Titration Schedule

[Yay-Z1]

Would love to hear yall’s criteria for going up in dosage and how frequently y’all are dosing.

For me I’m currently doing every 5 days and it’s working well. I still debate whether to bump up based on 2 week average scale loss or suppression.

Being a science based person, I’m having hard time embracing my feelings

 

[tzmeplz]

Personally, I only bump up if Ive reached a stall for at least a few weeks and nothing else seems to work.

 

[Snakez]

I started the middle of May. I did 2 weeks of 2.5, then went to 5, and have stayed there. I recently switched to Sunday and Wednesday splitting. I'm not sure I feel different. I don't have that lovely appetite suppression I did the first few weeks, but I'm not going to chase that. I weigh daily, and without fail, (except last week on vacation, I gained a tenth of a pound) the number has been lower than the previous week. There is anecdotal evidence that people can build resistance. If you get to 15, and stop making progress, then what? I don't care to be in that situation. I hope to reach my goal before I max out the dose. It's hard to evaluate financially - if you spend more, but lose faster, is that the same as slow and steady and cheaper? I also am up there in age, and while my skin has always previously bounced back from 30-40 pound losses, this time I'm going for 80-90. So far, so good at a nice two pound a week rate. I'm close to halfway to goal, and have started to have hopes that my skin is going to be reasonably okay. All of which is not to say that on days when the scale dies not match my expectations, I don't feel like, okay that's it! Going to 7.5! (Actually I'd probably go to 6 because that odd number bugs the crap out of me!) But I tell myself, just see what it looks like on Sunday, do you weigh less than last Sunday, are your measurements smaller - and so far the answer has been yes.

 

[Yay-Z1]

I started the middle of May. I did 2 weeks of 2.5, then went to 5, and have stayed there. I recently switched to Sunday and Wednesday splitting. I'm not sure I feel different. I don't have that lovely appetite suppression I did the first few weeks, but I'm not going to chase that. I weigh daily, and without fail, (except last week on vacation, I gained a tenth of a pound) the number has been lower than the previous week. There is anecdotal evidence that people can build resistance. If you get to 15, and stop making progress, then what? I don't care to be in that situation. I hope to reach my goal before I max out the dose. It's hard to evaluate financially - if you spend more, but lose faster, is that the same as slow and steady and cheaper? I also am up there in age, and while my skin has always previously bounced back from 30-40 pound losses, this time I'm going for 80-90. So far, so good at a nice two pound a week rate. I'm close to halfway to goal, and have started to have hopes that my skin is going to be reasonably okay. All of which is not to say that on days when the scale dies not match my expectations, I don't feel like, okay that's it! Going to 7.5! (Actually I'd probably go to 6 because that odd number bugs the crap out of me!) But I tell myself, just see what it looks like on Sunday, do you weigh less than last Sunday, are your measurements smaller - and so far the answer has been yes.

I personally want to stay on the lowest effective dose. It’s an easy decision when losing and feeling suppression.

Becomes a little muddy when still losing a little but suppression isn’t as strong

 

[ZippityDooDah]

I switched to a 5-day dosing schedule while still on MJ pens after reading a lot about the half-life before anyone ever mentioned it online.

I did manage to stay on 2.5mg for 2 months before titrating to 5mg (and lost 20 lbs on 2.5), but since then I've pretty much been going up every 4 weeks on schedule as the appetite suppression markedly wanes and the food noise starts to return. I obviously would prefer to stay on the lowest dose possible as long as it keeps working, but I also didn't want to risk losing ground by trying to squeeze every penny out of each vial.

 

[WOLFMAGE]

It's it not a good idea to titrate at small levels? Like go from 2.5 mg to 3mg instead of 5mg?

 

[Pikamom]

I started out at 2.5 mg of triz for 4 weeks. Have been on 5mg since July. I did start .25 of sema in September. So far I feel pretty good on both.

 

[ZippityDooDah]

It's it not a good idea to titrate at small levels? Like go from 2.5 mg to 3mg instead of 5mg?

Everyone is different so you may have to experiment to see what works for you. Obviously they developed the recommended schedule based on trials and with diabetics, but it looks like the weight loss schedule will likely remain the same. My main concern as mentioned in my earlier reply is the chance of losing ground by trying smaller increases and not getting the desired results.

 

[WOLFMAGE]

chance of losing ground by trying smaller increases and not getting the desired results

I hear you there. I'm injecting every other day (with calculating the half life). Right now .8 mg. Continue this 5x then increase to 1 mg. until I see some weight loss. 2 lbs a weeks is ok with me. Doesn't have to be crazy

 

[Yay-Z1]

It's it not a good idea to titrate at small levels? Like go from 2.5 mg to 3mg instead of 5mg?

I moved up in smaller .5 mg increments to avoid the bad side effects I had initially. All has been good

 

[FourthQuintile]

Everyone is different so you may have to experiment to see what works for you. Obviously they developed the recommended schedule based on trials and with diabetics, but it looks like the weight loss schedule will likely remain the same. My main concern as mentioned in my earlier reply is the chance of losing ground by trying smaller increases and not getting the desired results.

The more trials and everything I read (across numerous pharmaceuticals, not just GLP-1s), many dosing protocols seem to lean towards what is most likely to ensure medication adherence. Tirz is a good example of this IMO; based on the half-life of the peptide and the anecdotal reports of many users of both pharma and non-pharma tirz, administration every 5 days seems like the way to go. I personally have administered research tirz as close to every 5 days as I am able to, as I personally believe this is likely optimal. But, pharma tirz is of course dosed for weekly administration, and many of the studies were done with weekly administration. This is most likely because weekly use has been shown to have the highest adherence rates by population broadly for administration. This is important with a medication that was likely expected before trials even began to cause some amount of gastro discomfort very quickly in many users. This approach was backed up by the dropout rate in the early trials, which wasn't extremely high but was higher than other studies I've seen. However, is this the optimal way to administer tirzepatide, presuming complete adherence to whatever protocol this results in by 100% of the population? I personally doubt it. And, while I wouldn't blame anyone for doing what is easiest for them, I personally can adhere to a non-weekly schedule, and based on everything I've read so far, that's what I'm going with.

For me, personally, I started at 1.25mg every 5 days. After 8 doses, I bumped up to 1.66mg every 5 days as I changed vials and had a slight stall in weight loss. I'm through 9 doses at this amount with one more to go before I will have to reconstitute a new vial (I try not to change doses within a vial if at all possible). It's a little tougher to say how this has affected me as I took several extra days between doses twice: once to try to reduce bad ISRs I was having, and once for bloodwork to try to limit how it might affect those results. I had meant to get it done before starting, but best-laid plans and all that. Of course, with every 5 day administration, I'm already not on the pharma recommended schedule, but I also don't plan the 100% dose increase that the pharma one has. This jump seems to be where a lot of those taking tirz have their worst sets of side effects. To me, that indicates that perhaps this degree of a jump in dosage may not be the best way to proceed. These don't seem to reoccur as much with the 5.0-7.5 jump (50%) or the 7.5-10 jump (33%), so perhaps smaller increases may be more optimal in terms of limiting side effect profile. I've personally had zero side effects from tirz related to the tirz itself, only ISRs. I also have the individual approach that I'm not trying to lose all of the weight I want to lose very quickly or on some sort of specific short timeline, so I feel I can increase dosage more slowly. To me, this isn't a race to 15mg weekly, especially with the cost increase involved on reaching that point with research tirz. But, to me, at the end of the day, we are all n=1 making our way through this, trying to figure out what works best for each individual. This is just my n=1 set.