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Phase 2 NEJM titration (still common in research) Phase 2 retatrutide titration schedule Phase Initiation Weeks Weeks 1-4 Weekly Dose 1 mg Phase Early escalation Weeks Weeks 5-8 Weekly Dose 2 mg Phase Mid escalation Weeks Weeks 9-12 Weekly Dose 4 mg Phase High escalation Weeks Weeks 13-16 Weekly Dose 8 mg Phase Maximum Weeks Weeks 17+ Weekly Dose 12 mg Source: Jastreboff et al., NEJM 2023
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Tirzepatide came off the FDAs official drug shortage list in December 2024, and semaglutide followed in February 2025, eliminating the legal pathway that allowed compounding pharmacies to produce copies of the drugs
If you are already experiencing symptoms at the starting dose, increasing will make them worse
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