A titration plan has a start dose, a step size, an interval, a target and a fallback. How to turn your prescriber's plan into dates.
Key points
- 01Every titration plan has the same five parts. A starting dose, a step size, an interval between steps, a maintenance target, and a rule for what happens if a step is not tolerated. If you can name all five for your own plan, you can build the calendar. If you cannot, that is the question to bring to your appointment.
- 02The interval on GLP-1 labels is commonly four weeks. The approved labelling for the once-weekly GLP-1 medicines describes holding each dose for a period, frequently four weeks, before the next increase. The point of the interval is tolerability, so it is a clinical parameter rather than a number to compress.
- 03Your job is the calendar, not the plan. Take the plan you were given, mark the first injection date, and count the interval forward to find each step date. Writing the date and the dose for every step on one page is what turns an abstract escalation into something you can actually follow.
- 04Every step changes the number on the syringe. If you draw from a vial rather than using a fixed-dose pen, each increase means a new volume and a new unit count. Recalculate at every step rather than reusing last month's number, and check it against the concentration written on the vial.
- 05Plan supplies against the steps, not the weeks. Consumption rises as the dose rises, so a vial that covered four weeks at the starting dose will not cover four weeks at the target. Work out the milligrams each step consumes before ordering, and allow for the in-use window as well.
- 06A step you cannot tolerate is a conversation, not a calculation. Labels describe holding at the current dose or stepping back when an increase is poorly tolerated, but which applies to you is a prescriber decision. Log what happened and when, and bring the log rather than a self-adjusted plan.
Frequently asked questions
How is a titration schedule calculated?+
From five inputs: starting dose, step size, interval, target dose, and the rule for a step that is not tolerated. You supply the calendar dates; the five inputs come from your prescriber and the approved labelling. Not medical advice.
How long is each step in a GLP-1 titration?+
The approved labelling for the once-weekly GLP-1 medicines commonly describes holding a dose for four weeks before increasing. The specific plan, including any longer hold, is set by your prescriber.
Do I need to redo the syringe math at every step?+
Yes, if you draw from a vial. The concentration is unchanged but the dose is not, so the volume and unit count both change. Recalculate from the concentration written on the vial rather than adjusting last month's number.
What if I cannot tolerate the next step up?+
Record what you experienced and when, and raise it with your prescriber. Labels describe holding or stepping back in that situation, but which applies is a clinical decision rather than something to work out from a schedule.