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The consistency across different populations and healthcare systems strengthens the evidence for causation, particularly given the temporal relationship between drug initiation and NAION onset with many cases occurring within months of starting semaglutide

Here's what to expect: Typical Semaglutide Titration: Weeks 1-4: 0.25 mg weekly (lowest dose) Weeks 5-8: 0.5 mg weekly Weeks 9-12: 1.0 mg weekly Weeks 13-16: 1.7 mg weekly Week 17+: 2.4 mg weekly (maintenance) Typical Tirzepatide Titration: Weeks 1-4: 2.5 mg weekly Weeks 5-8: 5 mg weekly Weeks 9-12: 7.5 mg weekly Weeks 13-16: 10 mg weekly Weeks 17-20: 12.5 mg weekly Week 21+: 15 mg weekly (maintenance) You'll have a nurse check-in at each dose adjustment to monitor tolerability, appetite suppression, weight change, and side effects

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Advanced CKD (Stage 4-5) and Dialysis Considerations For patients in Stage 4 (GFR 15-29) or Stage 5 (GFR below 15 or on dialysis), the clinical landscape shifts toward a more cautious specialist methodology