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maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the maintenance arms of the withdrawal trials actually showed.

44 questions · sorted by votes · page 1 of 2

54 votes 3 answers41k views
What does the regain curve actually look like after stopping, and how fast does it happen?

I am going to have to stop, not by choice: my supply arrangement is ending and the alternative is not affordable for me long term. I have gone from 108 kg to 79 kg…

discontinuation
discontinuation

Stopping treatment: tapering versus abrupt cessation, what the trial withdrawal arms measured, clinically driven stops, and the practical planning…

21 questions
weight-regain
weight-regain

Regain after stopping or reducing: the trajectory reported in the withdrawal extensions, how much is fluid, and what the maintenance arms tell us…

14 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
asked by thabo_maseko 20k · 21 months ago
50 votes 3 answers29k views
Why does the constipation outlast the nausea by months when both are supposedly the same mechanism?

The nausea followed exactly the pattern I was told to expect: bad for a fortnight after each dose step, better by week four, essentially gone by month five. The…

constipation
constipation

Slowed transit as a consequence of delayed gastric emptying and reduced intake: incidence figures, fibre and hydration evidence, and why it often…

14 questions
gi-side-effects
gi-side-effects

The gastrointestinal cluster as a whole - nausea, vomiting, diarrhoea, constipation, reflux, early satiety - with trial incidence rates, dropout…

416 questions
glp1-mechanism
glp1-mechanism

Receptor-level pharmacology: GLP-1R as a class B GPCR, cAMP and PKA signalling, biased agonism, internalisation and resensitisation, and the…

175 questions
maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
asked by swab_stopper 16k · 23 months ago
49 votes 3 answers15k views
Is there any pharmacological reason to taper rather than just stop, or is that a placebo ritual?

I am planning to come off semaglutide 2.4 mg and everyone has an opinion about tapering. The suggestions I have been given range from "step down 2.4 to 1.7 to 1.0 to…

discontinuation
discontinuation

Stopping treatment: tapering versus abrupt cessation, what the trial withdrawal arms measured, clinically driven stops, and the practical planning…

21 questions
maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
titration
titration

Stepwise dose increases over weeks, why the label schedules exist at all, and what tolerability-driven deviation from a schedule looks like in…

444 questions
weight-regain
weight-regain

Regain after stopping or reducing: the trajectory reported in the withdrawal extensions, how much is fluid, and what the maintenance arms tell us…

14 questions
asked by Dr_Signe_Baldursdottir 46k · 11 months ago
43 votes 3 answers19k views
Week 14 and still nauseated most of the week. How do I tell titration nausea from a persistent problem?

Fourteen weeks in, currently at the second-to-top dose, and I have been told repeatedly that the nausea settles. It has not settled. It has changed shape. Weeks 1-6…

nausea
nausea

The dominant tolerability signal in every trial of the class: incidence, timing relative to a dose step, duration, and the distinction between…

346 questions
gi-side-effects
gi-side-effects

The gastrointestinal cluster as a whole - nausea, vomiting, diarrhoea, constipation, reflux, early satiety - with trial incidence rates, dropout…

416 questions
titration
titration

Stepwise dose increases over weeks, why the label schedules exist at all, and what tolerability-driven deviation from a schedule looks like in…

444 questions
maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
asked by ayo_fadipe 19k · 11 months ago
40 votes 3 answers52k views
Does extending the interval work as well as reducing the dose?

My records go back to the first dose with dates, so I can reconstruct the timeline exactly. These are treated as interchangeable and I do not think they are. If both…

maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
glp1-mechanism
glp1-mechanism

Receptor-level pharmacology: GLP-1R as a class B GPCR, cAMP and PKA signalling, biased agonism, internalisation and resensitisation, and the…

175 questions
asked by Dr_Colm_Fitzhenry 85k · 22 months ago
38 votes5 answers51k views
Is 5 mg weekly a defensible maintenance dose for cagrilintide?

What I am working with: 5 mg · cagrilintide. I would like to set this up properly once, rather than adjust it repeatedly. My budget is real but not tight, and my…

maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
asked by dmitri_savchuk 17k · 2.3 years ago
37 votes5 answers48k views
Is 15 mg weekly a defensible maintenance dose for ecnoglutide?

