The original poster started feeling queasy, bloated, and had diarrhea after the first 5 mg dose despite good results and zero issues on 2.5 mg. Several responders said there was no need to titrate up for only 12 kg of weight loss and advised staying at the effective lower dose. Others suggested splitting the 5 mg pen into smaller increments via vial or click counting to allow slower increases if desired. The thread shows the user decided to return to 2.5 mg.
What this discussion establishesWhether any dose increase was necessary at all versus following the standard titration schedule
Nothing here is advice.
I had been on tirzepatide for six weeks through my doctor using the four-dose pen, which let me stretch the first 2.5 mg pen to five doses. Progress was solid at half a kilo a week with no food noise and zero side effects, so I was happy staying there. My doctor still moved me to the 5 mg pen after the check-in and said we could drop back if needed. I took the first 5 mg shot midday yesterday and now feel queasy with diarrhea and general malaise. I want to know if others who were doing fine on 2.5 mg stayed at the higher dose and saw sides settle or went back down, and why increase at all when the prior dose worked.
Half a kilo a week is reasonable depending on total weight to lose. Feeling off can come from what was eaten because digestion slows, so greasy foods linger longer. The body often adjusts after a few doses and sides ease. What were your starting and goal weights, and did you avoid heavy or fried foods that day? The pen could be emptied into a sterile vial for syringe use if you want more control.
You could keep the same amount but shorten the interval instead. If 2.5 mg every seven days feels off at the new level, try every five days to raise levels more gradually. Once symptoms allow, shorten further until the full 5 mg weekly is tolerable.
I started at 107 kg aiming for about 95 kg. Delayed emptying on 2.5 mg was noticeable but milder than now. Yesterday I only had two protein shakes yet still feel overly full and bloated, like the water I drank is sitting there. My food choices were clean. The core question is whether moving up was required when 2.5 mg already gave good results without any sides.
I would not have increased. With only 12 kg to lose there is no reason to push; half a kilo weekly is plenty.
Stay at 2.5 mg and move the contents into a sterile vial the way another user suggested. That creates a small reserve while keeping the dose that suits you.
The issue is the pen I have now is set for 5 mg, so reaching 2.5 mg requires dividing the dose somehow.
Move it into a sterile vial and pull doses from there. I stayed at 2.5 mg for months and only went up to 3 mg later.
I am happy with that pace of loss. Next injection I will return to 2.5 mg.
This is why I prefer having direct control over the product and dosing choices. If titration were wanted, smaller steps like 3 or 4 mg for a couple of weeks would make more sense than the fixed jumps the manufacturer tested. Those schedules are the only data they have, so the pens enforce them. It is not your fault; most of us have run into the same thing. You seem to have found a workable path now.
No need at all. I moved from 2.5 to 3, then 3.5, 4, and finally 5, taking it slowly. The 5 mg dose does not upset my stomach, though I stay very full.
Sorry, I missed that detail earlier, so disregard my last suggestion.
After reading everything, the vial approach is the strongest option. Even a 3 mg draw becomes possible once the concentration is known.
You could empty the whole pen, count the total units, measure the volume, and calculate from there in case the fill is not exactly 20 mg.
The calculation is straightforward. I checked the pen and found I can turn the plunger back, so counting half the clicks should give the right amount. This will probably be my final brand pen anyway.
Seriously, am I chopped liver here?
You can also move the liquid into your own pen cartridge once you know the concentration. Then you dial each dose with the same needles and keep full control over how slowly you increase, which should make the medication last longer too.
No transfer to a vial is required with the 5 mg pen that has 60 clicks per full dose. Just turn to 30 clicks for 2.5 mg. Charts online show clicks per milligram for these pens.
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