I've been on semaglutide since September and the titration up to 1.0mg was totally manageable. Mild nausea first couple days at each new dose, nothing crazy. I was actually feeling great — down 28lbs, food noise gone, energy up.

Then I moved to 1.7mg last Tuesday and OH. MY. GOD. The nausea hit like a truck. I'm talking can't-get-off-the-couch, room-spinning, constant waves of wanting to throw up. It's been 5 days and it's barely improving.

I've tried:

• Ginger tea/candies
• Small bland meals
• Staying hydrated
• Zofran (ondansetron) 4mg — helps a little but doesn't eliminate it

Is this normal for the 1.7 jump? The jump from 0.5 to 1.0 was nothing compared to this. I'm seriously considering asking my doc to go back to 1.0. Has anyone else had this experience?

The 1.0 → 1.7 jump is notorious. You're going from 1.0 to 1.7 which is a 70% increase in dose. Compare that to the 0.5 → 1.0 jump which is "only" 100% — but you had less drug in your system overall. At 1.7mg you're getting into serious territory with serum levels.

It took me a solid 10-12 days to adjust to 1.7. The first week was rough but by day 10 I was back to normal. Hang in there if you can.

Some things that helped me that you didn't mention:

• Eating protein FIRST, before any carbs or fat
• Peppermint oil capsules (enteric coated)
• Not lying down after eating — sit upright for at least 30 min
• Smaller, more frequent meals — I was eating 5-6 tiny meals instead of 3

e thing happened to me. I actually dropped back to 1.0 for an extra 4 weeks then tried 1.7 again and it was WAY more tolerable the second time. My endo said this is a totally reasonable approach and there's no rule that says you have to do exactly 4 weeks at each dose.

Previously posted:

I'm seriously considering asking my doc to go back to 1.0. Has anyone else had this experience?

Before you step back down, a few clinical points to consider:

The 1.0 → 1.7 transition does have higher discontinuation rates in the trials. In STEP 1, the most common time for participants to drop out due to GI adverse events was during the 1.0 → 1.7 and 1.7 → 2.4 transitions.[1]

Options your prescriber might consider:

1. Extended titration: Stay at 1.0 for 8 weeks instead of 4 before attempting 1.7 again
2. Intermediate dosing: Some prescribers use compounded semaglutide to do a 1.25mg or 1.5mg intermediate step (note: this is off the standard Wegovy titration)
3. Antiemetic protocol: Zofran + famotidine (Pepcid) together can be more effective than Zofran alone
4. Dietary modifications: Strict low-fat, low-fiber diet for the first 2 weeks at the new dose

If you were doing well at 1.0 and losing weight, there's also the question of whether you even need to go to 1.7. The dose-response curve for weight loss starts to flatten at higher doses — the incremental benefit of 1.7 over 1.0 is less than the benefit of 1.0 over 0.5.

tbh the intermediate dosing thing saved me. I was on compounded sema and my provider did 1.0 → 1.25 → 1.5 → 1.7 with 3 weeks at each step. Barely any nausea at all. The big jumps on Wegovy are just too aggressive for some people's GI systems.