Dr.LipidDallas said:The mechanism that matters here is not stomach emptying, it is central.
This is where I part company with the consensus forming above. The trial means are being read too generously in this thread. STEP populations were selected, supported, and titrated by protocol, and the real-world curves are consistently a few points worse. That difference is not noise, it is what happens when you remove the study infrastructure.
One concrete data point for the thread. For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and subcutaneous bioavailability near 89%. Those four numbers explain most of the questions people ask about timing.
Dr.SurgeonPGH said:The trial means are being read too generously in this thread.
Adding the part of the answer the thread has not reached. Most of what circulates confidently in this community traces back to one summary of one study, and the qualifier was dropped somewhere in the third retelling.
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Browse GL BiochemFollowing on from DanielChem_CHI — and this may be the naive question:
Did your prescriber agree with that reading, and if not what was their objection?
Closing the loop on my own question.
Following this thread I went back and re-read the extension data properly. The point about trough rather than peak explains the pattern I was seeing on day six, which I had been blaming on the vial.