Titration

Titration (or dose escalation) is the planned, gradual increase from a low starting dose of a GLP-1 medication to the full treatment dose. You don’t start at the dose that produces the headline trial results — you climb to it.

Typical schedules

• Wegovy (semaglutide): 0.25 mg → 0.5 mg → 1 mg → 1.7 mg → 2.4 mg, stepping up every 4 weeks.
• Zepbound (tirzepatide): starts at 2.5 mg for 4 weeks, then 5 mg, with optional steps through 7.5 mg, 10 mg, and 12.5 mg up to 15 mg.

The exact path is individual: prescribers commonly hold a dose longer if side effects are rough, or stop climbing at a middle dose that’s working. Staying longer at a lower step is normal treatment, not failure.

Why so slow

The starting doses aren’t expected to do much for weight — they exist to let your gastrointestinal system adapt. Nausea and other GI side effects cluster around dose increases; the slow ramp is the main tool for keeping them tolerable. This is also why side-effect timing is worth logging: “nausea for three days after each step-up, then fine” and “nausea all month” are very different messages to bring to your prescriber.

Related terms

The dose you settle at long-term is your maintenance dose. Side effects during titration are the most common reason people adjust their shot day routine or eating pattern.