Dosing & titration schedule
GLP-1 medications are almost always started low and then increased step by step, usually every four weeks. This is called titration and it limits side effects such as nausea. The schedules below are indicative (source: the Farmacotherapeutisch Kompas and the EMA); your doctor determines the final schedule and the maintenance dose.
Why increase the dose step by step?
With a GLP-1 medication you begin with a low starting dose that does not yet have the full effect. This lets the body get used to the medication gradually. By moving up a step every ±4 weeks, the chance of side effects such as nausea, vomiting or diarrhoea stays smaller. After the build-up comes a maintenance dose that is kept for a longer period.
Indicative titration schedules
The schedules below are general, indicative guidance based on the Farmacotherapeutisch Kompas and the EMA product information. The steps, pace and final dose can vary from person to person.
| Product | Start | Increase | Maximum |
|---|---|---|---|
| Mounjaro (tirzepatide) | 2.5 mg/week | +2.5 mg every ±4 wks | 15 mg/week |
| Ozempic (semaglutide) | 0.25 mg/week | step by step every ±4 wks | 2 mg/week |
| Wegovy (semaglutide) | 0.25 mg/week | step by step every ±4 wks | 2.4 mg/week |
The starting dose (for example 0.25 mg semaglutide) is an introductory dose to get used to the medication and is not yet the maintenance dose. The doctor determines which schedule suits you and whether the final dose is reached.
Dose and price
The dose often affects the price: a higher maintenance dose or a stronger pen can be more expensive than a lower one. Because most people use different strengths during the build-up, the monthly cost can vary. You can find a factual overview on cost and information about any reimbursement on reimbursement.
Frequently asked questions
Why do I start with a low dose?
How long does the build-up take?
Does the dose affect the price?
Official sources on this topic
Independent, authoritative information from official bodies: