Step-up reference for the three current GLP-1 family compounds. The package-insert cadence is the floor, not the target - for the dose-strategy framing (titrate-and-hold, when not to climb, what stops people on the cut), see the GLP-1 and Muscle Preservation article and Cycling Strategies.
Semaglutide (Wegovy / Ozempic / compounded)
| Step | Dose / week | Hold |
|---|---|---|
| 1 | 0.25 mg | 4 weeks |
| 2 | 0.5 mg | 4 weeks |
| 3 | 1.0 mg | 4 weeks |
| 4 | 1.7 mg | 4 weeks |
| 5 | 2.4 mg | maintenance (or hold lower if effective) |
Slow-ramp variant: hold each step 6β8 weeks instead of 4 if GI tolerance is an issue. Skipping a step (e.g. 0.5 β 1.7) routinely produces treatment-discontinuing nausea.
Tirzepatide (Zepbound / Mounjaro / compounded)
| Step | Dose / week | Hold |
|---|---|---|
| 1 | 2.5 mg | 4 weeks |
| 2 | 5 mg | 4 weeks |
| 3 | 7.5 mg | 4 weeks |
| 4 | 10 mg | 4 weeks |
| 5 | 12.5 mg | 4 weeks |
| 6 | 15 mg | maintenance (or hold lower if effective) |
Most operators stop climbing at 7.5 or 10 mg if fat loss is steady at 0.5β1% body weight per week. The 15 mg ceiling is for non-responders, not the default goal.
Retatrutide (investigational)
No approved label. Phase 2 (Jastreboff 2023) used once-weekly arms ranging from 1 mg to 12 mg with stepwise escalation. Community use mirrors the trial cadence:
| Step | Dose / week | Hold |
|---|---|---|
| 1 | 2 mg | 4 weeks |
| 2 | 4 mg | 4 weeks |
| 3 | 6 mg | 4 weeks |
| 4 | 8 mg | 4 weeks |
| 5 | 12 mg | maintenance ceiling (rarely needed) |
Heart-rate elevation is the differentiator vs. GLP-1-only agents - track resting HR weekly. A sustained 8β10+ bpm increase warrants holding or dropping a step.
Split-dosing variant (all three)
- Halve the weekly dose and inject twice weekly (e.g., 1.25 mg tirzepatide on Monday and Thursday instead of 2.5 mg once weekly).
- Reduces peak serum concentration and the nausea that tracks with it. Keeps trough hunger from returning at end of week.
- Off-label deviation from the half-life-driven schedule. Pharmacokinetically sound for these compounds because half-lives are 5β7 days; doesnβt work for shorter-half-life GLP-1s like liraglutide.
Climb / hold / drop rules
- Climb only when fat loss has stalled (no scale or body-comp movement) for 2+ consecutive weeks at the current dose, AND side-effect tolerance is acceptable.
- Hold indefinitely if the current dose is producing 0.5β1% body-weight loss per week. The lowest effective dose is the target, not the maximum.
- Drop a step if nausea, vomiting or HR elevation is treatment-limiting. Climb back up only after a 4-week settle.
- Maintenance taper after goal: drop to ~50% of the cutting dose for 6β12 months before considering discontinuation. Cold-stopping correlates with rebound; the maintenance phase is the protocol, not the afterthought.
Cross-references
- Semaglutide vs Tirzepatide vs Retatrutide - per-compound choice and the SURMOUNT/STEP trial numbers.
- GLP-1 and Muscle Preservation - why titrate-and-hold matters for body comp.
- Cycling Strategies - the "GLP-1 is not a cycle" framing.
- Fat Loss application - broader decision tree across families.