Concentration and dose get conflated constantly in this subcategory. Changing how much diluent you add changes the volume you draw and changes nothing about the dose.
Worth checking against a second source before it gets quoted onward.
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Practice · Dosing & titration · continued
Stepping down deliberately, and how to do it without losing progress — what changed since posts 91–100
This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.
I came in to disagree and I am leaving without a disagreement.
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Answering the question post #89 raises rather than the one it answers.
Research-use-only material is not a licensed product and no labelling covers it. Everything in this subcategory about published schedules describes what was done in trials of licensed formulations.
The uncertainty is in the assumption, not in the calculation.
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cohort_notes, post #78: Narrowing post #75, because the general version has more than one answer. Nothing here is medical advice, and a titration question is one of the few where a prescriber can genuinely answer in a minute what a thread will take a week to circle. I looked this up rather than remembered it, which is the right order. Go to post
The arithmetic in post #93 is right; the assumption feeding it is the part to check.
Concentration and dose get conflated constantly in this subcategory. Changing how much diluent you add changes the volume you draw and changes nothing about the dose.
The short version is the first sentence; the rest is why.
o.vukovic, post #17: Where I part company with post #13, and it is a narrow parting. The most common practical error is not the schedule at all — it is losing track of which step you are on after a break, and then resuming at the top rather than re-approaching it. Go to post
Everything in post #93 holds. The case it does not cover is the one I have.
Dose equivalence between different incretin analogues is a weak concept. The molecules differ in structure, half-life, receptor selectivity, and in what has been studied clinically. One mg of semaglutide is not equivalent to one mg of something else in any meaningful sense.
The conclusion is tentative; the arithmetic underneath it is not.
Collapsed as off-topic by two members at trust level 3 or above
Stepping down deliberately: the withdrawal trials show that stopping is followed by regain. The step-down literature is thinner. The conservative assumption is that stepping down is followed by some regain, with the magnitude unknown.
I would put this at better than even and not much better.
a.vestergaard, post #71: Post #67 and I disagree about the size of the effect, not about the direction. Concentration and dose get conflated constantly in this subcategory. Changing how much diluent you add changes the volume you draw and changes nothing about the dose. Written quickly, so the reasoning may be tighter than the wording. Go to post
Concentration and dose get conflated constantly in this subcategory. Changing how much diluent you add changes the volume you draw and changes nothing about the dose.
Confirming post #97 from a second method, which matters more than confirming it from a second person.
There is no published evidence about slower escalation because nobody studied it. That means the trials support not going faster and are silent on going slower, which is a different claim from "slower is fine".
I have separated what I observed from what I concluded, which does not always happen.
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This topic was referenced in
- Reaching a dose and staying there for a year: a longitudinal notePractice › Dosing & titration · 2 replies
- Follow-up: The lowest dose that does anything: is that a real question?Practice › Dosing & titration · 75 replies
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