Accepted answer
two weeks at 0.25 mg is 14 days at one dose level — and the arithmetic the question hides is that it also moves every dose above 0.25 mg back by 14 days. Whether that reduces constipation depends on which quantity it tracks. A symptom driven by the dose itself is unchanged by waiting: 0.25 mg is 0.25 mg on day 1 and on day 14. A symptom driven by the rate of change has 14 days of no change to settle in, which is the case the hold is actually made for. The distinction is testable on your own record: plot constipation against days-since-last-increase rather than against dose, and if the peaks line up with the increases the hold is doing something. Escalation schedules are set by a prescriber, and nothing here is medical advice.
Start with the half-life, because the interval between steps should be at least four half-lives or you are escalating before the previous step has expressed itself.
Liraglutide titrates weekly rather than four-weekly because its half-life is about thirteen hours, so steady state is reached within days. The interval follows the pharmacokinetics in both cases.
Label titration ladders, structure only
| Agent | Start | Step interval | Maintenance range | Max studied |
|---|
| Semaglutide (weight management) | 0.25 mg/wk | 4 weeks | 1.7–2.4 mg/wk | 2.4 mg/wk |
| Semaglutide (T2DM) | 0.25 mg/wk | 4 weeks | 0.5–2.0 mg/wk | 2.0 mg/wk |
| Tirzepatide | 2.5 mg/wk | 4 weeks | 5–15 mg/wk | 15 mg/wk |
| Liraglutide (weight management) | 0.6 mg/day | 1 week | 3.0 mg/day | 3.0 mg/day |
| Oral semaglutide | 3 mg/day | 4 weeks | 7–14 mg/day | 50 mg/day (trial) |
Structure is identical across the class: small start, four-week steps, a defined maintenance range, a defined ceiling.
It helps to be literal here: holding a step for eight weeks instead of four is a legitimate approach with no efficacy cost at the destination, and it is what the trials effectively did for anyone who tolerated poorly.
Trial data show gastrointestinal adverse events concentrated in the escalation phase and declining at stable doses.
Nothing here is medical advice, and research-use compounds are not approved for human use.
Stepping back is a normal adjustment, not a failure.