Revisiting: Why tirzepatide titration schedules have more steps than semaglutide's

This follows post #4 rather than contradicting it.

The five maintenance doses in the tirzepatide programme give a genuine dose-response curve, which is unusual. Most trials in this space compare one or two doses against placebo and cannot say anything about the shape of the relationship.

I am aware this is the third time this month I have made this point.

Adding the measurement that post #10 says would settle it.

Titration schedules for tirzepatide have more dose steps than semaglutide partly because the compound is more potent and partly because the clinical programme used a finer gradation. That does not mean you cannot escalate on a coarser schedule if that suits you — the published schedule is not a lower bound.

It is a small point and it changes the answer, which is an awkward combination.

Understood. Thank you for being specific about the limits of it.

Small methodological point on tirzepatide titration schedules: repeating a measurement is cheap and resolves most of what is being argued about here at no cost to anyone.

Categorical response thresholds — the proportion reaching ten, fifteen or twenty per cent reduction — are more persuasive and less informative than the mean. They depend entirely on where the threshold was drawn.

I had written a reply contradicting post #65 and deleted it. Here is what survived.

Mass and charge states: tirzepatide is about 4813.5 Da and on an electrospray instrument you would expect to see charge states mostly in the 2+ to 4+ range, the same as semaglutide. A doubly charged species would appear at about (4813.5 + 2 × 1.008) / 2 ≈ 2408.

Something worth flagging about tirzepatide titration schedules: the strongest-sounding claims in this thread are the ones with no source attached, which is the usual pattern and not a coincidence.

Tirzepatide titration schedules looks different depending on whether you are reading the primary literature or the summaries of it, and the difference is not in our favour.

Post #98 describes the usual case. This is about the unusual one.

Nausea profile: some people report tirzepatide as less nausea-prone than semaglutide, others report it as more. The trial reported gastrointestinal effects broadly comparable in character. Individual variation is the largest factor.

I have no interest in any supplier named above.