Understanding dose escalation

Why does my dose start low?

GLP-1 medications are always started at a low dose and increased slowly over several weeks or months. This is called dose escalation or titration.

The reason is straightforward: side effects (especially nausea and digestive discomfort) are much more common when the dose increases too quickly. Starting low gives your body time to adapt to the medication's effects.

Typical escalation pattern

Escalation schedules vary by medication and by individual prescriber guidance. As a general illustration:

Weekly semaglutide (e.g. Wegovy)

• Starting dose: 0.25 mg weekly for 4 weeks
• Gradually increased every 4 weeks
• Maintenance dose: typically 2.4 mg weekly (reached around week 17–20)

Weekly tirzepatide (e.g. Mounjaro / Zepbound)

• Starting dose: 2.5 mg weekly for 4 weeks
• Increased by 2.5 mg every 4 weeks
• Maintenance dose: 5–15 mg weekly, as guided by your prescriber

Daily liraglutide (e.g. Saxenda)

• Starting dose: 0.6 mg daily for 1 week
• Increased by 0.6 mg each week
• Maintenance dose: typically 3.0 mg daily (reached around week 5)

Important: These are general examples only. Follow your prescriber's specific instructions for your medication and dose.

What happens when my dose increases?

Each time your dose goes up, you may experience a temporary return of mild side effects — particularly nausea. This is normal. Your body needs 1–2 weeks to adjust to each new dose level.

What if I can't tolerate a dose increase?

Some people need to stay at a lower dose for longer before moving up. This is a normal part of the process. Discuss with your prescriber if you are struggling — dose escalation is not a race.

Will I always be on the highest dose?

Not necessarily. The goal is to find the dose that gives you the right balance of effect and tolerability. Some people do well at a lower maintenance dose.

General information note

Dosing schedules mentioned in this guide are general examples for educational purposes only. Always follow your prescriber's specific instructions. Do not adjust your dose without speaking with your healthcare provider.