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Pre-treatment: Measure morning resting heart rate for 5 days Calculate average baseline Record any existing caffeine or stimulant use During treatment: Measure resting heart rate 3 times weekly during dose escalation Continue at each dose for minimum 4 weeks before increasing If resting HR exceeds baseline by more than 15 BPM, hold dose for an additional 2 weeks If resting HR exceeds 100 BPM at rest on two or more measurements, consult physician Expected timeline: Weeks 1-8: minimal heart rate change at starting doses Weeks 8-24: gradual increase of 5-10 BPM at therapeutic doses Weeks 24+: stabilization and gradual decline toward baseline This is the approach most researchers follow successfully, and it aligns with the standard retatrutide dosing protocol used in clinical trials

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doi: 10.1016/j.jdiacomp.2014.01.012 73 BolliGBMunteanuMDotsenkoSNiemoellerEBokaGWuYet al

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All three are also indicated for diabetes under different names and dosing schedules, which can be confusing (see the table GLP Agonists for Obesity)

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Effect of Intravenous Infusion of Exenatide (Synthetic Exendin-4) on Glucose-Dependent Insulin Secretion and Counterregulation During Hypoglycemia

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Pancreatology 16: 2-7, 2016

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Koffert J, Honka H, Teuho J, Kauhanen S, Hurme S, Parkkola R, Oikonen V, Mari A, Lindqvist A, Wierup N, et al

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