Dose escalation schedule: difference between revisions
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| 1 | {{Infobox concept | 1 | {{Infobox concept |
| 2 | | name = Dose escalation schedule | 2 | | name = Dose escalation schedule |
| + | 3 | | subtitle = Dosing practice | |
| 3 | | image = titration.svg | 4 | | image = titration.svg |
| 4 | | caption = Stepwise increases held long enough for tolerance to develop at each level. | 5 | | caption = Stepwise increases held long enough for tolerance to develop at each level. |
| ⋮ | ⋮ | ||
| 20 | 21 | ||
| 21 | The four-week step interval matches the pharmacokinetics. With a half-life of about seven days, steady state is reached in four to five weeks, so a step held for four weeks is assessed at close to its full expression. A shorter step assesses a dose whose effect is still increasing.{{r|knudsen2019}} | 22 | The four-week step interval matches the pharmacokinetics. With a half-life of about seven days, steady state is reached in four to five weeks, so a step held for four weeks is assessed at close to its full expression. A shorter step assesses a dose whose effect is still increasing.{{r|knudsen2019}} |
| + | 23 | ||
| + | 24 | == Representative schedules == | |
| + | 25 | | Product class | Starting dose | Steps | Interval | | |
| + | 26 | |---|---|---|---| | |
| + | 27 | | Weekly [[Semaglutide]], obesity | 0.25 mg | 0.25 → 0.5 → 1.0 → 1.7 → 2.4 mg | 4 weeks | | |
| + | 28 | | Weekly [[Tirzepatide]] | 2.5 mg | 2.5 → 5 → 10 → 15 mg | 4 weeks | | |
| + | 29 | | Daily [[Liraglutide]], obesity | 0.6 mg | 0.6 → 1.2 → 1.8 → 2.4 → 3.0 mg | 1 week | | |
| + | 30 | ||
| + | 31 | Daily agents escalate weekly rather than monthly, for the same pharmacokinetic reason in reverse: steady state is reached in days, so a week is ample. The number of steps is similar; the calendar time is very different.{{r|wilding2021}} | |
| 22 | 32 | ||
| 23 | == References == | 33 | == References == |