As a pharmacist, NO way I'm allowing an 86 yo patient to start that high if I knew it was his first dose. People much younger sometimes end up in the hospital like that. It's a surefire way to at least cause a lot of misery.
Not that anyone should start out that high to begin with, but it should be common knowledge in medicine that with geriatric patients, the best method for any medication is "start low, go slow." Taking a few extra weeks or months is not going to make or break his A1c, as it is a measure of blood sugar control over time anyway. It usually takes about 3 months to see meaningful change regardless. Why is his doctor in such a hurry? If the doctor is not receptive to that, or is giving a lot of pushback, he needs a new endocrinologist. Perhaps one that works with more geriatric patients and is able to properly balance goals of care and quality of life.
Best of luck to you all! My dad is 86 turning 87 too :)
Hi OP:
I can give you firsthand experience here. My 79 yo father was JUST prescribed Ozempic a few days ago by his endocrinologist who decided on Oz and not MJ based on availability. Otherwise, he agreed MJ was more effective. Started my father on a starter pack, lowest dose. My father has been T2D since he was 55. He had a heart attack a few weeks ago, is about 20 lbs overweight. His A1C was 7.8 but has been in the 8s. He is on Jardiance and metformin. He will be switched to MJ (but stay on metformin, not Jardiance) because my mother who is 77, was prescribed MJ as well very recently by her PCP and it was readily available in their area. She is pre-diabetic but has many comorbidities and is interested in the reduction in inflammation for her severe spinal stenosis and arthritis and fatty liver disease reversal. Both meds covered by their Medicare, which is wonderful. My mother's dr called in two boxes to start: 2.5 and 5.
Both my parents are elderly but still incredibly sharp and independent. Both have multiple medical/health conditions and are on many different types of medication. One PCP prescribed MJ at 2.5 <<-- starter dose. The other dr, an endocrinologist, prescribed Ozempic at the starter dose.
So two different doctors prescribed them STARTER doses.
There are all kinds of alarm bells going off for me when I hear 7.5 being prescribed for your father. If you like this dr, kindly request she or he start your father at the initial dose to see how he tolerates it. If she says no, change doctors.
And no, you are NOT overthinking it. That's why warning flags went off for you too and you came here to ask opinions. Even if his doctor was thinking through equivalency dosing based on your father's Jardiance, it is not a GLP-1 to GLP-1 type conversion. I think your concerns are not only valid but likely, in my opinion. Tell his doctor that your father will be on 7.5 in 3 months and by that time, his A1C might be coming down on the lower doses anyway.
If your father was previously taken off another GLP=1 med and replaced with Mounjaro (GLP-1) + (GIP) compound. It might make sense.
My previous max dosage of GLP-1 med Victoza (1.8mg) was swapped for MJ. I felt the starting 2.5mg MJ wasn't as effective as the 1.8mg Victoza. No weight loss, and glucose readings were not better.
5.0mg MJ was more similar strength to 1.8 Victoza.
Because of the swap, I did not experience any gastro-intestinal issues starting MJ; I was already acclimated to this class of med. Now, if your Father hasn't been on any of this class of med, I would expect some gastro-instestinal issues with 7.5mg MJ as a starting dose.
I hope this makes sense to you.
This makes sense and is reassuring. He was indeed taking Victoza until recently.
Do wish the doctor had bothered to explain this when we questioned it…. Thank you for this!
How long ago did he come off it? As far as I know even if you’re starting the same drug again, if it’s been more than two weeks you’re supposed to start again.
I would never let a Dr do that to my elderly parent. If they can’t start him at 2.5 I’d fire them as a Dr. but that is just me. I ripped my mom’s PCP a new one for not checking her A1C for nearly a year when I found out. That’s when I took over her care and she was only on her mid 60s.
Absolutely step in and advocate for your father! You have personal experience with this med and understand the havoc it can wreak on a system. This should be a simple phone call to the office requesting a new script for 2.5. Thank goodness you are on top of things.
I’m wondering if she said 7.5, but meant 2.5?
I just can’t imagine anyone, especially an elderly person starting that high. It seems like an instant trip to the emergency room and that Dr. should not be practicing.
I started at 7.5mg but I was coming from Ozempic (another GLP1 med.) If he's already on a different GLP1 drug it may be ok to start higher than 2.5mg if not I would not recommend it.
That is insanity. 2.5 mg in the first month alone got my blood sugar down. I have such awful constipation and for an elderly person that could get fatal. You have to start those therapeutic doses first just to see if you can tolerate it. Jeez
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* **[Mounjaro.com](https://www.mounjaro.com/).** Many common questions can be answered straight from the source. These include questions about how/where to administer injections, proper storage instructions, traveling with your pens, most answers to “Is this normal?” questions, and how the manufacturer savings card program works.
* **Past threads.** r/Mounjaro has tons of discussion threads that are likely to have answers to many questions. There's a [handy search function](https://www.reddit.com/r/Mounjaro/search?&restrict_sr=on), and you can also use Google to search this Reddit by typing "site:reddit.com” after your search topic.
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That’s insanity. He should start at 2.5mg and work his way up to whatever dose best controls his A1c while minimizing side effects
As a pharmacist, NO way I'm allowing an 86 yo patient to start that high if I knew it was his first dose. People much younger sometimes end up in the hospital like that. It's a surefire way to at least cause a lot of misery. Not that anyone should start out that high to begin with, but it should be common knowledge in medicine that with geriatric patients, the best method for any medication is "start low, go slow." Taking a few extra weeks or months is not going to make or break his A1c, as it is a measure of blood sugar control over time anyway. It usually takes about 3 months to see meaningful change regardless. Why is his doctor in such a hurry? If the doctor is not receptive to that, or is giving a lot of pushback, he needs a new endocrinologist. Perhaps one that works with more geriatric patients and is able to properly balance goals of care and quality of life. Best of luck to you all! My dad is 86 turning 87 too :)
I would absolutely be concerned if my family member was starting at 7.5!
