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ForumsSemaglutide (Ozempic / Wegovy)Heart rate increase on sema — when to worry vs normal physiology Page 2

Heart rate increase on sema — when to worry vs normal physiology

Dr.RaviCardio Thu, Apr 9, 2026 at 10:07 AM 7 replies 593 viewsPage 2 of 2
FDA_TrackerJim
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Apr 9, 2026 at 11:18 PM#6

Adding the numbers, since they settle part of this. Worth knowing that the injection site changes very little. Abdomen, thigh and upper arm are bioequivalent for semaglutide, so a site change is not a plausible explanation for a bad week.

That is the short version; the long version is somebody else's post.

25 20Dr.Martinez, mike_mod, SarahChen_PharmD and 22 others
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tammy_FL
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Apr 10, 2026 at 4:31 AM#7

One thing that is still open after PharmD_Rodriguez’s answer:

Whether anyone has held at a sub-maximal dose long term and kept the result, or whether the maintenance data only exists at 2.4mg?

24 19alex_tucson, kevin_tulsa, Dr.PainCLE and 21 others
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GenomicsKate
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Apr 10, 2026 at 9:44 AM#8
FDA_TrackerJim said:
Worth knowing that the injection site changes very little.

Coming at FDA_TrackerJim’s question from a different direction. Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak. People who dose late are not losing a peak, they are letting the trough fall, and the appetite effect tracks the trough.

23 18MarkLI_maint, Dr.PeteFamMed, claudia_zurich and 20 others
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Dr.RaviCardio
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Apr 10, 2026 at 2:57 PM#9

OP back with an update, since a thread like this is useless without one.

Six weeks on from posting: I stopped reading the weekly number and started reading a four-week average, and the "stall" I opened this thread about was a 1.8kg loss I could not see.

22 17hans_munich, jason_sac26, chris_chi24 and 19 others
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RetaRick_CA
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Apr 11, 2026 at 4:01 PM#10
GenomicsKate said:
Albumin binding above 99% is the whole reason weekly dosing works, and it is also why the trough matters more than the peak.

GenomicsKate has the substance of this right. The condition it depends on is worth stating. The dose-response is real but shallow at the top. Across STEP 1 and STEP 4 the gap between 1.7mg and 2.4mg is a couple of percentage points of body weight on average, and the average is carrying a wide spread — plenty of people at 1.7mg sit above the 2.4mg mean. If a dose is working and tolerable, "working" is the relevant variable, not "maximal".

20 18MounjBrad, nick_newbie, DadBodDave and 17 others
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