GLP-1 Dose Titration Schedule Calculator

Side effects (nausea, vomiting, GI distress) are dose-dependent. Starting at maintenance dose causes severe symptoms - 40-60% of patients would discontinue. The 4-week titration protocol ramps slowly so the gut adapts. Wegovy: 0.25 → 0.5 → 1.0 → 1.7 → 2.4mg over 16 weeks. Zepbound: 2.5 → 5 → 7.5 → 10 → 12.5 → 15mg over 20 weeks. Skipping doses ahead is dangerous - stay or step down if symptoms severe.

List prices 2026: Wegovy ~$1,350/month, Zepbound ~$1,000, Ozempic ~$900, Mounjaro ~$1,000. With commercial insurance + manufacturer copay savings (Novo Save Card, Lilly Card), out-of-pocket can be as low as $25-$650/month. Medicare does NOT cover GLP-1s for weight loss as of 2026. Cash-pay direct from Lilly: Zepbound vials $349-$499/month (lower-dose only). Compounded versions ~$200-$400 but FDA scrutiny + safety concerns.

Standard protocol: stay at current dose for 8 weeks (instead of 4) before increasing, OR step BACK one dose level temporarily. About 5-15% of patients can't tolerate the maintenance dose and stay on lower doses long-term - weight loss is reduced (~7-12% at lower doses vs 15-20% at max) but still meaningful. Severe vomiting, dehydration, or pancreatitis symptoms warrant immediate medical consultation. NEVER skip doses ahead to "catch up."

For most patients, yes - to maintain weight loss. STEP-4 trial: patients who stopped semaglutide regained ~two-thirds of lost weight within 1 year. Lifestyle changes (diet, exercise, behavioral therapy) maintained during treatment substantially reduce rebound risk. Some patients on maintenance doses indefinitely, but as drug class matures, "off-ramping" protocols (gradual taper + intensive lifestyle support) may emerge. Always work with prescriber on discontinuation plans.