Need advice on switching from Sema to Reta dose 🙏
- Thread starter Westdonut
- Start date
Since reta is a triple agonist medication and sema is only a single agonist, there's more happening with reta, so the 2mg dose used in the trials is the right place to begin. Because you're going back to a starting dose, appetite suppression will probably feel much weaker than what you're used to.
If needed, step up to 4mg after 4 weeks. Then, if needed again, go to 6mg after another 4 weeks. The same pattern applies for 9mg and 12mg should you require those higher doses.
If needed, step up to 4mg after 4 weeks. Then, if needed again, go to 6mg after another 4 weeks. The same pattern applies for 9mg and 12mg should you require those higher doses.
Calm Logic
Explorer
Starting at 2 mg weekly sounds right to me. If it were me, I'd split it into 1 mg twice a week, particularly because a new kit is also entering the picture.
Holding one dose steady for a month was more patience than I had, unless someone is nearing maintenance. Should weight keep creeping up after the switch, another route is stacking some of your leftover sema.
Holding one dose steady for a month was more patience than I had, unless someone is nearing maintenance. Should weight keep creeping up after the switch, another route is stacking some of your leftover sema.
lessthanhalf
Explorer
Starting Reta at 2mg seems reasonable to me as well. That said, if there's a good chance you'll want to move up in dose more often than once every 4 weeks — and the fact that you're asking this makes me think that's likely — then 1mg twice weekly would be my suggestion instead. Smaller amounts taken more frequently tend to cause fewer problems than bigger, less frequent ones. Since you report no side effects at 2.4mg of semaglutide, stepping up somewhat faster than every 4 weeks is probably fairly safe. Reta on average likely causes side effects at slightly lower rates than sema, particularly GI ones, though it brings some of its own, such as a higher heart rate and occasionally anxiety or insomnia. If you plan to adjust doses or do anything other than the usual increase every 4 weeks, check out GLP plotter — it makes it much easier to see how the drug level in your body changes over time.
Calm Logic
Explorer
Are you maintaining your weight and dealing with FOMO? Hoping to shed another 10 pounds? Sleeping too well?, haha.
If stacking is how you want to begin (a common approach when moving from tirz to reta), then for me the bigger question is how much reta to add. In all likelihood, no more than 1 mg in the first week, or 0.5 mg taken twice weekly, before increasing at some point. As for how much sema to reduce, I'm not sure.
If stacking is how you want to begin (a common approach when moving from tirz to reta), then for me the bigger question is how much reta to add. In all likelihood, no more than 1 mg in the first week, or 0.5 mg taken twice weekly, before increasing at some point. As for how much sema to reduce, I'm not sure.
BNLFL
Explorer
I'm with you on starting at 2mg/week for 4 weeks, then increasing by 2mgs each time. My wife had hit a long stall, so we recently added Tirz to her Reta schedule — Tirz on Tuesdays and Reta on Fridays. It looks like it may have kick-started things for her, though it's only been since Tuesday a week ago. Best of luck, OP.
Calm Logic
Explorer
That's essentially right. Still, to be clear: if you're combining reta with sema, I wouldn't go above 1 mg of reta in week one. You could likely maintain your full sema dose without problems, particularly if you split reta into 2 shots of 0.5 mg per week.
Also, if maintenance is near, gaining a few pounds may be acceptable, so stacking might not be necessary. Since you've never used tirz before and responses vary widely, it's genuinely hard to predict how strongly reta will hit you at the start.
Splitting doses (taking half the reta and possibly sema twice weekly) reduces side effects and gives you more room to react. So after that first small reta dose, wait a few days and assess how you feel before the next injection. Heartburn or bloating may signal that constipation or diarrhea is coming, which is a reason to think about skipping the next dose and reducing your weekly total.
