Introduction to Weight Loss Medications and Gradual Dosing
What are weight loss medications?
Weight loss medicine is a tool to help people who are struggling to lose weight using diet and exercise changes alone. Used correctly, along with lifestyle changes, they can be really effective for losing weight.
Although there are other options like weight loss tablets, weight loss injections such as Wegovy and Mounjaro are becoming increasingly popular. Mounjaro contains the active ingredient tirzepatide, and Wegovy contains the active ingredient semaglutide. These ingredients work on slightly different pathways in the body by mimicking naturally occurring hormones.
Semaglutide works similarly to the hormone glucagon-like peptide-1 (GLP-1), slowing down how fast the stomach empties, reducing hunger cues, and stabilising blood sugar levels. Tirzepatide works similarly to semaglutide but mimics two hormones: GLP-1 and glucose-dependent insulinotropic peptide (GIP). As tirzepatide targets two pathways, studies suggest it may lead to better weight loss results than Wegovy. However, Wegovy is also an effective weight loss treatment, with patients losing an average 17% of their bodyweight after taking Wegovy for 68 weeks.
These weight loss medications are effective as they keep you fuller for longer, helping you to eat less without feeling hungry. Whilst weight loss medications can be a helpful weight loss tool, they're only effective when used alongside diet and exercise changes.
Why is the dosage increased gradually?
When you start taking weight loss injections, your body needs time to get used to the medication. By starting with a low dose, only a small amount of medication is given, and the risk of side effects is reduced.
The dose is gradually increased over time to allow your body to adjust to each increase. As these medications are usually more effective at higher doses, increasing the dose typically leads to better weight loss results.
The Importance of Starting with a Lower Dose
What is the starting dose of weight loss medications?
The starting dose of your weight loss injection depends on the active ingredient and brand.
Mounjaro dosage starts at 2.5mg once a week for 4 weeks. Wegovy starts at 0.25mg, injected once a week for 4 weeks.
Lower doses of Wegovy and Mounjaro are prescribed initially to minimise the risk of side effects while the drug is new to the body.
How does a lower dose reduce the risk of side effects?
A low dose of your weight loss medication still allows the drug to work whilst limiting the negative effects it has on your body initially.
Side effects, such as vomiting, nausea, diarrhoea, constipation, and abdominal pain, usually get better with time as the body becomes familiar with the drug. You can always contact a healthcare professional here at Quick Meds for further advice.
What happens if you skip or miss a dose?
It's important to take your medication on the same day every week. However, if you miss your dose and it's been fewer than 4 days (Mounjaro) or 5 days (Wegovy) since you were due to take it, then you should take the missed dose.
If it's been more than 4 days (Mounjaro) or 5 days (Wegovy) since your scheduled day, you should skip the dose you missed and take your next scheduled dose as normal. If you've missed more than one dose, you may need to reduce your dose and restart the dosing schedule - you'll need to discuss this with a healthcare professional.
Regularly missing doses affects how well the medication works and can delay the time it takes to increase your dose. If you're often missing doses, you may want to change the day or time you are taking Mounjaro or Wegovy, so that it's more convenient for you. When changing the day you use your medication, always make sure to leave 3 (Mounjaro) or 2 (Wegovy) days between doses.
Do not double-dose a forgotten dose. If you are unsure how to proceed with your weight loss treatment, contact a healthcare professional who will advise you appropriately.
Gradual Dose Increase: How Does It Work?
Why is my Mounjaro/Wegovy dose increasing?
Both medications are more effective for weight loss at a higher dose, although lower doses are still beneficial. The aim of your dosing schedule is to increase the dose to a point where you're seeing impressive weight loss results without struggling with side effects.
What is the dosing schedule for weight loss medications?
The Mounjaro dose starts at 2.5mg, which is injected once a week for 4 weeks. This is increased by 2.5mg every 4 weeks up to a maximum of 15mg. Some people take longer than this to reach the maximum maintenance dose, and some people stop at an earlier dose to maintain it if they're having good results.
For Wegovy, the starting dose is 0.25 mg once a week for 4 weeks. The dose is then increased to 0.5mg for the next 4 weeks. For weeks 9-12, the dose is increased to 1mg, then it is increased to 1.7mg for weeks 13-16. Finally, the maintenance dose of 2.4mg can be reached from week 17 onwards. Again, not everyone will increase their dose so quickly, and some people will stop at a lower maintenance dose.
