When should I move up to the next dose?

The short answer: When your current dose stops working effectively for appetite suppression and weight loss, it's usually time to consider moving up.

But let's break this down a bit more.

What the name-brand schedules look like

The FDA-approved titration schedules are pretty standard across the board:

For semaglutide (Ozempic/Wegovy): Start at 0.25 mg per week and gradually increase to 2.4 mg per week for weight loss, titrating every four weeks. So you'd typically go 0.25mg → 0.5mg → 1mg → 1.7mg → 2.4mg, spending about a month at each dose.

For tirzepatide (Mounjaro/Zepbound): Start at 2.5 mg, then increase to 5 mg once a week for 4 weeks, followed by increases to 7.5 mg once a week. The full schedule is usually 2.5mg → 5mg → 7.5mg → 10mg → 12.5mg → 15mg, again with about 4 weeks between increases.

These schedules are designed to minimize side effects while your body adjusts to the medication, while getting up to a maximum dose relatively quickly.

Here's where compounding gets interesting

One of the biggest advantages of working with a compounding pharmacy is that you're not locked into those rigid manufacturer schedules. You and your doctor can create a custom titration plan that works for YOUR body and YOUR goals.

Maybe you need to go slower because you're sensitive to side effects. Maybe you want to micro-dose increases by going up in smaller increments. Or maybe you're responding well and want to move a bit faster. With compounding, you have that flexibility.

The "stay low as long as possible" approach

A lot of people try to ride out lower doses for as long as they can, and that's totally understandable. For tirzepatide especially, we see folks wanting to stay at 2.5mg or 5mg forever because they're seeing results and don't want to deal with increased side effects or higher costs.

If you're still losing weight consistently, feeling good, and your appetite is well-controlled, there's nothing wrong with staying put. Some people genuinely do great on lower doses long-term.

But many people need higher doses to see full benefits

Here's the reality though: this isn't going to work for everybody. Many people won't see the full weight loss potential of these medications until they reach higher doses. If you've been stuck at the same weight for several weeks, your appetite is creeping back, or you're finding it harder to stick to your eating plan, it might be time to consider moving up in dose. There's no shame in that!

Signs it might be time to increase

• Weight loss has stalled for 4+ weeks (a week or two is not a stall)
• Your appetite is returning to pre-medication levels
• You're having more food noise and cravings
• You're not feeling satisfied after meals like you used to
• You're having to white-knuckle it through your eating plan again

The bottom line

Work with your doctor to find the right balance for you. There's no shame in needing higher doses — these medications are dose-dependent, meaning more medication often equals better results. The goal is finding your own personal sweet spot where you're getting maximum benefit with manageable side effects.

And remember, with compounding, you have way more flexibility to fine-tune your dosing than you would with the name-brand pens. Take advantage of that flexibility to create a plan that actually works for you.