Dose Titration
The practice of gradually increasing a drug's dose over time to reach the optimal therapeutic level while minimising side effects. Dose titration is standard practice for GLP-1 receptor agonists — for example, semaglutide is started at 0.25mg weekly and gradually increased to the target dose.
Technical Context
Dose titration is used when the dose-response curves for efficacy and side effects differ in their threshold doses. For GLP-1 RAs, gastrointestinal side effects (nausea, vomiting) are most prominent at treatment initiation, while efficacy accumulates over weeks. Starting low and escalating allows the GI tract to adapt (tachyphylaxis to nausea) before reaching fully effective doses. Semaglutide (Ozempic) titration: 0.25mg weekly × 4 weeks → 0.5mg × 4 weeks → 1mg (target for diabetes); for weight management (Wegovy): continued escalation to 2.4mg. Tirzepatide titrates from 2.5mg to 5/10/15mg. Dose titration schedules are established during Phase II dose-ranging trials and refined in Phase III.