GLP-1 Titration Tool
Free Dose Escalation and Safety Guidance
Whether you take Ozempic, Wegovy, Mounjaro, or any of the 15 plus Indian generic semaglutide brands now available from ₹1,290 a month, this tool tells you where you are in your titration ladder, flags side effects that need attention, and identifies when to seek urgent care.
Supports both patients and clinicians. No email required. No paywall. Results delivered immediately in your browser and never stored on any server.
Reviewed by Dr. Rejeesh M. Menon, MD Internal Medicine
Based on FDA and DCGI prescribing information
Your health data stays in your browser only
Covers Indian generics not found on any Western tool
How does the GLP-1 Titration Tool work? The DermaVue GLP-1 Titration Tool uses physician-reviewed CTCAE-graded logic to determine whether your current dose of semaglutide, tirzepatide, or liraglutide should be escalated, held, or reduced. It supports all major brands sold in India, including Ozempic, Wegovy, Mounjaro, and 15 plus generic semaglutide products. Results are delivered in your browser and never stored on a server.
The DermaVue Clinics GLP-1 Titration Tool applies CTCAE-graded symptom severity scoring and the FDA and DCGI prescribing rules for semaglutide, tirzepatide, and liraglutide to deliver safe dose escalation guidance for both patients and physicians. The tool covers all 15 plus Indian generic semaglutide brands approved after the March 2026 patent expiry, including products from Natco, Sun Pharma, Zydus, and Dr. Reddy's. It is reviewed by Dr. Rejeesh M. Menon, MD Internal Medicine, with more than a decade of experience in obesity medicine across the US and Indian healthcare systems. All processing happens in the browser. No data leaves the device.
GLP-1 Missed Dose. What to Do by Medication
Missed dose instructions per GLP-1 medication. India 2026.
Medication
Take Missed Dose If
Skip Missed Dose If
Never
Ozempic or generic semaglutide (weekly)
5 or fewer days since scheduled dose
More than 5 days have passed
Double-dose or take two injections in one week
Wegovy or Noveltreat (weekly)
Next dose is more than 2 days (48 hours) away
Next dose is within 2 days
Mounjaro or Yurpeak (weekly)
4 or fewer days (96 hours) since scheduled dose
More than 4 days have passed
Rybelsus (daily oral)
Always skip. Take next tablet the following morning.
Take two tablets in one day
Saxenda or liraglutide (daily)
Always skip. Resume normal daily schedule.
Take two injections in one day
Per FDA and DCGI prescribing information. GLP-1 half-life determines the safe missed-dose window. Semaglutide t½ around 7 days. Tirzepatide t½ around 5 days.
INTERACTIVE TOOL
Start your free titration check below
Select your medication, enter your dose, score your symptoms. Results in under 3 minutes.
GLP-1 Titration Tool
LIVE
DermaVue GLP-1 Titration Tool
Find your safest next dose.
A board-reviewed tool for GLP-1 titration in India. Built on CDSCO labeling, MHRA pancreatitis guidance, and CTCAE v5 grading. Your data stays in this browser tab and clears when you close it.
This tool supports clinical decision making. It does not replace a consultation with your prescriber.
The Workflow
How This Tool Works
Select your medication and format. Choose your brand from Ozempic, Wegovy, Mounjaro, Rybelsus, Saxenda, Victoza, Trulicity, or any of the 15 plus Indian generic semaglutide brands. Specify pen, multi-dose vial, or oral.
Tell us your current dose and timing. Enter your current dose, when you started it, and your next scheduled dose. The tool calculates your steady-state position automatically.
Report symptoms using CTCAE-graded severity. Score nausea, vomiting, diarrhoea, and abdominal pain on a clinically validated 4-point scale. Red flags are surfaced immediately.
Get a clinically grounded recommendation in seconds. Escalate, hold, reduce, or seek urgent care. A physician-friendly EMR summary is available for clinicians who want to print or paste it into a record.
Patient and Physician Profiles
Who This Tool Is For
Patients already on GLP-1 therapy.
Walk through each step of your titration ladder with clinical guardrails. Get a clear answer on when to escalate your dose, when to hold, and when to seek urgent care. Every recommendation applies the FDA and DCGI minimum 4-week step gate that a physician would apply in clinic.
Physicians supporting patients remotely.
CTCAE-graded assessment, EMR-style output, print-friendly physician summary, and the only Indian generic brand database in one place. Built for the realities of telemedicine consultations across Kerala, Tamil Nadu, and the wider Indian market.
Patients not on GLP-1 yet.
