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#dosing-titration 2025-04-27

Sunday47 messages10 participantstimes are UTC
Highlights from this day
  • month_six_me — slightly off topic but came down from a treatment dose to maintenance over about three months and it was uneventful i drifted from sunday to wednesday over a year and… 20:08
  • retention_time — i went up too fast and im paying for it, do i drop back or ride it out 21:52
  • retention_time — the people who do best here are almost always the ones going slowest 22:22

anyone here split their weekly into two and would they do it again

PT

if i took it 5 days late do i shift the schedule or go back to the old day

update from 9 months ago: held at the same dose the whole time and still losing slowly, ymmv

the ladder in the trials is a starting point, not a schedule you owe anyone, i have it written down somewhere

MS

slightly off topic but came down from a treatment dose to maintenance over about three months and it was uneventful
i drifted from sunday to wednesday over a year and only noticed when i checked the log

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genuine question if the current dose is still working, going up is spending headroom you might want later

*VendorInvestigate not the other one

after a gap of more than about three weeks i restart one rung lower. thats my own rule, not advice

two weeks is nothing

RT

if it "stopped working after four days" that is almost never pharmacokinetics

MM

i escalate on symptoms. if the current dose is still doing something i stay on it, not advice obviously

TT

plateau versus set point is not answerable in under six months of data, anyway

VB

Reminder for dark_for_ten_days: dose day is today. Set 6 days ago.

TC

with a roughly seven day half-life you are near steady state after about five weeks at a dose

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TT

you do not have to escalate at all. that is a real option that gets forgotten, still working it out

WV

if you are asking whether to go up, the fact you are asking usually means not yet

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pick a day and stick to it

TT

if i hold at 0.5 indefinitely am i losing anything

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T5

is it normal for appetite to come back at the end of the week

[edited]

is week 22 too early to be thinking about the next step

RT

i went up too fast and im paying for it, do i drop back or ride it out

Trial scheduleWhat most people here do
Step interval4 weeks, fixed4-12 weeks, on symptoms
Holdingprotocol deviationnormal and expected
Top dosereached by designoften never reached
Coming downnot studiedcommon at maintenance
VB

Inter-lab diff for lot KP-0925: 99.4% vs 99%. Within expected range.

DF

appetite returning at the end of the week is extremely common and is not the dose failing

Cited study
Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1)
New England Journal of Medicine · 2022
72 weeks, tirzepatide 5, 10 and 15mg against placebo.

the honest answer is that most of us are running protocols nobody has ever studied

the argument for splitting is a flatter curve. the argument against is you have doubled your injections for a guess

too early imo

stepping back down on purpose is a completely reasonable move and this channel should say so more often

RT

whats the longest anyone has stayed on one dose

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the people who do best here are almost always the ones going slowest

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MS

the trials escalated on a fixed schedule because a trial has to. you are not a trial, someone check my working

is there any actual reason to escalate every 4 weeks other than the trial did it

how long did you hold at 2 before you moved up

MS

dose day drift is mostly harmless with a weekly compound, but pick a day and defend it