Tirzepatide vs Semaglutide: Titration Speed Compared
Both compounds require titration but at different speeds and different ladders. Here's a side-by-side comparison.
Why titration exists
GLP-1 (and GLP-1/GIP for tirzepatide) agonists slow gastric emptying. Going to a high dose immediately produces severe nausea, vomiting, and constipation in most people. Slow titration gives the GI tract time to adapt.
Side-by-side ladders
| Week range | Semaglutide dose | Tirzepatide dose |
|---|---|---|
| 1–4 | 0.25 mg/week | 2.5 mg/week |
| 5–8 | 0.5 mg/week | 5 mg/week |
| 9–12 | 1.0 mg/week | 7.5 mg/week |
| 13–16 | 1.7 mg/week | 10 mg/week |
| 17–20 | 2.4 mg/week | 12.5 mg/week |
| 21+ | 2.4 mg (max) | 15 mg (max) |
Time to max dose
Semaglutide: 17 weeks to maintenance (2.4 mg).
Tirzepatide: 21 weeks to max (15 mg).
Tirzepatide titration is one rung longer because there are more dose levels.
Side effect profiles
Both share GI side effects (nausea, fatigue, constipation, sulfur burps). Tirzepatide's GIP component appears to reduce nausea slightly compared to pure GLP-1, though individual variation dominates.
Weight loss expectations (clinical trial data)
| Compound | Average weight loss at max dose, 72 weeks |
|---|---|
| Semaglutide 2.4 mg (Wegovy STEP 1) | ~14.9% body weight |
| Tirzepatide 15 mg (SURMOUNT-1) | ~22.5% body weight |
Tirzepatide produces meaningfully more weight loss on average. Individual response varies widely.
Hold + step-down patterns
Many users (with clinician input) deviate from the manufacturer schedule:
- Holding: stay at a dose 4+ weeks longer than scheduled because side effects haven't resolved
- Step-down: drop back one rung if a higher dose became intolerable
- Skipping rungs: less common, generally not recommended
How Peptra tracks both
Both schedules are pre-loaded. You can advance manually or auto-advance with the manufacturer cadence. Weight is logged weekly with side-effect severity scored 0-3. The chart shows weight trajectory overlaid with dose changes — easy to see if a titration step is producing the expected response.