GLP-1 Cheat Sheets: Dose Ladders, Missed Doses, Red Flags
Phone-friendly reference cards for high-stakes GLP-1 decisions — titration ladders, missed-dose protocols, red-flag side effects. Every dose number on every card was verified against the DailyMed FDA-approved Structured Product Label.
Wegovy Dose Ladder 2026: Both the Shot and the Tablet
6 min read · Wegovy · dose schedule · titration
Wegovy is no longer one product with one ladder. There is a weekly injection that climbs in four steps, a high-dose 7.2 mg strength above the usual maintenance, and a once-daily tablet with a completely separate 90-day schedule and its own rules about food. This page holds all of it against the current label, including the missed-dose arithmetic people most often get wrong.
Zepbound Dose Steps 2026: Ladder, Ceiling and the 96-Hour Rule
4 min read · Zepbound titration · tirzepatide dose ladder · Zepbound 2.5 mg starting dose
The Zepbound ladder is often described as six steps to 15 mg, which quietly implies 15 mg is where you are meant to end up. The label says something different: raise the dose in 2.5 mg increments until you reach a maintenance dose that works, and three doses qualify — 5, 10 and 15 mg. This page sets out the steps, the four-day window for a missed dose, the 72-hour rule for moving injection day, and the symptoms that mean stop climbing.
Mounjaro Step-Ups 2026: When to Climb, When to Stay Put
5 min read · Mounjaro · Mounjaro dose increase · Mounjaro titration
Mounjaro and Zepbound are the same molecule on the same six-dose ladder, and that similarity hides the difference that matters: Mounjaro is licensed for type 2 diabetes, so what decides whether you climb is your blood sugar rather than the scale. This page gives the ladder, the checkpoint logic for advancing or holding, the separate 10 mg ceiling for younger patients, and the symptoms that mean stop.
Foundayo Dose Steps 2026: the Oral GLP-1 Ladder
4 min read · Foundayo titration · orforglipron dose ladder · Foundayo 0.8 mg starting dose
Foundayo is the first GLP-1 tablet licensed for weight, and its practical advantage is genuine: swallow it once a day, food or no food, no needle and no fasting ritual. The trade-off is less advertised. Built as a small molecule instead of a peptide, it travels through the same liver enzyme as a lot of other drugs — which caps the dose for some people and pushes anyone on an oral contraceptive onto a different method.
Missed an Ozempic Dose? The Five-Day Window Explained
4 min read · Ozempic · missed dose · semaglutide
Ozempic's forgiveness window is five days from the day the shot was due, which is longer than the four-day window on tirzepatide — one reason applying a rule learned on another GLP-1 gets people into trouble. This page covers the decision, the 48-hour minimum between any two injections, and the far murkier question of what to do when the gap has run to weeks rather than days.
Sick on a GLP-1: When to Hold the Dose and When Not To
4 min read · GLP-1 · sick day · anesthesia
Nobody writes a sick-day rule into a GLP-1 label, which leaves the most common practical question of all without an official answer. What does exist is anesthesia guidance about surgery, and a warning about kidney injury from dehydration that appears on all four major labels. Put those together and the decision becomes reasonably clear: it turns almost entirely on whether you can keep fluids down.
GLP-1 Injection Sites: Rotation, Technique and the Lump to Avoid
4 min read · injection sites · rotation · lipohypertrophy
Every weekly GLP-1 permits the same three injection sites and every one of them tells you to move around. The reason is a lump called lipohypertrophy — thickened fat that soaks up the drug at an unpredictable rate. When absorption becomes erratic so does appetite suppression, and a stalled month gets blamed on the dose when the cause is a favorite square inch of belly.
GLP-1 Pen Storage: the Day Counts Differ by Drug
4 min read · GLP-1 · pen storage · travel
The single most useful thing to know about storing these pens is that the drugs do not behave alike. Ozempic gives you 56 days at room temperature; tirzepatide gives you 21. Assuming one drug's grace period applies to another is how a month of medication quietly gets ruined, and the pen looks completely normal while it happens.
