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Some may start at 5 mg for patients who tolerated semaglutide well, but this is the exception rather than the rule

Doyle AJ, Doyle JJ, Bessling SL, Maragh S, Lindsay ME, Schepers D, Gillis E, Mortier G, Homfray T, Sauls K, Norris RA, Huso ND, Leahy D, Mohr DW, Caulfield MJ, Scott AF, Destre A, Hennekam RC, Arn PH, Curry CJ, Van Laer L, McCallion AS, Loeys BL, Dietz HC

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If you notice worsening rather than improvement, discontinuing use and reassessing is appropriate