Concretely: 2.4 mg · liraglutide.
The failure mode I am trying to avoid is making this decision emotionally.
I have twelve months in view and I would like the plan to survive that long.
How would you structure this, and what thresholds would you set in advance?
2.4 mg a week is 0.343 mg a day averaged out and 125 mg over a year — but "defensible" is not a property of the number, it is a property of where the number came from. A maintenance dose is defensible when a trial randomised people to it and reported what happened, and indefensible when it was arrived at by interpolation between two doses that were studied. So the question to ask of 2.4 mg is which arm it corresponds to: if a programme ran 2.4 mg as a maintenance level, there is an efficacy figure, a tolerability figure and a discontinuation rate attached to it. If it sits between two studied levels, everything said about it is extrapolation, and the burden of that is on whoever proposed it. The other half of the arithmetic is supply: at 2.4 mg a week a 10 mg vial is 4.17 weeks and you will need about 13 of them a year, which is worth knowing before the dose is settled rather than after. Maintenance doses are set by a prescriber against an individual; nothing here is medical advice.
Start with what is being maintained — weight, glycaemia or both — because they have different dose-response curves.
Gastrointestinal tolerability generally improves on a reduced dose, which is a genuine quality-of-life argument for the search rather than only a cost one.
Mechanically, if the result deteriorates on a lower dose, returning to the previous one is straightforward and does not require re-titration from the bottom provided the gap has been short.
Gastrointestinal adverse event rates in the trials are dose-related, which supports the tolerability argument for the lowest effective dose.
The withdrawal trials answer stopping, not reducing. Different questions.
edited 17 Jul 2026 by Dr_Ilse_Vandenberg — added a caveat about sampling
HPLC purity, identity confirmation and quantified content on the vial you actually hold. Reports arrive with the chromatogram attached, not just a number.
Submit a sampleFounded 1998. ISO 9001 and cGMP certified, 1,500+ staff and 200+ patents. The synthesis house behind a great many of the vials that get sent out for testing - batch-specific documentation with every order.
Visit GL BiochemSpecifically, this is a question the trial programmes answered only partially, and it is worth saying which parts are evidenced.
The maintenance dose is not necessarily the same a year later, since the counter-regulatory response attenuates slowly if at all.
In practice, maintenance and loss are different endpoints. Loss requires a sustained energy deficit; maintenance requires only that the counter-regulatory drive is offset, and that may need less exposure.
STEP-4 and SURMOUNT-4 evaluated withdrawal rather than dose reduction, which is the limit of the direct evidence on this question.
Search downward, one step, eight weeks each, on a rolling average.
Ask PeptideStack is a static archive. Posting is closed, but the norms are worth stating: answer the question that was asked, show your working, cite the trial or the certificate, and say plainly where the evidence runs out.