GLP-1s, Pregnancy and Birth Control: What the Labels Require
5 min read · GLP-1 · pregnancy · fertility
Two things in this area are written into the labels rather than inferred, and both get missed. Semaglutide asks for a two-month gap before a planned pregnancy. Tirzepatide asks anyone on the contraceptive pill for a barrier method across four weeks from the start, then four weeks again from every single increase — which, on a six-step ladder, is a great deal more often than people realize.
Saxenda Dose Ladder: Five Weeks, and the Three-Day Trap
5 min read · Saxenda · liraglutide · dose schedule
Saxenda is the odd one out: liraglutide, injected every day, climbing to its full dose in five weeks rather than sixteen. The short half-life that makes daily dosing necessary also creates the rule most people do not know about — three consecutive missed days and you restart the whole ladder from 0.6 mg, because your tolerance for it is already gone.
Adding a GLP-1 to Diabetes Medication: What Comes Down First
4 min read · GLP-1 · diabetes · insulin
GLP-1s lower blood sugar in a way that responds to how high it already is, which is why they cause very little hypoglycemia on their own. Insulin and sulfonylureas do not work that way — they push regardless. Put them together without adjusting anything and the combination, not the GLP-1, is what puts someone on the floor.
Switching Between GLP-1s: Why You Start at the Bottom Again
5 min read · GLP-1 · switching · Wegovy
Switching is common — a formulary changes, side effects bite, or you reach the top of a ladder with weight still to lose — and no label tells you how to do it. The rule that surprises people is that you go back to the bottom even though you have been on a GLP-1 for a year. Tolerating one of these drugs does not buy you tolerance of another, because they do not act on the same receptors.
Eating on a GLP-1: Protein Targets and What Your Stomach Will Accept
5 min read · GLP-1 · protein · muscle preservation
The mistake that costs people most on these drugs is treating the loss of appetite as permission to eat nothing. Weight comes off either way — but where it comes from depends almost entirely on whether you kept eating protein and kept loading your muscles. Get that wrong and a third or more of what you lose is the tissue you wanted to keep.
Training on a GLP-1: the Habit That Decides What You Lose
5 min read · GLP-1 · exercise · strength training
GLP-1s take weight off reliably; what they do not do is decide what kind of weight. That part is settled by whether you load your muscles. In the trial that tested this directly, exercise alone protected lean mass and exercise plus the drug produced the best body composition of any group — which makes lifting the highest-return habit available to anyone on one of these.
Who Cannot Take a GLP-1: What the Label Forbids, and What It Only Warns About
5 min read · GLP-1 · contraindications · MTC
Ask what rules someone out of a GLP-1 and you will get a long list. Read the labels and Section 4 has two entries: medullary thyroid carcinoma or MEN 2, and a serious allergy to the drug. Everything else — pregnancy, type 1 diabetes, a history of pancreatitis — is real but lives elsewhere in the document, and treating a warning as a prohibition is as unhelpful as ignoring one.
GLP-1 Blood Tests: What to Draw, and What Not To
5 min read · GLP-1 · lab monitoring · HbA1c
Two failures are possible here and only one gets discussed. Under-testing means missing a kidney that dropped after a bad week of vomiting. Over-testing means a lipase drawn on someone with no symptoms, a mildly abnormal number, and a workup that never needed to start. This card covers both directions.
In the ER on a GLP-1: What Nobody Will Think to Ask You
5 min read · GLP-1 · emergency room · anesthesia
If you end up in an emergency department on one of these drugs, the single most consequential fact about you is when you last injected — because it changes how safely you can be sedated. Nobody at triage will ask. This is the page to hand over, with the four things to say before anything else happens.
GLP-1s and Bariatric Surgery: Before, After, and Which Operation
6 min read · GLP-1 · bariatric surgery · sleeve gastrectomy
These two treatments share a patient population and are constantly used in sequence, yet the surgeon, the obesity clinic and the insurer often give three different answers. The pre-op hold is the best-defined part. The restart is consensus rather than rule. And which operation you had matters more than most people are told — a sleeve and a bypass are not the same proposition.