Why does nausea come back when a GLP-1 dose goes up?

Nausea, vomiting, diarrhoea and constipation are among the most commonly reported effects of semaglutide and tirzepatide, and they are frequently reported around the point a dose changes rather than steadily throughout treatment.

The prescribing information for these medicines describes a stepped increase over time rather than starting at a maintenance amount. How large those steps are and how long you stay on each one is set by the person prescribing, and that is deliberately not something a page like this can tell you.

What you can do is make the next conversation useful. A dated record of which days were difficult, how severe, and what changed just before, tells your prescriber far more than trying to summarise a month from memory. If something feels severe or is not settling, that is a reason to contact them rather than wait for a scheduled appointment.