Putting this up for argument rather than for agreement. I have read it twice and I am still not certain what it supports.
Splitting does smooth the curve, and that is the problem. With a one-week half-life the weekly curve is already fairly flat — peak-to-trough is modest — so splitting buys very little smoothing while doubling the number of punctures, the number of arithmetic opportunities and the number of chances to lose material to dead space. The people who report a real benefit are usually those whose difficulty is a day-one side effect, which is a peak problem and is the one case where splitting genuinely helps.
Where I think it is weakest: the follow-up is short relative to how long people actually take these drugs, so durability is an assumption here rather than a finding.
What I am trying to establish is what the pharmacokinetic argument against splitting a weekly dose actually is, since intuitively it should smooth the curve. Numbers rather than impressions, if you have them.
Figures above are from the primary publication rather than the press summary. If a number here disagrees with one you have, post yours and we will work out which of us is reading a secondary source.
DebRD_ATL said:Splitting does smooth the curve, and that is the problem.
Dose splitting update on split dosing: instead of 2.4mg once weekly, I've been doing 1.2mg twice weekly (Mon/Thu) with my doctor's approval. The appetite suppression is more consistent and side effects are noticeably milder.
Not medical advice, just sharing what's worked for me. Discuss with your provider before trying this.
DebRD_ATL said:Splitting does smooth the curve, and that is the problem.
Pushing back on DebRD_ATL here. Halving the dose and calling it splitting is not the same intervention, and this thread keeps mixing them. One changes the schedule; the other changes the exposure.
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Browse GL BiochemThis one has a reasonably settled answer, so here it is. Whatever the answer turns out to be, the method for getting there is the same: state the assumption, do the arithmetic in public, and invite the correction. That is slower than asserting, and it is the only version that survives being wrong.
LarryQC_SD said:Dose splitting update on split dosing: instead of 2.4mg once weekly, I've been doing 1.2mg twice weekly (Mon/Thu) with my doctor's approval.
Same pattern here, and in the same order. The detail I would add is minor and it is already implied above.