Titration means starting a medicine at a low dose and stepping it up gradually over weeks, rather than starting at the full dose. Approved GLP-1 labels (Wegovy, Zepbound and similar) are written this way.
It matters for two separate reasons:
- Tolerance. Stepping up slowly is how the label manages side effects like nausea.
- Cost. Compounded products are usually priced by the milligram, so the monthly price often climbs as the dose goes up — which is why the GLP-1 cost calculator prices compounded options by dose.
Getting it wrong is a documented safety problem. In a July 2024 alert, the FDA warned that dosing errors with compounded semaglutide led some people to take 5 to 10 times the intended dose, with some requiring hospitalization.[1] Miller et al. reported that poison-center calls about GLP-1 drugs rose 2.2-fold after 2021, mostly from unintentional errors such as taking a weekly dose daily or skipping the step-up schedule.[2]
The schedule itself comes from the prescriber and the product label.