Nothing really shows these GLP meds mess up receptors, so there is no reason to take a long break, especially when blood sugar needs managing. Letting glucose climb for weeks is not helpful. Some tolerance shows up for nausea and for gastric emptying slowing down over months, but nothing indicates loss of effect on blood sugar, appetite, or weight for at least three years. Tirz gives better glucose control and more weight loss with fewer side effects than sema. Since the max sema dose is not moving weight anymore, switching straight to tirz makes sense without any washout.
I'm stuck and looking for others who have been through something similar. I did fine on the brand-name sema through 2024 and into 2025 until access ended in May. I finished what I had in early July. My doctor was fine with me trying cash brand sema or tirz in August. Since I'm type 2 diabetic I went with grey sema because I already knew how it felt and what to monitor in my own testing. Started at 0.25 mg in September and worked up to 2.4 mg. No weight change at all from early September through late November. Added 0.1 mg cagri at that point and have kept both going. Only dropped two pounds between late November and mid December. We've been away since the 12th and I left the sema at home. Took a partial dose plus the cagri last Wednesday and skipped yesterday. Back tomorrow. Not sure how to fix the schedule now.