Simultaneous start protocol (standard approach) When to use: Starting both peptides fresh (no prior use) Following clinical trial model exactly Want maximum proven efficacy Can tolerate both from beginning Week-by-week dosing schedule: Weeks 1-4: Semaglutide: 0.25mg weekly Cagrilintide: 0.6mg weekly Inject same day OR different days (preference) Separate injection sites if same day Tips: Start ginger supplementation, small meals, hydrate well Weeks 5-8: Semaglutide: 0.5mg weekly (2x increase) Cagrilintide: 1.2mg weekly (2x increase) Nausea typically increases this phase Tips: Anti-nausea meds ready, protein shakes if needed, slow eating Weeks 9-12: Semaglutide: 1.0mg weekly Cagrilintide: 1.8mg weekly Peak side effect window Tips: May need to extend by 1-2 weeks if struggling, Zofran helpful Weeks 13-16: Semaglutide: 1.7mg weekly Cagrilintide: 2.4mg weekly (cagrilintide at target) Semaglutide still escalating Tips: Cagrilintide side effects should be stabilizing Week 17+: Semaglutide: 2.4mg weekly (both at maximum) Cagrilintide: 2.4mg weekly Maintenance dosing Continue indefinitely Tips: Side effects typically moderate by now (adapted) Injection logistics: Both subcutaneous injections Can inject same day (different sites: left/right abdomen) OR split: Semaglutide Monday, Cagrilintide Thursday Rotate sites to prevent irritation 29-31 gauge insulin syringes See our peptide injections guide , how to reconstitute peptides , and peptide dosing guide
Not because the peptides stopped working, but because your receptors downregulated in response to chronic stimulation
If this severe elevation is accompanied by chest pain, severe headache, shortness of breath, or neurological symptoms, call 911 immediately as this represents a hypertensive emergency
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