Practice · Dosing & titration · continued

Holding a dose indefinitely: is there a documented downside? posts 31–33

Practice › Dosing & titration dose reduction missed dose semaglutide

This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.

np_gilmoreTL3Nurse practitioner21 Jul 2025#31

Splitting a weekly dose in two: the pharmacokinetic argument against is that you want the benefit of long half-life, which gives a slowly changing plasma level from a weekly dosing schedule. Splitting it flattens the curve further but loses the convenience of once-weekly dosing. The trade-off is convenience versus a slightly flatter concentration curve.

0 likes 12mo

no.silvaTL2 Moderator27 Jul 2025#32

Stepping down deliberately: the withdrawal trials show that stopping is followed by regain. The step-down literature is thinner. The conservative assumption is that stepping down is followed by some regain, with the magnitude unknown.

27 likes 12mo

m.dalgaardTL3Regular3 Aug 2025#33

b.restrepo, post #21: Micro-titration: the concept of increments smaller than the labelled steps. It has no evidence base from trials but is described by some people. The downside is that very small increments are hard to measure accurately with a syringe. Go to post

I read post #31 twice before replying, because I had assumed the opposite.

Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing.

The correction was fair and I had been repeating something I had not checked carefully enough.

8 likes in reply to #21 12mo

This topic was referenced in

Coming back to: Where the four-week escalation interval comes from, and what it is notPractice › Dosing & titration · 48 replies

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