Titration schedules on paper assume everything goes smoothly. Real titration involves holding a dose when side effects are rough, and sometimes stepping back down. This tool builds a dated calendar from the approved schedules, then adapts it based on how you are actually tolerating each step.
Expect: nausea and reduced appetite peaking 1-3 days post-increase, then easing; possible diarrhea or constipation, fatigue, burping.
Manage: smaller, slower meals and stop at first fullness; hydrate well; lean protein and fiber; go easy on greasy, fried, very sweet, or large meals and alcohol.
Educational estimate, not medical advice or a prescription. These medicines are prescription-only and must be started, adjusted, and stopped by a licensed clinician, who may hold you at a dose far longer than shown. Contraindicated with a personal or family history of medullary thyroid carcinoma or MEN2; caution with pancreatitis or gallbladder disease.
GLP-1 medications are started low and increased gradually because the gastrointestinal side effects, nausea, vomiting, constipation and reflux, are dose dependent and improve with adaptation. Jumping ahead is the fastest route to feeling terrible and abandoning treatment.
The schedules here follow the approved labels for each medication, which differ from one another in ways people frequently get wrong. Run the exact reconstitution and units for your specific drug in the Semaglutide Dosage Calculator or Tirzepatide Dosage Calculator.
Report a step as manageable and it advances on schedule. Report it as rough and it holds you at the current dose for an additional two weeks, shifting every subsequent date accordingly. Report it as severe and it recommends stepping down rather than pushing on.
It also handles missed doses, which have specific rules for each medication, and re-titration when a gap has been long enough that restarting at your previous dose would be unwise.
Rapid weight loss on any GLP-1 costs lean mass alongside fat unless protein intake and resistance training are deliberately maintained. This is the most consequential thing most users are never told. Losing weight quickly while losing muscle leaves you lighter, weaker and with a worse metabolic rate than when you started. Set your target with the Protein Intake Calculator before you start, not after the scale has already moved.
Standard titration steps up every four weeks, provided the current dose is tolerated. If side effects are significant, staying at the current dose for longer is entirely reasonable and usually better than pushing through.
Each medication has its own rule based on how much time has passed since the missed dose. If enough time has elapsed, the missed dose is skipped and the next is taken on schedule. Long gaps may require restarting at a lower dose.
No. The goal is the lowest dose that produces the result you want. Many people do well below the maximum, and staying at an effective lower dose means fewer side effects and lower cost.
Titrate slowly, eat smaller meals, reduce fat and fried food, stop eating when full rather than finishing the plate, and stay hydrated. Nausea usually improves within days to weeks at a given dose as the body adapts.
Some lean mass loss accompanies any substantial weight loss, and it can be considerable when loss is rapid. High protein intake and consistent resistance training substantially reduce it. This matters more than the number on the scale.