For reference: 15 mg · ecnoglutide. I am at the decision point and I would rather think it through than improvise. I would rather spend money on measurement than on…

maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
asked by low_dead_space 42k · 2.3 years ago
37 votes 3 answers20k views
Does hitting a plateau mean the dose needs to go up, or is that the wrong inference?

I am on tirzepatide 10 mg and have been flat for seven weeks. The reflex answer everywhere is "titrate up", and 12.5 and 15 mg exist, so the option is there. But I…

plateau
plateau

A stall in progress: distinguishing adaptive thermogenesis from measurement error from adherence drift, how long to observe before changing…

35 questions
dose-escalation
dose-escalation

The decision to move up a step: what evidence supports a four-week interval, what happens when you compress it, and how trial protocols handled…

88 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
asked by tare_weight 47k · 9 months ago
35 votes 5 answers37k views
Is 8 mg weekly a defensible maintenance dose for orforglipron?

Numbers first: 8 mg · orforglipron. This is a planning question. I know what my options are; I do not know how to weigh them. What I want is the minimum viable…

maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
subcutaneous
subcutaneous

Subcutaneous administration as a route: absorption kinetics from abdomen versus thigh versus upper arm, tissue depth, and why site rotation…

14 questions
asked by t_oyelaran 41k · 2.4 years ago
35 votes3 answers16k views
Is 60 mg weekly a defensible maintenance dose for mazdutide?

Setup, so nobody has to ask: 60 mg · mazdutide. I would like to set this up properly once, rather than adjust it repeatedly. My budget is real but not tight, and my…

maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
asked by bridget_nyathi 16k · 17 months ago
34 votes 5 answers60k views
Is 40 mg weekly a defensible maintenance dose for tirzepatide?

Conditions: 40 mg · tirzepatide. 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…

maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
sleep-apnea
sleep-apnea

Obstructive sleep apnoea and the apnoea-hypopnoea index response to weight loss, including the SURMOUNT-OSA dataset and the question of whether…

14 questions
asked by Dr_Idris_Coulibaly 40k · 23 months ago
34 votes 5 answers15k views
Is 4 mg weekly a defensible maintenance dose for survodutide?

The specifics, since they change the answer: 4 mg · survodutide. I am at the decision point and I would rather think it through than improvise. I would rather spend…

maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
asked by oona_kekkonen 16k · 16 months ago
34 votes 3 answers14k views
Does maintenance at a fraction of the therapeutic dose actually work, and is there any evidence for it?

I have reached a weight I am happy with on tirzepatide 12.5 mg and I do not want to keep losing. Cost is a factor and so is the fact that I would rather take less of…

maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
discontinuation
discontinuation

Stopping treatment: tapering versus abrupt cessation, what the trial withdrawal arms measured, clinically driven stops, and the practical planning…

21 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
cost-analysis
cost-analysis

Cost arithmetic done honestly: cost per milligram after dead-space loss, list versus net price, comparing a multi-dose vial to a fixed-dose pen,…

261 questions
asked by fill_volume 13k · 5 months ago
32 votes 2 answers34k views
Is 30 mg weekly a defensible maintenance dose for retatrutide?

What I have: 30 mg · retatrutide. I would rather over-plan the first cycle and simplify later. I am prepared to do the work if someone can tell me which work matters.…

maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
asked by claudia_ferrante 46k · 14 months ago
30 votes 5 answers36k views
Is 50 mg weekly a defensible maintenance dose for ecnoglutide?

For reference: 50 mg · ecnoglutide. I am at the decision point and I would rather think it through than improvise. I would rather spend money on measurement than on…

maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
asked by sasha_ferreira 15k · 23 months ago
30 votes0 answers20k views
Is 50 mg weekly a defensible maintenance dose for semaglutide?

For reference: 50 mg · semaglutide. I would like to define my thresholds before I have a result, for obvious reasons. I want a plan with explicit stopping rules, not…

maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
asked by coldbox9 13k · 12 months ago
30 votes3 answers8.9k views
How do I tell a plateau from a new set point, and how long should I wait before changing anything?

