dosing based on your response, just as with brand-name medications. The advantage of compounded formulations is sometimes more flexible dosing increments.
Personalized Dosing with Trimi
Our clinicians customize your titration schedule based on your response. Compounded semaglutide from $99/mo or tirzepatide from $125/mo — same price at every dose level.
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Sources & References
- Wilding JPH et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. NEJM 2021;384:989-1002.
- Jastreboff AM et al. Tirzepatide Once Weekly for the Treatment of Obesity. NEJM 2022;387:205-216.
- Lincoff AM et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. NEJM 2023;389:2221-2232.
- FDA Prescribing Information for Wegovy (semaglutide) and Zepbound (tirzepatide).