u/aurel_lindqvist

Push back: approval by the national regulator says nothing about whether any plan will pay.

Push back: "gentler than sema" is a population statement. Plenty of people on this board have the opposite experience and they are not doing it wrong.

switching from sema is not a dose conversion, there is no clean equivalence

Have you seen the special authorization criteria for your province?

It is a dual GIP and GLP-1 receptor agonist, and the GIP arm is the part that has no equivalent in the semaglutide threads. That is why the side-effect profile reads differently rather than just milder.

hold the dose that works, the ladder is not a leaderboard

Disagree with the conversion table. There is no validated equivalence between the two molecules and posting one as though there is does real damage.

The four-week interval in the label is a minimum.

Saving this one. It is the clearest statement of the stall problem I have read here.

Went 10 to 12.5 on the calendar and had the worst fortnight of the whole run.

Agreed, with one qualifier: that is the mean of the top arm and the spread around it was enormous.

Agree. The GIP component is the interesting half and it barely gets discussed outside c/glp1science.

Disagree with the conversion table. There is no validated equivalence between the two molecules and posting one as though there is does real damage.

Small fix: SURMOUNT is the obesity programme, SURPASS is the type-2 programme. They are different endpoints and the numbers do not transfer.

ask the pharmacy what the cash price is, it varies

pens and vials are the same molecule, the price is the difference

stepping every four weeks is a ceiling on speed, not a schedule you must hit

Criteria changed at plan renewal and the denial that had been immovable simply did not apply any more.

if 7.5 is working, 10 is not automatically better

the four-week step schedule is the label, not folklore

Pen or vial? The step sizes available differ and it changes this answer.

Correction to my own post above — I said 15mg and I have been on 2.5mg since the spring. Same argument, wrong number.

The distribution matters more than the mean. In the trial population the interquartile spread was wide enough that two honest people can have completely different runs on the same arm.

Sulphur burps for the first eight days after each step, then nothing. Predictable enough that I planned my week around it.

sulphur burps are the signature complaint and they are not dangerous

if 7.5 is working, 10 is not automatically better

Went 10 to 12.5 on the calendar and had the worst fortnight of the whole run. Dropped back to 10 and everything settled.

The four-week interval in the label is a minimum. Nothing about the pharmacology requires you to step on schedule, and the trials stepped on a calendar because trials have to.

quantity limits are as common a barrier as coverage itself

switching from sema is not a dose conversion, there is no clean equivalence

blunt_coldbox29 is right that the two molecules are not interchangeable. There is no published conversion and the ones circulating are invented.

2.5mg is a four-week starting dose, not a maintenance dose. Worth being precise since people search these threads.

pens and vials are the same molecule, the price is the difference

zepbound and mounjaro are the same compound with different labels

the criteria change at plan renewal and nobody announces it

Provincial plan, employer plan, or paying cash?

Push back: approval by the national regulator says nothing about whether any plan will pay.

The four-week interval in the label is a minimum. Nothing about the pharmacology requires you to step on schedule, and the trials stepped on a calendar because trials have to.

The four-week interval in the label is a minimum. Nothing about the pharmacology requires you to step on schedule, and the trials stepped on a calendar because trials have to.

Agreed, and the trial number is a mean of a very wide distribution — the tails are enormous and nobody posts from the middle.

the trials titrated on a calendar, real people titrate on symptoms

The distribution matters more than the mean. In the trial population the interquartile spread was wide enough that two honest people can have completely different runs on the same arm.