Education only. Not medical advice.
Titration changes require prescriber supervision.

TL;DR

If GI symptoms flare, slow the ramp. Hold your current dose longer, or step back one dose for a week, then retry. Never modify device volumes beyond labeled settings.

What “micro-titration” means

Small, on-label adjustments to the pace of dose increases:

• Extend each step by 2–4+ extra weeks

• Add a pause week at the current dose after a rough week

• Use a step-back week once, then return

• Skip the next increase if symptoms persist at week 4; reassess at week 6–8

Goal: fewer nausea days, better adherence, same endpoint dose later.

When to slow down

• Moderate or recurring GI symptoms

• Recent illness, dehydration, or travel

• New meds that irritate the GI tract

• After a missed dose and restart

• Before anesthesia per clinician guidance

Patterns by dosing type

Weekly injectables (semaglutide, tirzepatide, dulaglutide)

• Keep ≥4 weeks per step as baseline

• If symptomatic at week 4, extend to week 6–8

• One step-back week if needed, then retry prior step ≥2–4 more weeks

• Do not split weekly doses or change injection frequency

Daily GLP-1s (liraglutide, oral semaglutide)

• Increase weekly only if fully tolerated

• If symptomatic, hold an extra 1–2 weeks before the next increase

• Do not alternate partial daily doses

Practical micro-titration moves

• Pause week: Stay at today’s dose for one more week; resume if symptom-free

• Step-back week: Drop to the last well-tolerated dose for one week, then retry

• Extended step: Add 2–4 more weeks at the current dose before advancing

• Retry window: If two retries fail, consider longer-term maintenance at this dose

What not to do

• Do not alter pen settings beyond labeled dose options

• Do not split a weekly dose into multiple injections

• Do not “air-shot” to reduce delivered volume

• Do not self-direct rapid catch-up dosing after a miss

Symptom control while you slow

• Smaller meals; lower fat during ramp weeks

• Hydration, fiber, light activity; add stool softener if constipated

• Pause escalations while symptomatic

• Track triggers and recovery days

ScriptScores™: Slow-Ramp Strategies (0–10)

Higher = better.

Scoring method: editorial heuristic weighting tolerability, adherence, and operational simplicity.

Checklist before advancing

1. Last 7 days free of moderate GI symptoms

2. Regular meals tolerated

3. Hydration and bowel habits at baseline

4. No upcoming anesthesia or acute illness

5. Prescriber alignment on next step and timing

When to contact your prescriber now

• Persistent vomiting, dehydration signs, or severe abdominal pain

• Repeated intolerance at the same dose after pause/step-back

• Questions about other meds or upcoming procedures

Disclaimers

• Not medical advice. General education only.

• Safety first. Seek urgent care for severe or worsening symptoms.

• Labels change. Doses and warnings update; follow current package inserts and your clinician.

• Individual results vary. Weight, A1c, and side-effect rates differ.

• Drug interactions. These agents delay gastric emptying; review all meds and supplements with your prescriber.

• ScriptScores™. Editorial heuristics, not treatment directives.
  Last updated: September 3, 2025.