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ForumsDosing & ProtocolsTirzepatide 7.5mg — what worked for you?

Tirzepatide 7.5mg — what worked for you?

tane_welly Fri, Mar 6, 2026 at 1:30 AM 13 replies 819 viewsPage 1 of 3
tane_welly
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Mar 6, 2026 at 1:30 AM#1

I moved from semaglutide to tirzepatide after a long stall and the first eight weeks looked like starting over — which I gather is the usual pattern rather than a lucky one.

The question I want answered is how much of the tirzepatide advantage is the GIP component and how much is simply that the dose ladder goes higher in receptor-occupancy terms.

Not looking for reassurance. Looking for the part I have got wrong.

14 9GraceAZ_72, carl_compliance, DanielChem_CHI and 11 others
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mike_nyc
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Mar 6, 2026 at 3:01 AM#2

Short answer first, then the reasoning. Steady state is faster than people expect: half-life about five days, so you are at plateau in roughly three to four weeks rather than five. That matters when you are deciding whether a dose step has finished expressing itself.

Last edited: Mar 6, 2026 at 7:01 AM
13 8stefan_berlin, Dr.EM_Chicago, pete_RVA and 10 others
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LipidDoc_ATL
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Mar 6, 2026 at 4:32 AM#3
mike_nyc said:
Steady state is faster than people expect: half-life about five days, so you are at plateau in roughly three to four weeks rather than five.

True, though the ladder is longer and that is not a neutral detail — six dose steps means six opportunities to stall on the way up, and plenty of people never reach the dose the headline number came from.

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sean_dublin
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Mar 6, 2026 at 6:03 AM#4
tane_welly said:
I moved from semaglutide to tirzepatide after a long stall and the first eight weeks looked like starting over — which I gather is the usual pattern…

This matches mine closely enough to be worth saying so. SURMOUNT-1 landed around 20.9% mean weight loss at 15mg over 72 weeks, against roughly 15% for semaglutide 2.4mg in STEP 1. Different trials, different populations, so the comparison is indicative rather than decisive — but SURPASS-2 was a genuine head-to-head and it pointed the same way.

Last edited: Mar 6, 2026 at 7:03 AM
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Dr.GastroMayo
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Mar 6, 2026 at 2:55 PM#5

From the other side of the consultation, briefly.

Dose-response modeling for tirzepatide: Emax model fitting to the STEP/SURMOUNT dose-finding data shows:

Semaglutide: ED50 ≈ 0.6mg, Emax ≈ -18%, Hill coefficient ≈ 1.3
Tirzepatide: ED50 ≈ 6mg, Emax ≈ -25%, Hill coefficient ≈ 1.5

Clinical implication: most patients achieve >80% of maximal response by the mid-range dose (1.7mg sema, 10mg tirz). Going to the maximum dose provides diminishing returns — possibly not worth the additional side effect burden for some patients. Individualize dosing based on response vs tolerability.

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