This tool is for active treatment. If you are exploring whether GLP-1 therapy is right for you, take our eligibility assessment first. The titration tool assumes you have already started a medication.
Indian Market Context
Indian Generic Semaglutide Brands
The semaglutide patent expired in March 2026 and the Indian market changed overnight. More than 15 generic brands cleared the CDSCO approval queue in the first six weeks, with prices dropping from around Rs 8,100 per month for branded Ozempic to as low as Rs 1,290 for Natco and Glenmark generics. Sun Pharma, Zydus, Dr. Reddy's, Eris, and Alkem followed with their own products. The molecule is identical across all of them. The differences lie in pen design, dose precision, titration ladder coverage, and distribution.
Most Western titration tools do not know these brands exist. This tool tracks all of them, and Sun Pharma Noveltreat and the Zydus reusable pen are the only two Indian generics that execute the full 5-step Wegovy obesity path. Read our full guide to generic GLP-1 in India for brand-by-brand pricing, pen comparisons, and dose precision data.
Storage and Cold Chain
Storing Your GLP-1 Medication Correctly
All injectable GLP-1 medications require refrigeration between 2 and 8 degrees Celsius before first use. After first use, most pens can be stored at or below 30 degrees Celsius for a defined window. Wegovy holds for 28 days after first use. Ozempic holds for 56 days. Tirzepatide holds for 21 days. Saxenda holds for 30 days. Trulicity holds for 14 days at room temperature.
Never freeze. A frozen pen or vial must be discarded. The protein structure of semaglutide and tirzepatide is destroyed by ice crystallisation.
Avoid sunlight and heat. Keep the pen in the original box until use. Indian summer temperatures above 35 degrees Celsius will degrade the medication faster than the labelled window.
Travel cold packs work. A medical-grade insulated pouch with a cold pack maintains 2 to 8 degrees Celsius for 8 to 12 hours, which covers most domestic flights and road trips.
Multi-dose vials require even more care. Once opened, always refrigerate, never leave at room temperature. Discard after the manufacturer-stated window even if drug remains.
If your medication has been frozen, exposed to high heat, or stored beyond the labelled window, do not inject. Contact your supplying pharmacy or physician.
You should not escalate if you are still having moderate or severe nausea, vomiting, or diarrhoea on the current dose, if you have lost more than 1.5 percent of your body weight per week for two consecutive weeks, or if you are dehydrated. The CDSCO March 2026 prescribing directive is clear that minimum 4 weeks at each dose is the floor, not a target. If side effects are not yet under control, holding the current dose for another 4 weeks is the right call. Escalation while symptomatic increases the risk of pancreatitis, severe gastroparesis, and hospital admission. Patient comfort is the gating factor, not the calendar.
Minimum 4 weeks for once-weekly semaglutide and tirzepatide. Minimum 1 week for daily liraglutide such as Saxenda. These minimums come from the FDA and DCGI prescribing information and are based on the steady-state pharmacokinetics of each drug. Semaglutide has a 7-day half-life, so it takes about 4 weeks to reach steady state. Tirzepatide has a 5-day half-life and reaches steady state in about 3 to 4 weeks. Daily liraglutide reaches steady state in 3 days, but a 1-week buffer allows GI tolerability to settle. Many patients benefit from 6 to 8 weeks at intermediate doses to consolidate weight loss and tolerate side effects.
The five red flags I screen for at every follow-up are severe upper abdominal pain radiating to the back (possible pancreatitis), persistent vomiting that prevents fluid intake (possible gastroparesis or dehydration), a neck lump or hoarseness lasting more than 2 weeks (thyroid signal), vision changes or sudden severe headache, and any signs of allergic reaction including facial swelling or difficulty breathing. Any one of these means stop the medication and seek urgent care. Mild to moderate nausea, early satiety, and constipation are expected and manageable. Pain that wakes you from sleep or vomiting that lasts more than 24 hours is not.
For Indian patients I use Asian BMI cutoffs, not Western ones. A BMI of 23 to 24.9 is overweight in the South Asian context, and a BMI of 25 or higher is obesity. I consider GLP-1 therapy from a BMI of 27.5 if there is a comorbidity such as type 2 diabetes, prediabetes, PCOS, fatty liver, or hypertension. Without a comorbidity, the threshold is a BMI of 30. Waist circumference matters as much as BMI for South Asians. A waist above 90 cm in men or 80 cm in women raises visceral risk even when BMI reads normal. The 2022 Indian Consensus on Obesity is the reference framework I work from.
