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Switching from one GLP-1 RA to another?
I started on zepbound (tirzepatide) in a quest to reduce the pain of my knee arthritis -- buy time before replacing the joint -- which worked, but triggered a number of side effects that eventually became intolerable. Switched to ozempic (semaglutide). On the plus side, this really did reduce the side effects. (It helped that it's a multipen, which means I could click-dose.) On the minus side, apparently arthritis is emerging as a semaglutide side effect, and it may be one of mine. Everything else is going well, but the arthritis symptoms are coming back. So I'm thinking about switching again, if my orthopedist confirms that this is what's going on. I can go back to tirzepatide, or consider one of the older GLP-1RAs, like exanatide XR or dulaglutide. Or I could wait it out, and switch to a new product now in the pipeline when it becomes commercially available. Or I could get really creative, and alternate 6 months on semaglutide and 6 months on tirzepatide. Or something. Anyone else have experience with switching between these meds or thoughts on how to approach this problem?
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Just FYI, I'm taking my GLP-1 RA every six days instead of every seven, and have had no problems. Just because the clinical trials tested every seven days (for very logical reasons -- I would have done that, too) doesn't mean that it's the best answer for everyone. That being said, if your insurance is covering it, they will balk at a six-day cycle, so you may need to talk to your pharmacist and doctor about doing a box occasionally on private pay to sync it all up.
And yeah, the single-dose injectors are annoying from a variety of perspectives, and in fact, are not necessarily used in other countries, as I understand it. But hey, it's not an aspect of this that is under our control, right? So it's just another thing to roll with.
Good to know other feel the difference on day 6 & 7. All my best.
@projfan - my husband found that semaglutide (Wegovy) drops off in effectiveness for him after 6 days, as well.
You mentioned the food noise was coming back on the maintenance dose and you are managing it. What are you doing to manage it, and do you find it effective?
Interesting that your husband has had the same experience with a six-day cycle. It makes sense given the rate at which it flushes out of the blood. I'm sure the primary reason to test a seven-day cycle was because it's so much easier for people to comply with a once-a-week schedule than a once-every-six-days pattern.
In terms of the food noise, I've found time-restricted eating is helpful -- the food noise doesn't kick in until after my first meal of the day, which I've pushed to late morning. I'm also leaning heavily into protein and fiber -- more fiber than I've ever eaten before. And a lot of processed foods still don't appeal, and I still can't handle large meals. Therefore, I eat lightly and frequently and more healthily, which so far is working out. It's been a question of building eating habits that don't make me feel deprived, because if I feel deprived, I'll be back into weight cycling.
My fallback option is going to be jacking up the dosage again. I use ozempic rather than wegovy specifically because the multi-pen lets me control the dose I'm taking. I'm maintaining at the moment at quite a low dose, which gives me room to ramp up if I need to. Also, of course, there are more options in the pipeline: https://www.primetherapeutics.com/web/primetherapeutics/search?q=GLP-1%20Pipeline%20Update.
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2 ReactionsOzempic doesn't take any food noise for me. That's why I wanted to switch.
Has anyone had chronic diarrhea since having roux-n-y (gastric bypass) surgery?
@tslayden
You might find some helpful information in this discussion, it has many comments about diarrhea after RNY:
https://connect.mayoclinic.org/discussion/anyone-have-trouble-finding-a-balance-between-constipation-post-rny/
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1 ReactionI was on Ozempic for a year and lost 110 pounds. I felt like after a year, I started to plateau and wasn't losing weight. The food noise started again. I talked to my doctor and she switched me to Mounjaro. From the time I quit Ozempic and am currently on 10 mg and am not feeling any difference in the noise. I've gained 45 pounds back in 2 months from the switch. My doctor is not very supportive and tells me to be patient also. I don't know how much longer I can hold on for the Mounjaro to start working for me. I am very frustrated and feel my doctor is dismissing my frustration. Any advice would be so appreciated. Thank you!!
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1 ReactionI hear your frustration, @ozzieandeva2025. Your experience echoes mine with switching and gaining weight back.
One thing my doctor mentioned to me yesterday is that sometimes people who don't lose weight on tirzepatide (Zepbound) often do better losing weight if they start doing the injections in their arms instead (in the arm location mentioned on the paperwork for the shots).
I have had to return to some previous clothes, but I also donated a number of clothes in my former size a year ago. How have you managed the regain and clothing, ozzieandeva2025?
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1 ReactionYes. After years of suffering I found a great GI doctor. Having by-pass surgery and my gallbladder removed was a double whammy. It turns out that I have BAM (bile acid malabsorption). He put me on a medication and it’s been a life saver good luck.
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