How to Build a GLP-1 Titration Schedule

Step 1: Map Your Dose Ladder

Write out every dose you plan to reach, in order, with the number of weeks at each dose. A standard semaglutide schedule looks like this: 0.25mg for 4 weeks, 0.5mg for 4 weeks, 1mg for 4 weeks, 1.7mg for 4 weeks, 2.4mg maintenance. Tirzepatide has a different ladder: 2.5mg, 5mg, 7.5mg, 10mg, 12.5mg, 15mg, each held 4 weeks minimum.

These are starting points, not rules. Some people stay at 0.5mg for 8 weeks before moving. Some never reach maximum dose and don't need to. Write the schedule as a plan, not a contract.

Step 2: Map Vial Changes to Dose Changes

Vial sizes don't always align neatly with dose steps. A 2mg vial reconstituted with 2mL gives 1mg/mL and covers two 0.25mg weeks or one 0.5mg week. When the dose increases past what a given vial size covers efficiently, you'll need a different vial size, which means a different reconstitution calculation.

The most error-prone moment in any GLP-1 protocol is the first injection from a new vial size. Write the new concentration and draw units in your log before you inject, not after. Recalculate every time. Full calculation guide: How to Track a GLP-1 Protocol.

Step 3: Build In a Step-Back Plan

Nausea or GI distress that makes a dose genuinely unmanageable is not a failure — it is a signal to step back one level. Build this into the schedule before you start: "If side effects at [dose] are severe for more than 3 days, return to [previous dose] for 2 additional weeks."

Writing the step-back rule in advance removes the decision under duress. People who plan for setbacks handle them without abandoning the protocol. People who don't plan for them often stop entirely.

Step 4: Set a Review Point

At week 12, review what's happened versus what you planned. How many dose steps did you complete? How many times did you extend a dose level? What side effects appeared and when? This review tells you whether your titration rate matches your individual tolerance pattern and lets you adjust the second half of the schedule accordingly.

A protocol log from the first 12 weeks contains more useful information than any standard schedule. The schedule is the starting estimate. The log is the actual data.

What to Track at Every Step

Dose in mg. Draw units. Injection site. Weight (weekly, not daily). Side effect notes. Reconstitution date and vial concentration whenever the vial changes. These six data points produce a picture of your titration that is actually interpretable. Anything less and you're navigating by feel.