Every GLP-1 medication starts at a low dose and gradually increases over weeks or months. This process—called titration—isn't optional. Here's why it matters and what to expect at each stage.
Why Titration Is Essential
Starting at full dose would cause severe side effects in most people:
- GI tolerance — Your digestive system needs time to adapt
- Nausea management — Gradual increases minimize nausea
- Side effect monitoring — Allows identification of problems early
- Finding optimal dose — Some people do well on lower doses
Standard Titration Schedules
Ozempic (Semaglutide for Diabetes)
| Weeks | Dose | Purpose |
|---|---|---|
| 1-4 | 0.25 mg | Initial tolerance |
| 5-8 | 0.5 mg | Building up |
| 9+ | 1 mg | Maintenance (can go to 2 mg) |
Wegovy (Semaglutide for Weight Loss)
| Weeks | Dose |
|---|---|
| 1-4 | 0.25 mg |
| 5-8 | 0.5 mg |
| 9-12 | 1 mg |
| 13-16 | 1.7 mg |
| 17+ | 2.4 mg (maintenance) |
Mounjaro/Zepbound (Tirzepatide)
| Weeks | Dose |
|---|---|
| 1-4 | 2.5 mg |
| 5-8 | 5 mg |
| 9-12 | 7.5 mg |
| 13-16 | 10 mg |
| 17-20 | 12.5 mg |
| 21+ | 15 mg (maximum) |
What to Expect During Titration
Early Weeks (Lowest Dose)
You may notice mild appetite reduction but don't expect dramatic weight loss yet. Some nausea is common but usually manageable. This phase is about adjustment.
Each Dose Increase
Side effects often temporarily return or worsen when you increase the dose. This usually settles within 1-2 weeks. Appetite suppression typically increases with each step.
Maintenance Dose
Once you reach your maintenance dose, effects stabilize. Weight loss continues but may slow compared to the initial rapid phase. Side effects typically diminish.
Don't Skip Titration Steps
It's tempting to move faster, especially when side effects are mild. But skipping steps increases the risk of severe nausea, vomiting, and other complications that might force you to stop treatment entirely. Patience during titration leads to better long-term outcomes.
When Titration Can Be Modified
Your doctor may adjust the schedule if:
- Side effects are severe — May stay at current dose longer before increasing
- Minimal response — May increase sooner if tolerating well with no effect
- Good results at lower dose — May not need to reach maximum dose
- Switching medications — May start higher if transitioning from another GLP-1
Official Summary
Titration isn't about delaying your weight loss—it's about setting you up for success. Rushing the process increases side effects and dropout rates. Trust the established schedules, communicate with your provider about how you're feeling, and know that the full effects will come with time.