Yes, when prescribed and supervised by a physician. After the semaglutide patent expired in March 2026, the CDSCO approved more than 15 Indian generic brands from manufacturers including Natco, Glenmark, Eris, Alkem, Sun, Zydus, and Dr. Reddy's. Prices range from Rs 1,290 to Rs 4,200 per month versus Rs 8,100 for branded Ozempic. The molecule and the safety profile are identical. Where the brands differ is in pen design, dose precision, and titration ladder coverage. Only Sun Pharma Noveltreat and the Zydus reusable pen execute the full 5-step Wegovy obesity path in generics. Most other brands cap at 1 mg.
Use the calculator built into this tool. Do not hand-compute from a generic example online. Indian generic semaglutide vials come in two concentrations and the math differs between them. The 2 mg per 1.5 mL and 4 mg per 3 mL vials (Semanat, GLIPIQ, Sundae) carry 1.333 mg per mL. The 8 mg per 3 mL vial carries 2.67 mg per mL. A 0.25 mg starter dose drawn from a 1.333 mg per mL vial is 19 units on a U-100 insulin syringe. The same 0.25 mg dose from a 2.67 mg per mL vial is only 9 units. Mixing those two answers is the single most common dosing error we see, and a 2 to 3 times overdose is the realistic worst case. The vial calculator inside this tool reads your exact brand, exact concentration, and exact prescribed dose, and tells you the precise volume, the U-100 unit count, and which syringe size (0.3, 0.5, or 1.0 mL) to ask the pharmacist for. U-40 insulin syringes are not compatible and should not be used. For your first vial draw, ask the prescribing physician or a nurse to demonstrate the technique once.
For weekly semaglutide (Ozempic, Wegovy), take the missed dose if it has been less than 5 days since the missed day. If more than 5 days have passed, skip and resume on your normal day. For weekly tirzepatide (Mounjaro), the window is 4 days. Never double up. Always allow at least 48 hours between two doses of any weekly GLP-1. For daily semaglutide (Rybelsus) and daily liraglutide (Saxenda, Victoza), simply skip the missed dose and continue with the next scheduled dose. Doubling daily doses sharply increases nausea and vomiting. This tool calculates the right action for your specific drug and timing automatically.
No. Semaglutide, tirzepatide, and liraglutide are not approved during pregnancy or breastfeeding. The FDA places semaglutide and tirzepatide in pregnancy category data-insufficient, and animal studies have shown reproductive toxicity at higher doses. If you are planning pregnancy, stop GLP-1 therapy at least 2 months before conception for semaglutide and at least 1 month before for tirzepatide, both because of the long half-life. Effective contraception during treatment is essential. Tirzepatide specifically reduces oral contraceptive absorption, so a non-oral method or a barrier method is required for 4 weeks after initiation and after every dose escalation.
Three matter most. First, oral contraceptives with tirzepatide. Tirzepatide reduces oral contraceptive absorption and you need a non-oral or barrier method during initiation and dose changes. Second, sulfonylureas and basal insulin in type 2 diabetes. GLP-1 therapy increases hypoglycaemia risk when combined with these, and the dose of the sulfonylurea or insulin should be reduced at GLP-1 initiation. Third, oral medications with narrow therapeutic windows such as warfarin, levothyroxine, and certain antiepileptics. GLP-1 therapy slows gastric emptying and can change absorption timing. These need closer monitoring and sometimes a dose adjustment.
In India, GLP-1 receptor agonists are Schedule H prescription drugs. Any registered medical practitioner with an MBBS or higher can legally prescribe them, but in practice the drugs are best managed by physicians with specific training in obesity medicine, endocrinology, or diabetology. The DermaVue SuperHuman Program is led by physicians with more than a decade of experience in metabolic disease and GLP-1 titration across both the US and Indian healthcare systems. Online sellers and pharmacies offering semaglutide or tirzepatide without a valid prescription are operating outside the law, and the side effects from those cases account for a large share of the avoidable harm we see.
Reviewed by
Dr. Rejeesh M. Menon, MD Internal Medicine
The DermaVue GLP-1 Titration Tool and its underlying CTCAE scoring rules are
reviewed and signed off by Dr. Rejeesh M. Menon, MD Internal Medicine. With more
than a decade of experience managing obesity, type 2 diabetes, PCOS, and metabolic
disease across the US and Indian healthcare systems, Dr. Menon leads the SuperHuman
Medical Weight Loss Program at DermaVue Clinics. The output of this tool is
educational. A consultation is required before starting, escalating, or stopping
any GLP-1 therapy.