Short answer: With weight-loss injections, the dose is increased (titrated) step by step under medical supervision, usually in 4-week periods, so that the body can build tolerance to the medicine and digestive side effects are kept to a minimum.

Key takeaways

  • The starting dose is not a therapeutic dose; it is a low dose meant to build tolerance (for example tirzepatide 2.5 mg, semaglutide 0.25 mg).
  • In the standard schedules of the product information, the steps differ by product: tirzepatide (Mounjaro) uses intervals of at least 4 weeks, Wegovy 4-week intervals. The full tables are in Mounjaro dosage and Wegovy dosage.
  • Your GP or prescriber decides whether and when to step up.
  • Nausea and other digestive side effects can come back for a few days after a dose increase.

GLP-1 treatment starts at the lowest dose, and the dose is increased gradually under medical supervision. This gradual increase is called titration. Its aim is not to speed up the effect but to reduce side effects: it gives the body time to get used to each step.

This page is for general information only and does not replace medical advice. The timing and size of dose increases, and whether the dose goes up at all, are decisions for your GP or prescriber alone.

Why start at the lowest dose?

These medicines slow stomach emptying and prolong the feeling of fullness. Because the effect comes directly through the digestive system, starting on a high dose noticeably increases nausea, vomiting and diarrhoea. Starting low lets you reach the same point with less discomfort.

The starting dose is usually not a treatment dose; its only purpose is to get the body used to the medicine.

What can you expect after each increase?

Side effects become noticeable again at the start of treatment and after each dose increase. So nausea that settled in the first weeks coming back on a new step is to be expected; it does not mean the treatment is going badly.

This fluctuation usually lasts a few days and eases as the body gets used to the new dose. If it carries on or is severe, tell your GP or prescriber; whether the dosing plan needs to change is for them to assess.

When is the dose increased?

The dosing decision is your doctor's. The steps in the product information are a standard schedule, not a personal treatment plan. Which step to stay on, when to move and whether to step up at all is decided by your GP or prescriber.

The time between steps and the size of each step vary by product and are set out in the patient information leaflet. The standard schedules from the product information are set out as tables in Mounjaro dosage and Wegovy dosage. What the schedules share is that the next step does not come before the set time on the current one has passed. The prescriber may slow the schedule down depending on the response.

When a step is not well tolerated, the prescriber may decide to stay on it longer or go back down a step.

Things to watch out for when the dose goes up

  • Smaller portions and eating slowly can make the first days after an increase easier.
  • Fatty and very spicy foods can make nausea worse.
  • Vomiting or diarrhoea speeds up fluid loss, so fluid intake matters more during this period.
  • For personal advice on eating and activity, ask your GP or a dietitian.
  • Titration exists to reduce side effects; speeding up the schedule is not a use described in the product information.

Tracking your steps

Recording how long you stayed on each step and how you felt after each increase helps you give clear answers to your prescriber's questions at a review appointment. Haftra keeps your dose, injection day and symptoms together; it does not suggest doses or work out dose steps. It is free and can be used without creating an account.

iPhone, iPad and Apple Watch. Free.

Frequently asked questions

What happens when the dose goes up?

Side effects such as mild nausea and loss of appetite can become noticeable again for the first few days after each dose increase. This fluctuation usually eases as the body gets used to the new dose; it does not mean the treatment is going badly.

Why start at the lowest dose?

These medicines slow stomach emptying and prolong the feeling of fullness. Starting on a high dose noticeably increases nausea, vomiting and diarrhoea. Starting low lets you reach the same point with less discomfort.

When is the dose increased?

The time between steps and the size of each step vary by product and are set out in the patient information leaflet. The shared principle in the product information is that the next step does not come before the set time on the current one has passed. Whether and when to step up is your GP or prescriber's decision.

Do I have to increase the dose every month?

No. At least 4 weeks on each step is a minimum, not a fixed schedule. Your GP or prescriber decides whether and when to step up, and may keep the dose the same.

What happens if I cannot tolerate a dose increase?

When a step is not well tolerated, the prescriber may decide to stay on it longer or go back down a step. Describe your side effects to your GP or prescriber at your review.

What is the highest maintenance dose?

According to the product information, the maximum weekly dose of Mounjaro is 15 mg. Wegovy's usual maintenance dose is 2.4 mg; the EU approved a higher 7.2 mg dose in February 2026. The leaflet of the product you have is what applies.

Sources

Last reviewed: 15 October 2026