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 comparator does most of the work in how this gets reported, and it is not the comparator most people think they are citing.
What I am after is what the pharmacokinetic argument against splitting a weekly dose actually is, since intuitively it should smooth the curve. Tell me what I have not thought of.
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.
This is where I part company with the consensus forming above. 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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Shop Reference StandardsThis one has a reasonably settled answer, so here it is. The mechanism and the magnitude are separate questions. Agreeing that something happens says nothing about whether it happens enough to act on.
That is the short version; the long version is somebody else's post.
Dr.LipidDallas 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.
Second this.