Protocol
Weight Loss and Metabolic
Semaglutide Titration Protocol [2026]
Gradual GLP-1 receptor agonist titration to minimize nausea while reaching research dose targets.
Compounds
Semaglutide
Dose: 0.25 mg
Freq: Once weekly
Recon: 3mg + 1.5mL BAC
Conc: 2 mg/mL
Draw: 12 units (U-100)
Calculate Semaglutide dose
Protocol Phases
Initiation
Weeks 1 to 4
0.25 mg subcutaneous once weekly. Same day each week. Common sides: mild nausea, reduced appetite. Hydration is critical.
Escalation 1
Weeks 5 to 8
0.5 mg once weekly if 0.25 mg is well tolerated. Monitor GI tolerance. If nausea is significant, extend initiation phase by 2 weeks before advancing.
Escalation 2
Weeks 9 to 16
1.0 mg once weekly. Most research protocols hold here for at least 4 weeks before considering 1.7 mg or 2.4 mg.
Maintenance
Week 17 onward
Continue at effective dose. Some protocols cycle 8 weeks on, 4 weeks off. Others run continuous at maintenance dose.
FAQ
What is the standard semaglutide titration schedule?
Standard research titration: 0.25 mg weekly for 4 weeks, then 0.5 mg for 4 weeks, then 1.0 mg. Further escalation to 1.7 mg or 2.4 mg is protocol-dependent and should not be rushed. Each step requires 4 weeks minimum to assess tolerance.
How do I reconstitute semaglutide for injection?
Add bacteriostatic water to the lyophilized powder slowly down the inside wall of the vial. A common prep is 3 mg vial plus 1.5 mL BAC water for 2 mg/mL. For a 0.5 mg dose: 0.5 divided by 2 = 0.25 mL = the 25 unit line on a U-100 syringe. Use the ASCEND calculator for any concentration.
What day of the week should I inject semaglutide?
Any consistent day works. Most research subjects choose a day when reduced appetite will not interfere with social meals. The same day each week is more important than which day.
How do I manage nausea on semaglutide?
Nausea is most common in the first 2 weeks of each dose increase. Eat smaller, blander meals. Avoid high-fat foods on injection day. Ginger tea helps many subjects. If nausea is severe, hold at the current dose for an additional 2 weeks rather than pushing the titration.
Research Notes
- Never escalate dose early. 4 weeks minimum at each step.
- Keep reconstituted semaglutide refrigerated. Do not freeze.
- If a dose is missed by less than 5 days, take as soon as possible. If more than 5 days, skip and resume on regular schedule.
Related Protocols
For research use only. Not medical advice.