The protocol at a glance
Once a week, same day each week. Every trial started at 2 mg and stepped up every 4 weeks to the assigned dose.
| Weeks | Weekly amount in the trials (highest group) |
|---|---|
| 1–4 | 2 mg |
| 5–8 | 4 mg |
| 9–12 | 8 mg (phase 2) · 9 mg target group in TRIUMPH-1 |
| 13+ | 12 mg |
Phase 2 groups: 1, 4, 8 or 12 mg (ClinicalTrials.gov NCT04881760). TRIUMPH-1 groups: 4, 9 or 12 mg, all starting at 2 mg and stepping up every 4 weeks (Lilly, May 2026).
Community reports commonly start lower than the trials, around 0.5 mg a week, then step up to 1, 2 and 4 mg with at least 4 weeks at each amount. Some drop to about 1 mg a week once they reach their goal.
What people say they do, collected from community discussions. Not tested in a trial; shown so you can compare it with the evidence above.
Mixing calculator
Enter the vial size, the water you add and the amount you want to draw; it gives the mark on a 100-unit (1 mL) insulin syringe.
What the trials found
Average body-weight change in the two main obesity trials:
Placebo: −2.1% (phase 2, 48 weeks, 338 adults; Jastreboff et al., NEJM 2023) and −2.2% (TRIUMPH-1, 80 weeks, 2,339 adults; Lilly topline, May 21, 2026).
Side effects
- Nausea, diarrhoea, vomiting and constipation were the most common, more frequent at higher doses and during step-ups. In TRIUMPH-1 nausea affected 29–42% on retatrutide vs 15% on placebo.
- Dysesthesia (unusual skin sensations): 5–13% on retatrutide vs about 1% on placebo in TRIUMPH-1.
- Heart rate rose with dose in phase 2 and eased later in the trial.
- Stopping because of side effects in TRIUMPH-1: 4.1% (4 mg), 6.9% (9 mg), 11.3% (12 mg) vs 4.9% placebo.
How it works
GLP-1 receptor
Slows stomach emptying and signals fullness to the brain.
GIP receptor
Works alongside GLP-1 on insulin release and fat tissue.
Glucagon receptor
Raises energy use and liver fat burning. Tirzepatide does not have this part.
Sources
- ClinicalTrials.gov NCT04881760 (phase 2 dose groups)
- ClinicalTrials.gov NCT05929066 (TRIUMPH-1)
- Jastreboff AM et al. N Engl J Med 2023 (phase 2 results)
- Eli Lilly TRIUMPH-1 topline release, May 21, 2026