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ForumsDosing & ProtocolsWhen to hold at a dose vs continue titrating — my results so far Page 2

When to hold at a dose vs continue titrating — my results so far

Dr.BariatricHTX Mon, Nov 11, 2024 at 8:05 PM 18 replies 1,996 viewsPage 2 of 4
Dr.GastroMayo
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Nov 12, 2024 at 3:39 AM#6
RetaRick_CA said:
The trials generally allowed a step to be held or reduced and then retried, and people who did that mostly arrived at the same place a few weeks…

I disagree that the ladder is purely tolerability. The maintenance and regain data cluster at the top doses, so a ladder abandoned halfway leaves you outside the evidence base for the part that matters most — keeping it off.

2 22mike_nyc, VendorMark
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DataDave
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Nov 12, 2024 at 6:38 AM#7
Dr.BariatricHTX said:
I titrated faster than the label because I felt fine, hit a wall at the third step, and had to come back down — which I now think was the predictable…

Dose escalation anxiety for titration: I was terrified to move from 0.5mg to 1.0mg based on horror stories in this forum. But my actual experience? Slightly more appetite suppression, zero additional side effects.

Remember that the people posting about terrible side effects are a biased sample. Most people titrate up without drama — they just don't post about it because it's uneventful.

1 21mike_nyc
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PharmHunterJen
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Nov 12, 2024 at 9:37 AM#8
Dr.GastroMayo said:
I disagree that the ladder is purely tolerability.

Coming at Dr.GastroMayo’s question from a different direction. Most of what circulates confidently in this community traces back to one summary of one study, and the qualifier was dropped somewhere in the third retelling.

50 20kevin_tulsa, Dr.PainCLE, mike_mealprep and 47 others
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kevin_tulsa
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Nov 12, 2024 at 12:36 PM#9

Following on from fiona_VT — and this may be the naive question:

What the trials actually did with participants who could not tolerate a step, because that is the situation I am in and the protocol summaries skip it?

49 19quinn_sf, NurseLeah_Nash, gary_naperville and 46 others
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Dr.BariatricHTX
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Nov 13, 2024 at 2:55 AM#10

OP back with an update, since a thread like this is useless without one.

Closing this out: I held the step for six weeks rather than four and it settled without a dose change. The interval was the answer, not the dose.

Last edited: Nov 13, 2024 at 8:55 AM
35 8maya_sedona, stefan_berlin, Dr.EM_Chicago and 32 others
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