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c/tirzepatide·posted 1 year ago by u/throwaway_wl2026

genuine question about tirzepatide that I am slightly embarrassed to ask

Trial Data Receipts ×6 Sourced ×1

genuine question about tirzepatide that I am slightly embarrassed to ask. If this has been answered properly somewhere, link me and I will delete.

Research-use-only material is not approved for human use. Anything in this thread about how a research vial "should" titrate is a discussion about chemistry, not a plan.

SURMOUNT-1 ran 72 weeks with the top arm around 21% mean body weight change. SURPASS is the diabetes programme and reports glycaemic endpoints, so quoting the two interchangeably is a category error.

The four-week interval in the label is a minimum. Nothing about the pharmacology requires you to step on schedule, and the trials stepped on a calendar because trials have to.

If two or three other people have done the same thing we might actually learn something. Alone it is an anecdote.

2,366 up / 875 down73% upvoted65 commentsid sb1sd421 Dec 2024

65 comments

30 in this archive, depth 5

best — the order this archive was captured in

u/emil_okwuosa246 points·1 year ago

Vials and pens carry the same molecule; what differs is fill volume, device tolerance and whether you are doing your own arithmetic. Neither is inherently more accurate.

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u/copay_card_cc172 points·1 year ago

Small fix: SURMOUNT is the obesity programme, SURPASS is the type-2 programme. They are different endpoints and the numbers do not transfer.

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u/throwaway_wl2026OP95 points·1 year ago

That percentage is body weight change, not body fat. Different measurement, and the distinction gets lost every time.

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u/hair_shed_hannah79 points·1 year ago

Cosigning the four-week thing. It is a minimum interval, and treating it as a schedule to keep up with is how people end up miserable at 12.5.

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u/ahmed_fonseca63 points·1 year ago

the trials titrated on a calendar, real people titrate on symptoms

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u/blunt_coldbox290 points·1 year ago

Small fix: SURMOUNT is the obesity programme, SURPASS is the type-2 programme.

This. The step interval is a floor, and reading it as a timetable is the most expensive mistake in the thread.

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u/zeynep_zielinski-13 points·1 year ago

the muscle cramps profile is genuinely gentler than people expect coming from sema

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u/elin_varga134 points·1 year ago

Agreed, and the trial number is a mean of a very wide distribution — the tails are enormous and nobody posts from the middle.

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u/aurel_lindqvist104 points·1 year ago

2.5mg is a four-week starting dose, not a maintenance dose. Worth being precise since people search these threads.

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u/hugo_bergstrom28 points·1 year ago

It is a dual GIP and GLP-1 receptor agonist, and the GIP arm is the part that has no equivalent in the semaglutide threads. That is why the side-effect profile reads differently rather than just milder.

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u/piotr_nascimento92 points·1 year ago

a lot of people plateau nicely at 10mg and never need 15

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u/quiet_moderatorMOD89 points·1 year ago

Removed the conversion table. There is no published equivalence between the two molecules and posting one as fact is exactly the kind of thing that gets copied for years.

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u/laila_yilmaz71 points·1 year ago

stepping every four weeks is a ceiling on speed, not a schedule you must hit

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u/aksel_kjaer59 points·1 year ago

if 7.5 is working, 10 is not automatically better

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u/blunt_coldbox2917 points·1 year ago

switching from sema is not a dose conversion, there is no clean equivalence

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u/aurel_lindqvist8 points·1 year ago

switching from sema is not a dose conversion, there is no clean equivalence

blunt_coldbox29 is right that the two molecules are not interchangeable. There is no published conversion and the ones circulating are invented.

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u/crosspost_bot_no59 points·1 year ago

sulphur burps are the signature complaint and they are not dangerous

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u/ghrp_history68 points·1 year ago

Switching from semaglutide, since three people asked in this thread alone.

There is no published dose equivalence between the two. The conversion tables that circulate are somebody’s arithmetic, not data. What people report here is that the first month after a switch is often flat, that the appetite effect feels differently shaped rather than simply stronger, and that starting at the bottom of the ladder again is the common approach.

None of that is a recommendation. It is what the threads say, and the threads are not a clinic.

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u/copay_card_cc17 points·1 year ago

Appetite effect for me is flat across seven days. On sema it was a wave. Same person, different molecule.

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u/marta_dziedzic62 points·1 year ago

The distribution matters more than the mean. In the trial population the interquartile spread was wide enough that two honest people can have completely different runs on the same arm.

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u/curious_panel_only23 points·1 year ago

hold the dose that works, the ladder is not a leaderboard

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u/sten_bhattacharya6 points·1 year ago

pens and vials are the same molecule, the price is the difference

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u/britt_okwuosa35 points·1 year ago

zepbound and mounjaro are the same compound with different labels

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u/throwaway_wl2026OP5 points·1 year ago

Correction to my own post above — I said 10mg and I have been on 12.5mg since the spring. Same argument, wrong number.

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u/noor_hovland2 points·1 year ago

the appetite effect is blunter than sema, in a good way, most weeks

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u/amara_halonen2 points·1 year ago

Correction to my own post above — I said 10mg and I have been on 12.5mg since the spring.

Not sure about this bit. The GIP arm being real does not tell you that it is what caused your particular week.

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u/hugo_bergstrom43 points·1 year ago

Agree. The GIP component is the interesting half and it barely gets discussed outside c/glp1science.

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u/elin_ferrari14 points·1 year ago

Right. And the sema-to-tirz "conversion" people post is invented. There is no published equivalence.

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u/laila_yilmaz3 points·1 year ago

2.5 is the starter dose and it is not meant to be the dose that works

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u/throwaway_wl2026OP2 points·1 year ago

the four-week step schedule is the label, not folklore

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About c/tirzepatide

Tirzepatide-specific discussion: the dual-agonist pharmacology, the 2.5 → 15mg ladder, the appetite profile people describe as different from semaglutide, and the SURMOUNT/SURPASS trial programme. Comparisons with semaglutide are welcome as long as they are specific about dose equivalence being unknown.

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