I have a client in the hospital, started script trizepatide 2.5 mg/wk, was working well, losing weight (7 lbs in 4 weeks), some GI sides but manageable. Had run it before but quit bc of GI sides. Her doc took her to 5 mg/wk, no reason other than that's the way they are supposed to dose it. 3 days later she's in the ER with projectile vomiting and GI tract locked up with gastroparesis and severe cramping. No other causes found, just the TRIZ. On IV fluids and OXY for pain and that certainly doesn't help with the GI issues. Slowly improving, but doubling the dose really fucked her up. Word of caution on dosing these GLP-1s esp with GIP, start really low, about 1/2 of the lowest clinical dose and don't double the dose increase perhaps 50% to ramp up. Lastly, remember a 7 day t 1/2 take about 6 weeks to reach steady state and both maximal clinical response (good and bad), and come back down if something goes wrong.