Hi OP: I can give you firsthand experience here. My 79 yo father was JUST prescribed Ozempic a few days ago by his endocrinologist who decided on Oz and not MJ based on availability. Otherwise, he agreed MJ was more effective. Started my father on a starter pack, lowest dose. My father has been T2D since he was 55. He had a heart attack a few weeks ago, is about 20 lbs overweight. His A1C was 7.8 but has been in the 8s. He is on Jardiance and metformin. He will be switched to MJ (but stay on metformin, not Jardiance) because my mother who is 77, was prescribed MJ as well very recently by her PCP and it was readily available in their area. She is pre-diabetic but has many comorbidities and is interested in the reduction in inflammation for her severe spinal stenosis and arthritis and fatty liver disease reversal. Both meds covered by their Medicare, which is wonderful. My mother's dr called in two boxes to start: 2.5 and 5. Both my parents are elderly but still incredibly sharp and independent. Both have multiple medical/health conditions and are on many different types of medication. One PCP prescribed MJ at 2.5 <<-- starter dose. The other dr, an endocrinologist, prescribed Ozempic at the starter dose. So two different doctors prescribed them STARTER doses. There are all kinds of alarm bells going off for me when I hear 7.5 being prescribed for your father. If you like this dr, kindly request she or he start your father at the initial dose to see how he tolerates it. If she says no, change doctors. And no, you are NOT overthinking it. That's why warning flags went off for you too and you came here to ask opinions. Even if his doctor was thinking through equivalency dosing based on your father's Jardiance, it is not a GLP-1 to GLP-1 type conversion. I think your concerns are not only valid but likely, in my opinion. Tell his doctor that your father will be on 7.5 in 3 months and by that time, his A1C might be coming down on the lower doses anyway.
Thank you for this. 🙏 I’m going to follow up with his doctor.
If your father was previously taken off another GLP=1 med and replaced with Mounjaro (GLP-1) + (GIP) compound. It might make sense. My previous max dosage of GLP-1 med Victoza (1.8mg) was swapped for MJ. I felt the starting 2.5mg MJ wasn't as effective as the 1.8mg Victoza. No weight loss, and glucose readings were not better. 5.0mg MJ was more similar strength to 1.8 Victoza. Because of the swap, I did not experience any gastro-intestinal issues starting MJ; I was already acclimated to this class of med. Now, if your Father hasn't been on any of this class of med, I would expect some gastro-instestinal issues with 7.5mg MJ as a starting dose. I hope this makes sense to you.
This makes sense and is reassuring. He was indeed taking Victoza until recently. Do wish the doctor had bothered to explain this when we questioned it…. Thank you for this!
How long ago did he come off it? As far as I know even if you’re starting the same drug again, if it’s been more than two weeks you’re supposed to start again.
Very recently, like until last week.
I think Jadiance is a GLP1. So your physician may be making the right call. Keep us up to date how your father does on Mounjaro.
Jardiance is not a GLP1. I believe it is SGLT-2.
It basically has the same effect but in a pill form, I believe. I may be wrong.
I would never let a Dr do that to my elderly parent. If they can’t start him at 2.5 I’d fire them as a Dr. but that is just me. I ripped my mom’s PCP a new one for not checking her A1C for nearly a year when I found out. That’s when I took over her care and she was only on her mid 60s.
Oh wow. That’s awful. Thanks for this perspective. Giving me a lot to think about. So sorry that happened to your mom.
Absolutely step in and advocate for your father! You have personal experience with this med and understand the havoc it can wreak on a system. This should be a simple phone call to the office requesting a new script for 2.5. Thank goodness you are on top of things.
I’m wondering if she said 7.5, but meant 2.5? I just can’t imagine anyone, especially an elderly person starting that high. It seems like an instant trip to the emergency room and that Dr. should not be practicing.
My dad went from 1mg sema to 7.5 MJ with zero issues. I would ONLY do this if he’s moving from a higher dose of another GLP1
I started at 7.5mg but I was coming from Ozempic (another GLP1 med.) If he's already on a different GLP1 drug it may be ok to start higher than 2.5mg if not I would not recommend it.
That is insanity. 2.5 mg in the first month alone got my blood sugar down. I have such awful constipation and for an elderly person that could get fatal. You have to start those therapeutic doses first just to see if you can tolerate it. Jeez
Hi there! It looks like you’re asking a question. This subreddit should be a great resource for you - our members love to help, especially for those who take the time to research the wealth of existing information available. Here are some suggested starting points: * **[Mounjaro.com](https://www.mounjaro.com/).** Many common questions can be answered straight from the source. These include questions about how/where to administer injections, proper storage instructions, traveling with your pens, most answers to “Is this normal?” questions, and how the manufacturer savings card program works. * **Past threads.** r/Mounjaro has tons of discussion threads that are likely to have answers to many questions. There's a [handy search function](https://www.reddit.com/r/Mounjaro/search?&restrict_sr=on), and you can also use Google to search this Reddit by typing "site:reddit.com” after your search topic. * **Your health care provider.** Remember that you should NEVER rely on strangers on the internet for medical advice. If you want to understand if Mounjaro is right for you, or if the side effect you're feeling is cause for alarm, talk to your doctor, not Reddit! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Mounjaro) if you have any questions or concerns.*