Speed of titration to maximum dose

[CJsMom]

I found this in a study. Short version - you can titrate Cagri up to maximum dose (2.4mg) in 4 weeks or 16 weeks with no significant difference in gastrointestinal side effects. Of course everyone responds differently so caution is the better part of valor.

“Lau et al.[7] had a faster titration regimen (up-titration to cagrilintide 2.4 mg by four weeks of therapy) compared to the study by Frias et al.[9] (up-titration to cagrilintide 2.4 mg by 16 weeks of treatment). We compared the gastrointestinal side effects among the two studies. The occurrence of gastrointestinal side effects was not significantly different among both the studies (rapid vs. slow up-titration of cagrilintide) [OR 2.08 (95% CI: 0.89, 4.88); P = 0..”

Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC11642503/
It’s in the section on safety.

I still plan to take it slow as 0.25mg definitely had an effect on my RS’s desire to eat. I may not titrate any higher.

 

[JustMakeItHappen]

So max dose is 2.4 mg a week? Interesting..

 

[Abrakebabra]

As with many things in life, just because you can, doesn't mean you should.

 

[JustMakeItHappen]

Clinical Trial Dosing (Published, Phase 2 & 3)

• In the Phase 2 dose-finding trial, weekly cagrilintide was tested at multiple dose levels: 0.3 mg, 0.6 mg, 1.2 mg, 2.4 mg, and 4.5 mg. The 4.5 mg/week arm was the highest dose studied in that trial and showed dose-dependent weight loss.
• For Phase 3 development (REDEFINE / CagriSema program), the maintained and selected dose has been 2.4 mg once weekly (often combined with semaglutide 2.4 mg in the CagriSema regimen).

So it’s 4.5mg weekly on its own, or 2.4mg when stacked with Sema.

 

[lessthanhalf]

The rates of nausea and vomiting from cagri were quite high, and from this forum fatigue is common as well even at very low doses, So rapid increases with high rates of nausea and vomiting does not sound very appealing. Titrating more slowly does not necessarily stop you from getting side effects, but usually you are going to get some indication , maybe a bit of nausea at one dose to suggest that increasing it straight away might not be a good idea, as well as effects on appetite can be used to guide increases in dose. It is possible to slowly increase doses and have no side effects, then suddenly get hit with severe nausea or vomiting with a dose increase, but I do not think it is the most common experience. I do not know how adjustable the dose increases were in the study, they usually have pretty rigid schedules, rather than adjusting based on side effects or effects or waiting to increase doses etc. But the main advantage of more flexible titration is adjusting it based on existing effects and side effects.

 

[domin8brix]

Oh my god. .5 almost took me out. .33 is still kicking my ass. I would DIE if I went up that high or that fast.

 

[JustMakeItHappen]

Oh my god. .5 almost took me out. .33 is still kicking my ass. I would DIE if I went up that high or that fast.

I’ve run 1.5 along side 4-5 mg Reta before and I was pretty buckled 😂😂

 

[domin8brix]

 

[cloratheshadow]

As others have stated 2.4 is max dose but definitely be careful. Unless you just do not feel it I wouldn’t go up in dose. I went from .5 to .8 and it was pretty intense.