If you started a weekly GLP-1 and felt a jolt of doubt when you saw your dose, you're in good company. A GLP-1 starting dose is meant to be low, and the strength you're on today is often one rung on a planned ladder rather than the final destination. Here's how that ladder is built in US labeling, who signs off on each step, and what to do when the schedule gets interrupted.
Why a GLP-1 starting dose is meant to be low, who decides each step-up, and what to do when your dosing schedule breaks.
Why the Starting Dose Is Deliberately Low
Starting low is a tolerability strategy. Nausea, vomiting, and early stomach discomfort are the side effects most people notice first, and a slow ramp gives your body time to adjust before the dose climbs. The starting step is not the dose that does most of the work for most people. It is a ramp.
The step-up schedules in the prescribing information were set in clinical trials, and they remain the reference point for your prescriber. For several products people ask about most, the US label language looks like this:
- Wegovy (semaglutide): 0.25 mg once weekly for 4 weeks, then escalation no sooner than every 4 weeks.
- Zepbound (tirzepatide): 2.5 mg once weekly for 4 weeks, then increases in 2.5 mg steps no sooner than every 4 weeks.
- Ozempic (semaglutide): 0.25 mg once weekly for 4 weeks, then 0.5 mg.
- Saxenda (liraglutide): 0.6 mg once daily, increased at intervals of at least one week toward a maintenance dose of 3 mg.
Labels get revised, so the insert that came with your pen and the current version on DailyMed may not match. When in doubt, read the newest document.
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