Users report split dosing tirzepatide often restores full-week coverage before adding anything else. One person found cagrilintide helpful after retatrutide caused allodynia and no appetite control, while another added low-dose cagrilintide to retatrutide for renewed food-noise suppression. A long-term user who lost over 140 lb on tirzepatide described returning hunger and stable weight readings but noted the plateau may still be fluid-related.
What this discussion establishesWhether to add a second agent immediately or exhaust split-dosing adjustments first.
Still openHow long any stack remains effective or safe once tirzepatide alone has already produced substantial loss.
Nothing here is advice.
My tirzepatide seems to stop working as well toward the end of the week. Anyone who's tried those combinations, which one pairs better when added to tirz?
Have you tried splitting the dose before bringing in another medication? That approach usually works best when a weight-loss drug has been effective and side effects tolerable but the benefits no longer last the full seven days.
I also recommend splitting the dose. I began doing that in my third week on tirz, which was 13 weeks and 37 lb ago.
Retatrutide did nothing for my appetite and instead caused allodynia, so I tapered off and returned to tirzepatide. Adding cagrilintide slowly worked well. I worry about appetite returning because I credit calorie restriction for most of my loss; I mainly do OMAD plus protein shakes and vitamins. The experience has been smooth. I now split both tirzepatide at 12 mg weekly and cagrilintide at 2 mg weekly. The cagrilintide amount looks high but I seem to respond weakly to it. I had no problems starting at 0.2 mg and raised it only when hunger began to reappear.
Are you already at 15 mg per week of tirz? Starting weight, age, health status, height, current weight, and how long you've been losing all affect what makes sense at a plateau. If the medication still works but weakens a day or two before the next shot, splitting the dose is a straightforward fix.
Yes, I'm taking 15 mg of tirz. Started at 446 lb, now 297 lb. I'm 38, male, 5'11". Also have T2D and hypertension.
Fantastic job dropping so many pounds! Splitting the dose right at the beginning gets my backing too.
Has your desire to eat been affected lately? Running into any digestive problems?
Very minor GI issues, mainly inconsistent bowel movements rather than pain or nausea. Appetite stays low in the morning. It sometimes returns a bit in the afternoon, so I have a small snack or protein shake and it settles. At dinner I still eat a balanced but smaller meal for nutrition. I may be a weak responder overall because none of these drugs have caused me nausea. Reports mention GI problems with cagrilintide even at low doses, so starting low and going slow is wise if you try it. Good luck either way.
Thanks, that gives some hope. Sema once made me nauseous about 24 hours after the first dose last year, but otherwise I haven't had side effects from tirz, reta, or cagri. I tried cagri in the fall but couldn't tell if it was doing anything so I stopped.
For more context, food noise has been returning earlier each week. Recent weights: March 9 at 299, March 16 at 297.1, March 23 at 299.5, March 24 at 297.6, March 30 at 297.4. I may have been holding water the day before. It's frustrating.
With a starting BMI of 62, higher doses or combinations can be reasonable to consider. The strongest trial result so far is nearly 30 % loss with reta, so exceeding that moves outside studied ranges. You've already lost 33 %, which is more than average in any study, so further options are experimental and rely on forum anecdotes. A month without scale movement isn't long enough to rule out fluid shifts. You've clearly been on tirz for some time given the total loss, congratulations. I assume you get regular medical checks and have no obvious heart disease with reasonably controlled blood sugar. One question is whether you're taking other diabetes drugs, because adding more agents raises hypoglycemia risk that would need careful monitoring.
Appreciate the response. I began using a compounded version of semaglutide the previous year and continued until May, reaching a peak of 2.5. After that I moved over to a compounded form of tirzepatide starting at 10 and increased gradually. Later on I came across other options and experimented with retatrutide for several weeks during autumn but couldn't notice any clear effect, leading me to continue with tirzepatide. Regarding prescriptions, I take metformin at 1000 milligrams daily. My physician mentioned that my weight loss has been sufficient and my recent A1C results were 4.5 and 4.7, suggesting I might discontinue the metformin, yet I chose to maintain it. Additionally, I use Lisinopril HCTZ along with Amlodipine and atorvastatin, the last one being mainly for prevention. I informed my doctor about the compounded medication back when it was accurate last year, and he requests bloodwork quarterly. My current weight isn't ideal, though it's vastly better than before. It's surprising how much larger I was previously and how much simpler routine activities have become. Recently I had to chase after a bus and managed without exhaustion or heavy breathing. I take a daily walk lasting sixty minutes and find it pleasant. There's still progress ahead and I aim to avoid plateauing. I have some semaglutide left from before that expires soon, so I'll start incorporating it again shortly.
Metformin doesn't usually cause hypoglycemia and may add a small weight-loss effect, but checking sugars for lows is still sensible given the excellent A1C. None of the individual drugs typically cause lows, yet combinations lack study data so caution is reasonable.
Please share the timeline for this weight loss. Thanks.
Between the two options I'd lean toward cagrilintide rather than cagrisema for stacking with tirz, mainly because cagrisema brings in semaglutide and makes it harder to know which part is responsible for any change.
I've been on reta since March and recently added cagrilintide at 0.50 mg to help with food noise. It has worked for me. I'm also T2D and take 2000 mg metformin, though I may need to lower that dose soon. Blood sugar has run between 124-140 since adding the cagrilintide two weeks ago.
Sure. I started sema through a compounding pharmacy last January and saw no weight loss until late May once I reached higher doses, though that may also reflect when I began tracking calories and nutrition seriously. I switched to compounded tirz last June, started tracking intake, and began losing about three pounds weekly. I also began walking regularly in August, first 30 minutes three times a week and now an hour six days a week. I did break the stall that prompted this post.
If you have tried it, this topic is still open. Sign in to reply — it takes a minute.