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ForumsDosing & ProtocolsTirzepatide titration: 2.5→5→7.5→10→12.5→15mg guide Page 2

Tirzepatide titration: 2.5→5→7.5→10→12.5→15mg guide

Dr.Martinez Mon, Feb 19, 2024 at 5:20 PM 181 replies 34,127 viewsPage 2 of 20
VendorMark
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Feb 20, 2024 at 6:25 AM#6

The figures, for anyone assembling their own picture. Practical numbers: half-life about 5 days, steady state 3 to 4 weeks, ladder 2.5 / 5 / 7.5 / 10 / 12.5 / 15mg, and the maintenance doses with published data behind them are 5, 10 and 15mg.

If somebody has the primary source to hand I would rather cite it than paraphrase it.

Last edited: Feb 20, 2024 at 8:25 AM
1 21DebRD_ATL
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CanadaChris
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Feb 20, 2024 at 11:35 AM#7

Following on from chris_chi24 — and this may be the naive question:

How much of the tirzepatide advantage is the GIP component and how much is simply that the dose ladder goes higher in receptor-occupancy terms?

Last edited: Feb 20, 2024 at 5:35 PM
50 20stefan_berlin, Dr.EM_Chicago, pete_RVA and 47 others
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Dr.PathRoch
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Feb 20, 2024 at 4:45 PM#8
VendorMark said:
Practical numbers: half-life about 5 days, steady state 3 to 4 weeks, ladder 2.5 / 5 / 7.5 / 10 / 12.5 / 15mg, and the maintenance doses with…

There is a second half to this that has not been said yet. The GIP arm is doing real work rather than padding the label. GIP receptor agonism appears to improve adipose insulin sensitivity and lipid handling, and — counter-intuitively — GIP signalling in the CNS reduces nausea rather than adding to it, which is why tolerability at high total agonism is better than the GLP-1-only comparison would predict. SURPASS-2 is the cleanest head-to-head: tirzepatide beat semaglutide 1mg at every dose tier.

49 19WendyG_ATL, SaraMom3, Dr.MetabolicMD and 46 others
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Dr.Martinez
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Feb 20, 2024 at 9:56 PM#9

Closing the loop on my own question.

I stayed at 10mg. Another six months, another 7kg, no new side effects, and my reading of the dose-response says the last two steps were never going to be worth what they cost me.

48 18Dr.SurgeonPGH, rachel_ABQ, traveltech_sara and 45 others
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newstart_MO
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Feb 21, 2024 at 10:47 PM#10
Dr.PathRoch said:
The GIP arm is doing real work rather than padding the label.

True, though the ladder is longer and that is not a neutral detail — six dose steps means six opportunities to stall on the way up, and plenty of people never reach the dose the headline number came from.

40 15RunnerRach, TrialNerd_Beth, HPLC_Greg and 37 others
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