Nine weeks flat at 71.6 kg, from a start of 94 kg. Semaglutide 2.4 mg, month fourteen. Intake weighed, not estimated, at 1,650 kcal. Steps averaging 9,400. Three…

plateau
plateau

A stall in progress: distinguishing adaptive thermogenesis from measurement error from adherence drift, how long to observe before changing…

35 questions
maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
nutrition
nutrition

Eating on a suppressed appetite: hitting nutritional targets inside a small energy budget, micronutrient risk, meal structure, and what the trial…

92 questions
hydration
hydration

Fluid intake when thirst and intake cues are both blunted: how much of the early scale drop is fluid, how dehydration confounds a renal panel, and…

14 questions
asked by rukhsana_iqbal 14k · 2 months ago
28 votes 5 answers10k views
Is 4 mg weekly a defensible maintenance dose for semaglutide?

The specifics, since they change the answer: 4 mg · semaglutide. I would like to define my thresholds before I have a result, for obvious reasons. I want a plan with…

maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
asked by anders_vestby 17k · 12 months ago
27 votes0 answers18k views
Is 10 mg weekly a defensible maintenance dose for tirzepatide?

Conditions: 10 mg · tirzepatide. 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…

maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
asked by ines_delacruz 16k · 2.0 years ago
27 votes 3 answers6.9k views
How much of the weight effect is delayed gastric emptying, and is the plateau receptor desensitisation?

Two related mechanism questions I have never seen answered together. First, how much of the weight loss is attributable to delayed gastric emptying as opposed to…

glp1-mechanism
glp1-mechanism

Receptor-level pharmacology: GLP-1R as a class B GPCR, cAMP and PKA signalling, biased agonism, internalisation and resensitisation, and the…

175 questions
plateau
plateau

A stall in progress: distinguishing adaptive thermogenesis from measurement error from adherence drift, how long to observe before changing…

35 questions
gi-side-effects
gi-side-effects

The gastrointestinal cluster as a whole - nausea, vomiting, diarrhoea, constipation, reflux, early satiety - with trial incidence rates, dropout…

416 questions
maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
constipation
constipation

Slowed transit as a consequence of delayed gastric emptying and reduced intake: incidence figures, fibre and hydration evidence, and why it often…

14 questions
asked by syringe_ninety 15k · 3 months ago
26 votes 3 answers24k views
Is the top of the ladder the most effective dose, or just the highest one that was studied?

The label maximum gets treated as a destination — the "full dose", as though anything below it is partial. But a label maximum is the highest dose a sponsor took…

dose-escalation
dose-escalation

The decision to move up a step: what evidence supports a four-week interval, what happens when you compress it, and how trial protocols handled…

88 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
tirzepatide
tirzepatide

A dual GIP and GLP-1 receptor agonist. Questions here cover the SURPASS and SURMOUNT programmes, the practical differences from a pure GLP-1…

162 questions
retatrutide
retatrutide

An investigational GLP-1, GIP and glucagon receptor tri-agonist, studied in the TRIUMPH programme. Not approved anywhere. Use this tag for…

14 questions
maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
asked by sample_id 17k · 6 months ago
24 votes0 answers27k views
Is 15 mg weekly a defensible maintenance dose for semaglutide?

For reference: 15 mg · semaglutide. I am at the decision point and I would rather think it through than improvise. I would rather spend money on measurement than on…

maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
asked by pascal_thibault 13k · 23 months ago
23 votes 5 answers39k views
Is 2.5 mg weekly a defensible maintenance dose for tirzepatide?

The case in front of me: 2.5 mg · tirzepatide. I want to decide this in advance so that I am not deciding it under pressure later. Assume I will follow the plan I…

maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
asked by ayo_fadipe 19k · 21 months ago
20 votes5 answers17k views
Is 20 mg weekly a defensible maintenance dose for a GLP-1 receptor agonist?

Setup, so nobody has to ask: 20 mg · a GLP-1 receptor agonist. I am trying to build something sustainable rather than something thorough that I will abandon. I have…

maintenance-dose
maintenance-dose

Staying put: the lowest dose that holds a result, the difference between the maximum studied dose and the maximum useful dose, and what the…

44 questions
clinical-trials
clinical-trials

Reading the primary literature properly: estimands, intention-to-treat versus per-protocol, confidence intervals, absolute versus relative…

913 questions
dosing-math
dosing-math

The arithmetic itself: milligrams to millilitres to insulin units, concentration after reconstitution, dose per draw, and vial-days per vial. Show…

811 questions
asked by gradient_slope 41k · 21 months ago
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