Move up to 5mg or not

[Fatmumslim01]

How do you decide whether to move up to 5mg or stay at 2.5?

Ive done 2 weeks on 2.5 and my provider keeps emailing to get me to order my next dose.

Week 1 I had massive suppression the first 4 days literally had a few bites of each meal. I lost 3 pounds.

Week 2 seems to be one day suppression (not as strong as week 1) then one day not as much suppression. Food noise and food cravings has basically disappeared for the past 2 weeks. I had sweets today for the first time in 2 weeks usually it would be most days 😱

Week 2 I've also had terrible heartburn and reflux, feel like there's something in my throat for the past few days, heartburn tablets aren't really helping

1 pound lost in week 2 but was in period

I've had no other side effects.

Id like to go up to 5mg as I'd like the suppression to be more consistent and id like to lose more weight each week but I'm worried that' I've had no vomiting or diarrhoea etc yet on 2.5 and don't want to rock the boat going up to 5!

I could do click count to get 3.75 but how many times can you do that?

I did two lots of 2.5mg then found the suppression wearing off. Went up to 5mg but did 3.75 for the first week. I've been absolutely fine, zero side effects and decent suppression. Eight weeks in, 22lb down.

I thought about staying at 2.5mg but decided to go up to 5mg as I was worried the positive effects would wear off. It’s looking good so far, minimal side effects and finding sticking to my eating plan easy.

Hi @Fatmumslim01 I'm wk 3 day 5 of 2.5mg and have lost just over a stone 😱

I've just ordered 5mg. I'm going to attempt the golden dose from my 2.5mg in wk 5. The 5mg is the same price as the 2.5 so I figured if I have it, I have options. If I order 2.5 I can only use 2.5.

My plan us golden dose, then all being well 3.75 from the 5mg pen.

Price is often same for both doses. You can carry on on a lower dose if you wish to by counting the clicks and go up the moment it no longer works at 2,5 mg. Once, I ordered the same dose as it was working great, and by the time I got to use it, I felt like it wasn't enough.

I moved up to 5 but the suppression is almost too much. I can't eat. I'm not hungry, don't think about food and can't stomach a lot. On 2.5 I had 0 food noise and only ate when I was hungry and lost 10lb in 4 weeks so it was defo doing something. My suppression disappeared 4 days in to my second week of 2.5 which is why I moved up to 5 but in weeks 3 & 4 my suppression was consistent on 2.5. Gonna try 3.75 next jab day.

This is how I felt the first few days of week one... absolutely stuffed on a few bites and I liked it and want that to come back again hence my thinking of going up to 5mg

I just chose to follow the guidelines 🤷🏻‍♀️

This is the problem, the guidelines say you can move up or stay on 2.5?

I went up to 5mg as advised and the side effects were horrendous , constipation, indigestion, nausea I was sick 3 times and just felt ill.

I stopped for a week, still kept up the healthy eating and lost weight, and then did 2.5mg (30 clicks) for 2 weeks out of the 5mg pen.

I have reordered 2.5mg ever since, I have been on it since December and have lost over 3 stone.

I inject on a Friday morning and I have found if I am going to get side effects they usually appear around the 48hour mark after injecting.

I am getting suppression until around Tuesday, my diet has completely changed so I just carry on eating healthily all week.

You can order the 2.5mg if you wish or you can go up it is up to you.

The leaflet inside your box actually says “the starting dose is 2.5 mg once a week for four weeks. After 4 weeks your doctor will increase your dose to 5mg once a week.”

You are meant to move up from 2.5

But you don't need to if your suppression is still strong on a lower dose. Of course the prescribers want you to increase your dose - it's more expensive. MedExpress told me it was time but move up to 7.5 from 5, but I experienced terrible nausea on 5 so I reduced the dose on my 5 pen and ordered another 5 pen. I've no intention of increasing any time soon.

Advice is usually if you have suppression and loosing weight you can stay in current dose.
side effects are often stronger with higher doses

having done monthly increases previously I suffered side effects that made me stop, this time I’m staying at low dose of possible.

IMO its really important to use this medication to change eating habits, not stop eating, so if you are not eating usually (obviously not high fat, calorific foods), then you risk weight returning if you return to usual eating when off the meds.

Actual use of many prescription only medications often vary from the generic in box leaflets. If a qualified doctor or pharmacist is happy to support their patient to stay on 2.5mg they absolutely can. There are no health risks not moving up doses if it is not needed or desired, only benefits.

@Fatmumslim01 buy the 5mg pen - the cost difference is usually minor and it give your flexibility. Then take 2.5mg (30 clicks) from it until you feel it 2.5mg is no longer allowing you to stick to your chosen calorie deficit.

If you choose to go up to 3.75mg (45 clicks) you can do this for as many weeks as you want. I am on week 35 of 3.75mg.

@WeAllHaveWings if I was to do the 45 clicks of a 5mg would that mean throwing some away as the pen only does 4 pumps isn't that right and although I could syringe a golden dose out, I couldn't do that twice as would be over the 30 days if they are a week apart each dose?

@Fatmumslim01 with 45 clicks you will get 5 doses (45 clicks x 5 doses + 2 clicks x 5 primes = 235 clicks) out of the pen before it locks. The pen locks around 256 clicks as Eli Lilly allow for 4 doses and up to 8 primes.

5 doses would be on days 0,7,14,21,28.

There will be enough liquid left for a 6th 3.75mg / 0.45ml dose on day 35 using a syringe (as pen will lock around 20 something clicks). This will obviously be 5 days beyond the discard after 30 days instruction.

I personally am comfortable if pen has been kept in the fridge to do a 6th dose. Up to you to risk assess how you feel about doing that for yourself.