Tirz split dose + sema... how to?

6mg every 5 days and 5 lbs left that will not shift is a really common landing spot. Adding sema at a low dose alongside the tirz is a reasonable next move before bumping the tirz higher. What dose were you planning to start sema at?

The receptor blowout concern hasn't held up in practice at any dosing level that's been reported in the community or the clinical literature. The systemic mechanism these medications use doesn't create the tolerance pattern people worry about. Stacking for added GLP receptor coverage is a documented approach and the split-dose method is the right way to manage the pharmacokinetics when you're on a higher weekly total.

The once-weekly versus split dosing question comes down to whether the trough at day 6-7 is causing enough hunger to justify the more complex protocol. Some people find split dosing smooths out the end-of-week hunger spike significantly; others find the single weekly pin gives consistent enough coverage. Worth trying both to see which pattern works better.

The twice-weekly split improving appetite control is consistent with the pharmacokinetics - coverage is more even across the week with two smaller doses than one larger one, which avoids the end-of-cycle dip. Sunday and Wednesday spacing is close to optimal for distributing the half-life.