Scheduling, administration, biomarkers, and practical guidance.
Step up at 4-week intervals (0.5, 1.0, 1.7, 2.4 mg) as GI tolerance allows. Target maintenance 1.0–2.4 mg weekly. Slow titration is the primary tool for managing nausea and vomiting.
Step up by 2.5 mg every 4 weeks (5, 7.5, 10, 12.5, 15 mg) as tolerance allows. Switching from semaglutide: start at 2.5 mg regardless of prior semaglutide dose.
Not FDA-approved at time of writing. Dosing schedules are defined by trial arms; no standardised outpatient protocol exists.
Absorption depends on strict fasting window. Any food or other medication within 30 minutes degrades bioavailability significantly.
Investigational — not approved at time of writing. Doses reflect current trial protocols.
Emerging clinical strategy for long-term maintenance. Not yet validated in large trials. Clinician-supervised only.
Emerging alternative to continuous high-dose therapy. Rebound risk remains — monitor weight closely during the step-down period.
Standard before new peptide trial participation. For clinical practice, shorter gaps are common when switching between incretin agonists under supervision.