GLP-1 Dosing Calculator
Dose escalation schedules for GLP-1 receptor agonists. Select a medication, enter your current treatment week, and see the recommended dose with titration timeline.
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Disclaimer: For educational purposes only. Not a substitute for clinical judgment. Always verify dosing with the prescribing information.
About This Tool
What Are GLP-1 Receptor Agonists?
GLP-1 (glucagon-like peptide-1) receptor agonists are a class of injectable medications that mimic the incretin hormone GLP-1. They stimulate insulin secretion in a glucose-dependent manner, suppress glucagon, slow gastric emptying, and promote satiety. Originally developed for type 2 diabetes, several agents are now FDA-approved for chronic weight management. Tirzepatide is a dual GIP/GLP-1 receptor agonist with enhanced efficacy for both glycemic control and weight loss.
Why Dose Escalation Matters
All GLP-1 receptor agonists require gradual dose titration over weeks to months. Starting at the target dose causes unacceptable nausea, vomiting, and diarrhea in most patients. The escalation schedule allows the GI tract to adapt. Each dose level should be maintained for the minimum specified period (typically 4 weeks) before increasing. If side effects are intolerable, the dose can be held or reduced temporarily without restarting from the beginning.
Comparing GLP-1 Agonists
In clinical trials, tirzepatide (Mounjaro/Zepbound) produced the greatest weight loss — up to 22.5% body weight at the 15 mg dose in the SURMOUNT-1 trial. Semaglutide 2.4 mg (Wegovy) produced approximately 15% weight loss in the STEP trials. Liraglutide 3.0 mg (Saxenda) produced about 8% weight loss. Dulaglutide and exenatide are primarily used for type 2 diabetes with modest weight loss benefits. Choice of agent depends on indication, insurance coverage, patient preference, and tolerability.
Renal Considerations
Most GLP-1 agonists do not require dose adjustment in renal impairment. However, exenatide (both IR and ER formulations) should not be used in patients with CrCl <30 mL/min or end-stage renal disease, and should be used with caution in CrCl 30–50 mL/min. All GLP-1 agonists can cause dehydration through GI side effects, which may worsen renal function — monitor renal function during dose escalation, especially in patients with pre-existing CKD.
🔑 Clinical Pearls
- Tirzepatide and semaglutide are the most effective agents for weight loss. Tirzepatide's dual GIP/GLP-1 mechanism may offer advantages in glycemic control.
- Liraglutide is the only daily GLP-1 agonist still widely used; all others are weekly or twice-daily (exenatide IR).
- GLP-1 agonists should not be combined with each other. They can be combined with basal insulin but sulfonylurea/insulin doses may need reduction to avoid hypoglycemia.
- All GLP-1 agonists should be discontinued at least 1 week before elective surgery (some guidelines recommend longer for weekly formulations) due to aspiration risk from delayed gastric emptying.
- Weight regain is common after discontinuation. Discuss long-term plans with patients before initiating therapy.
Key References
- Jastreboff AM, et al. Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022;387(3):205–216. (SURMOUNT-1)
- Wilding JPH, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989–1002. (STEP 1)
- Pi-Sunyer X, et al. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med. 2015;373(1):11–22. (SCALE)
- Mounjaro (tirzepatide) Prescribing Information. Eli Lilly and Company, revised 2024.
- Ozempic / Wegovy (semaglutide) Prescribing Information. Novo Nordisk, revised 2024.
Formula last verified: February 2026