Semaglutide gray to dr prescribed Tirzepatide

[MTSpace]

Started my wife on Semaglutide via gray market and doctor wants to start her on Tirzepatide.

Doctor is unaware that she just started Semaglutide but we discussed pros and cons of both and he wants her on Tirzepatide. We have a request into insurance company for the Tirz but wanted to ask if anyone had any suggestions on switching? We won’t know until end of June if she qualifies for Tirz being covered by insurance.

Should she stop Sema now even though it’s not guaranteed she will move to Tirz via insurance. Or should I switch her to Tirz now and roll into doctor prescribed over the summer? Or maybe have to stay gray if rejected by insurance.

Any shared experience or advice is appreciated.

 

[Calm Logic]

How is she doing on sema? When did she start? A week ago? Two days? Current dose?

What are her goals (like how much weight to lose)? Any side effects? Any weight loss so far?

But in general, tirz is the better choice. Less nausea, if that is an issue or will be. Better/quicker bloodwork results. Faster/more weight loss.

Most people here, including myself, don't know why anyone would start with sema these days. Neither did my doc, who prescribed tirz. But these are generalities, so it really depends on the person. Extra sema is good for hoarding though. Degrades even slower than tirz, at least in theory.

 

[MTSpace]

How is she doing on sema? When did she start? A week ago? Two days? Current dose?

What are her goals (like how much weight to lose)? Any side effects? Any weight loss so far?

But in general, tirz is the better choice. Less nausea, if that is an issue or will be. Better/quicker bloodwork results. Faster/more weight loss.

Most people here, including myself, don't know why anyone would start with sema these days. Neither did my doc, who prescribed tirz. But these are generalities, so it really depends on the person. Extra sema is good for hoarding though. Degrades even slower than tirz, at least in theory.

She just started two weeks ago. .5 divided into Tuesday and Saturday doses. She started Semaglutide as we have friends who have had great success with Ozempic.

She is having nausea for 2 days after injections.

Doctor told us same thing that Tirzepatide is what he wants to put her on. Her goal is to lose 20-25 lbs and help her bloods as her A1C is always pre-diabetic range 6-7. She has lost 3 lbs so far but that could be just her paying more attention to her diet coupled with the nausea.

I am now thinking of switching her to Tirzepatide this week and rolling gray as long as we have to as who knows if/when insurance will cover.

 

[woundcarping]

I would skip sema and do grey tirz, although that may confound insurance coverage. Being pre-diabetic is probably not enough for my insurance to cover tirz.

 

[SoCalGirl]

Dosage may be too high, at .5 for semi. Can you pull back to .25 once a week and see how she feels, while you wait for Tirz script to come thru? Will you still get Tirz if insurance does not cover it?

 

[MTSpace]

Dosage may be too high, at .5 for semi. Can you pull back to .25 once a week and see how she feels, while you wait for Tirz script to come thru? Will you still get Tirz if insurance does not cover it?

I will discuss with her tonight. She counts on me for research as I have been doing peptides for a couple of years. Although I went straight to Reta for GLP. But her friends who have had good success with Sema seemed like a good starting peptide for her so she could compare experiences.

We share same primary doctor and I had a visit with him yesterday. She has a scheduled visit with him in June. I discussed with him GLP-1 and his opinion, and he was very much convinced Tirz was a better option for her considering all of her health history.

Thinking I will have a discussion with her to see if she wants to make the switch based on his recommendation and any feedback I get from experienced users on this forum on best method to do so. Quit Sema for a period and start Tirz? Or just replace on next dosage?

I tried to cut her back to .25 once a week but she firmly stated she wants to push through as she expected sides based on her friends feedback.

When we make the switch to Tirz we will stick with it - with or without insurance as gray market makes it affordable verses the coupon our pharmacy is offering at $750 a month if insurance doesn’t cover. I shared with her from beginning Zepbound or Mounjaro is where I feel would be next steps - figuring our doctor would put her on based on my research. And after yesterday, he confirmed. It would be good for our doctor to be overseeing her on this. And he will even if via gray market. But he will encourage us to use Ro or some other compounding pharmacy that meets fda standards and not my China buys. He already knows I use peptides and even helped me source unofficially TB and BPC with a source he trusted a couple of years ago to launch my peptide journey.

More research needed….

 

[chest rockwell]

unless you have really good insurance, they will want the cheapest glp1 to start with if they will cover it. probably oral semaglutide

 

[lessthanhalf]

You should be able to just swap over to tirz, the dose of sema is not high, 0.25 twice a week, and there are side effects at that dose. Generally tirz has less nausea than sema, starting tirz on 2.5mg/week is very unlikely to produce worse side effects than 0.5 of sema. It is probably a good idea to wait until any nausea from the most recent dose of sema has settled down, maybe 4-6 days since last sema dose to be on the safe side.

For me even very small doses of sema at 0.22mg every 2 days had much worse nausea than 15mg/week of tirz.

The insurance vs grey is much harder to comment on, at least with grey , no one else is in control of the medication. And people from the US have often complained about insurance companies changing their rules and cancelling their GLP medication.

 

[MTSpace]

You should be able to just swap over to tirz, the dose of sema is not high, 0.25 twice a week, and there are side effects at that dose. Generally tirz has less nausea than sema, starting tirz on 2.5mg/week is very unlikely to produce worse side effects than 0.5 of sema. It is probably a good idea to wait until any nausea from the most recent dose of sema has settled down, maybe 4-6 days since last sema dose to be on the safe side.

For me even very small doses of sema at 0.22mg every 2 days had much worse nausea than 15mg/week of tirz.

The insurance vs grey is much harder to comment on, at least with grey , no one else is in control of the medication. And people from the US have often complained about insurance companies changing their rules and cancelling their GLP medication.

Thank you for sharing your experience between the two meds. My wife is struggling to even eat on this low dose Semaglutide due to nausea so I think we will make the change next week as I ordered two vials of Tirz due in Wednesday next week. I like your thought on clearing nausea caused by Sema before introducing another variable to ensure we can differentiate the side effects.

Did you have any sides from Tirz?

Concerning gray vs insurance, we will have Tirz on hand incase insurance doesn’t cover or if they drop coverage some point in future.

 

[Grogu]

I would skip sema and do grey tirz, although that may confound insurance coverage. Being pre-diabetic is probably not enough for my insurance to cover tirz.

I agree, insurance coverage is probably unlikely just based on pre-diabetes.

When I tried insurance coverage for Zepbound I was pre-diabetic, had a BMI of 42, sleep apnea, and borderline high cholesterol. I was denied over and over again and even did a medical appeal. What I’ve learned is when a medication is excluded on an insurance plan there is no coverage no matter how sick you are.

The recommendation to go to grey tirz is also solid.