Dose Timing & Adjustment Strategy
Optimize your GLP protocol by comparing different dosing schedules. More frequent dosing provides smoother plasma levels and reduced side effects, while less frequent dosing offers greater convenience.
Dosing
Dose per Injection
0.30 mg
Rounded for practical measurement
Injections per Week
3.5
Blood Plasma Stability
Avg Plasma Level
1.52 mg
Lower indicates more stable blood levels and less side effects
Peak / Trough Ratio
22%
Clinical Considerations of Every Other Day Dosing (q2d)
SemaglutideGLP-1 agonist
Ozempic, Wegovy
Clinical Considerations for (q2d) Dosing
GLP-1 agonist
Ozempic, Wegovy
Every other day dosing provides the smoothest plasma curve—ideal during titration or for patients who are peak-sensitive.
Requires more supplies and injections per week. Discuss adherence and supply planning before switching.
Time to Steady-State
4-5 weeks
Until consistent drug levels in bloodstream
Wait Time to Increase Dose
≥ 4 weeks
Reach steady-state before increasing dose
Missed Dose Window
5 days
Until plasma stability is disrupted
Weekly Dose Planner
Accumulated Plasma Levels Over 12 Weeks
Plan Weekly Dose Adjustments
Ready to Plan Your Supply?
Calculate how much peptide you'll need for your protocol and ensure you have enough supply.
Frequency Comparison
| Frequency | Dose / Injection | Weekly Delivered | Plasma Stability | Injections/Week |
|---|---|---|---|---|
Every Other Day (q2d) | 0.30 mg | 1.05 mg +0.05 mg vs target | Excellent stability | 3.5× |
Every 3 Days (q3d) | 0.40 mg | 0.93 mg -0.07 mg vs target | Moderate stability | 2.3× |
Twice Weekly | 0.50 mg | 1.00 mg Matches target | Moderate stability | 2.0× |
Weekly | 1.00 mg | 1.00 mg Matches target | High variation | 1.0× |
Calculations assume steady-state pharmacokinetics with volume of distribution (Vd) ≈ 1 L. Lower peak/trough percentages indicate smoother plasma concentrations. Doses are rounded to 0.1 mg for practical administration.
Guardrails for Semaglutide
May affect absorption of oral medications
Hold ≥2 months before planned conception
Daily or q2d dosing provides near-steady-state levels with minimal fluctuation
Significantly reduces peak-related nausea and allows higher total weekly doses
Best option for patients with severe GI sensitivity or those unable to escalate on weekly dosing
4.3% discontinue for GI adverse events (vs 0.7% placebo), almost all during titration phase
>95% of patients with GI adverse events continued to week 68—symptoms diminish over time on maintenance dose
Gallbladder risk at ≥1.0 mg weekly (relative risk 1.58); monitor for right upper quadrant pain, especially during rapid weight loss
STEP trials: Nausea 31-44% on semaglutide vs 9-17% placebo, rising with dose (44.2% at 2.4 mg)
FDA 2025 warning: Monitor renal function during dose escalation. Hold if severe GI symptoms or dehydration.
Moderate-dose GI adverse events
Incidence: Nausea: 32.1% (STEP2) | Generally lower than 2.4 mg but higher than 0.5 mg
Intermediate tolerance profile between low and high doses
Gallbladder/biliary disorders (dose-dependent)
Incidence: Relative risk ~1.58 (CI 1.13–2.22) for ≥1.0 mg weekly vs <1.0 mg
Tracks with weight loss rate. Risk lower at ≤1.0 mg or with gradual titration. Monitor for right upper quadrant pain if experiencing rapid weight reduction.
Diabetic retinopathy worsening in patients with pre-existing DR
Incidence: SUSTAIN-6: 3.0% vs 1.8% placebo (HR 1.76, P=0.02)
Risk from rapid glucose lowering, not the drug itself. STEP-2 found similar events at 2.4 vs 1.0 mg short-term. Ophthalmologic monitoring advised when escalating doses in diabetics with eye disease.
Modest heart rate increase
Incidence: Typically +2-4 bpm
Monitor if baseline tachycardia. Overall CV benefits generally outweigh HR effects.
Acute kidney injury risk (dehydration-mediated)
FDA warning (2025): GI AEs (vomiting/diarrhea) during dose escalation can cause volume depletion. Monitor renal function; hold doses if severe GI symptoms or dehydration occur.
Pancreatitis (very rare)
Incidence: <0.3% in STEP trials
Discontinue if suspected. No definitive dose-response shown.