Moving to the Maintenance Dose: What You Need to Know
What is a maintenance dose?
A maintenance dose is the dose you will stay on long-term. For Wegovy, this is typically 17 mg or 2.4mg. For Mounjaro, maintenance can be at 5mg, 10mg, or 15mg.
Your maintenance dose will be determined by your weight loss goals and how well you're responding to the medication.
How long does it take to reach the maintenance dose?
It can take several weeks to reach the maintenance dose. How long it takes depends on the dose you wish to maintain, and whether you have to slow down the dose increases due to side effects or missed doses.
Why is a maintenance dose important for sustainable weight loss?
Mounjaro and Wegovy are generally more effective at a higher dose, resulting in the best weight loss results. However, not everyone will be on the highest dose if they see good results at a lower dose or experience side effects. This can help you maintain the weight you have lost on treatment once you have reached your goal weight or a healthy BMI.
Common Side Effects When Increasing Your Dose
What side effects should I expect during dose increases?
Common side effects of Mounjaro include nausea, vomiting, diarrhoea, abdominal pain, constipation, dizziness, bloating, wind, hair loss, acid reflux, and fatigue. Other side effects, such as inflammation of the pancreas/gallbladder, are much less common, with severe allergic reactions happening rarely.
Many of Wegovy's side effects are similar to Mounjaro's. When taking Wegovy, side effects such as headaches, vomiting, diarrhoea, abdominal pain, constipation, fatigue, dizziness, acid reflux, bloating, wind, and hair loss are common. Less common side effects include pancreatitis, gallstones, an increased heart rate, and rarely, serious allergic reactions.
Side effects are more likely to occur when you start the medication and with each dose increase.
If you experience serious side effects such as airway swelling, difficulty breathing, wheezing, or loss of consciousness, call 999 immediately. If you are experiencing a rash, increased heart rate, or any other symptoms that worry you, contact your doctor.
If you have symptoms of pancreatitis or gallstones, seek immediate medical attention.
Mild side effects like nausea can be managed at home by staying hydrated, eating plain foods, and not eating past the point of satiety.
How Dose Adjustments Contribute to Weight Loss Success
How does a gradual dose increase help with long-term weight loss?
Gradually increasing your weight loss medication dose allows your body to gradually become familiar with the medication and its effects. This may reduce the chance of experiencing side effects, which means you'll be more likely to stick with the medication, leading to better weight loss results.
What happens if the dose is increased too quickly?
Increasing the dose too quickly puts you more at risk of side effects. In some cases, this leads people to stop taking the medication altogether.
What Happens if You Reach the Maximum Dose?
What is the maximum dose for Mounjaro and Wegovy?
Although they work in similar ways, Mounjaro and Wegovy have different maximum dose strengths. The highest dose of Wegovy is 2.4mg weekly, while 15mg is the highest weekly Mounjaro dose.
Why might you need a higher dose for weight loss?
Different people respond differently to the medication. Some people experience significant weight loss results at a lower maintenance dose, while others need to be at the highest maintenance dose before they start seeing the results they want.
When will I stop increasing my dose?
If you're losing weight at a rate you're happy with, a healthcare professional may decide to keep you at your current dose. However, if you're not seeing the results you want, you may need to keep increasing your dose until you reach the maximum maintenance dose.
If you move up to higher Wegovy or Mounjaro doses and experience side effects, you may need to stop increasing your dose and stay at a lower dose. Your dose should always be changed by a healthcare professional - never be tempted to change the dose yourself.
The Role of Healthcare Professionals in Managing Dose Changes
Generally, healthcare professionals follow a set dosing schedule for each medication, although they may slow things down if you're experiencing side effects to give your body longer to adjust. Regular check-ins will help them to pick up on any issues or side effects.
What should I discuss with my healthcare professional before a dose increase?
Start by discussing your current weight loss results, how they compare to your goals and whether they're realistic. It's also good to bring up any side effects you have and ask any questions about managing them. If anything else has changed with your general health, you should mention this too.
Start a ConsultationConclusion: Gradual Dose Increases for Safe and Effective Weight Loss
Weight loss medications can be effective for helping you to lose weight, but some people struggle to continue taking them due to side effects. Gradually increasing the dose can help avoid this.
Your doctor or pharmacist should advise you on your own individual dosing schedule that's tailored to you. This will help you to get the results you're looking for while minimising side effects.
Looking for advice on weight loss medication, side effects or dosing schedules? Contact the Quick Meds team today.