Titration: Stepping a Dose Up Over Time, Explained
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[Glossary · How doses act in the body]

Titration (dose escalation)

Also called titration, dose escalation, titrating up, step-up dosing · Reviewed

Definition: Titration means adjusting a dose in planned steps, usually starting low and going up, until a target or best-tolerated dose is reached. Each step is held for a set time before the next.

Why it matters when you track doses

Titration is why the dose on a GLP-1 changes every month at first. The Wegovy label says to follow its schedule to reduce the risk of stomach side effects, and to consider delaying the next step by 4 weeks if a dose is not tolerated.

Each step is a new dose, and the body needs time to settle at it (see steady state). The Mounjaro label also tells people on birth control pills to use a non-oral method or add a barrier method for 4 weeks after starting and for 4 weeks after each dose increase. Knowing the date of every step matters.

Step-up schedules on the current US labels (injection).
ProductStartStepsTime at each step
Wegovy (semaglutide)0.25 mg weekly0.25, 0.5, 1, 1.7, then 2.4 mg4 weeks
Mounjaro (tirzepatide)2.5 mg weeklyUp by 2.5 mg, to a maximum of 15 mgAt least 4 weeks

Worked example: counting the weeks

Earliest week each label dose is reached

  1. Wegovy: 0.25 mg weeks 1-4, 0.5 mg weeks 5-8, 1 mg weeks 9-12, 1.7 mg weeks 13-16. The 2.4 mg dose starts in week 17.
  2. Mounjaro: 2.5 → 5 → 7.5 → 10 → 12.5 → 15 mg is 5 steps up. With 4 weeks at each of the first 5 doses, that is 5 × 4 = 20 weeks, so 15 mg is reached no sooner than week 21.
  3. A delayed step pushes everything after it back by the length of the delay.

Label figures are for the branded products. The Wegovy label lists both 1.7 mg and 2.4 mg as maintenance doses for weight reduction, so the top step is not the only end point.

Read more on Dose Track: Wegovy guide · Mounjaro guide · Semaglutide vs tirzepatide

General education drawn from labels and published studies, not personal medical advice. Your prescriber, pharmacist and the label that came with your product are the final word.
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Frequently asked questions

Why do GLP-1 doses start low?+
The Wegovy label says the step-up schedule is there to reduce the risk of stomach side effects. Starting low gives the body time to adjust.
What if I cannot tolerate the next step?+
The Wegovy label says to consider delaying the step by 4 weeks. Talk to your prescriber before changing the plan.
Is titration the same as a loading dose?+
No, it is close to the opposite. A loading dose starts high to reach levels fast; titration starts low and works up.

Sources

  1. Wegovy (semaglutide) US prescribing information, sections 2 and 12.3, DailyMed
  2. Mounjaro (tirzepatide) US prescribing information, sections 2.1, 7.2 and 12.3, DailyMed

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