<section class="ondra-article-page"> <div class="ondra-article-hero"> <div class="ondra-article-container"> <div class="ondra-article-meta-row"><span class="ondra-meta-pill">⏱ 6 min read</span><span class="ondra-meta-pill">Updated July 2026</span></div> <h1 class="ondra-article-title">Your First Refill and Dose Increase: What Changes and What to Expect</h1> <p class="ondra-article-intro">Your first refill is usually when two things happen at once: a new shipment arrives, and your dose may step up. Both raise practical questions — when does the refill ship, does my price change, will side effects return at the higher dose? This guide covers what to expect around your first refill and titration step, and how to raise concerns with your provider before the increase rather than after.</p> </div> </div> <div class="ondra-article-container ondra-article-body"> <div class="ondra-article-layout" id="ondraArticleLayout"> <div class="ondra-article-main" id="ondraArticleMain"> <a href="/blog" class="ondra-back-link">← Back to all articles</a> <div class="ondra-takeaways-card"> <h2 class="ondra-card-heading">Key takeaways</h2> <div class="ondra-takeaway-item"><span class="ondra-check"><svg width="16" height="16" viewBox="0 0 16 16" fill="none"><circle cx="8" cy="8" r="7" stroke="currentColor" stroke-width="1.4"/><path d="M4.5 8.5L6.5 10.5L11.5 5.5" stroke="currentColor" stroke-width="1.5" stroke-linecap="round" stroke-linejoin="round"/></svg></span><p>Your price stays flat as your dose increases — Ondra prices by plan, not by dose.</p></div> <div class="ondra-takeaway-item"><span class="ondra-check"><svg width="16" height="16" viewBox="0 0 16 16" fill="none"><circle cx="8" cy="8" r="7" stroke="currentColor" stroke-width="1.4"/><path d="M4.5 8.5L6.5 10.5L11.5 5.5" stroke="currentColor" stroke-width="1.5" stroke-linecap="round" stroke-linejoin="round"/></svg></span><p>Side effects can briefly return after a dose increase, similar to when you first started. This is common and usually eases.</p></div> <div class="ondra-takeaway-item"><span class="ondra-check"><svg width="16" height="16" viewBox="0 0 16 16" fill="none"><circle cx="8" cy="8" r="7" stroke="currentColor" stroke-width="1.4"/><path d="M4.5 8.5L6.5 10.5L11.5 5.5" stroke="currentColor" stroke-width="1.5" stroke-linecap="round" stroke-linejoin="round"/></svg></span><p>If you'd rather hold your current dose or titrate slower, tell your provider <em>before</em> the increase, not after.</p></div> </div> <div class="ondra-section"> <h2>Does my price change when my dose increases?</h2> <p>No. Ondra prices flat across all doses — your cost is determined by your plan, not by how many milligrams you're taking. Compounded semaglutide is $149 per month or $339 per quarter (as low as $113 per month). Compounded tirzepatide is $219 per month or $549 per quarter (as low as $183 per month). Moving from a starting dose to a higher one doesn't raise your price.</p> <p>If you started on a Starter Pack ($249 semaglutide, $399 tirzepatide for the first 3 months), your plan transitions to standard quarterly pricing afterward — $339 or $549 per quarter respectively.</p> </div> <div class="ondra-section"> <h2>When does my refill ship?</h2> <p>Refills are timed to your plan so your next shipment arrives before you run out. If the timing doesn't line up well with your injection schedule, you can request a change to your refill date through the <a href="https://care.ondra.health" target="_blank" rel="noopener">patient portal</a> or by messaging your care team — ideally well before the current refill date so the change takes effect in time.</p> <div class="ondra-info-card"> <p class="ondra-info-title">If you're running low</p> <p>Don't wait until your last dose to flag a timing problem. Message your care team as soon as you can see a gap coming, and tell them your target date. Adjusting a refill date is straightforward when there's lead time and much harder at the last minute.</p> </div> </div> <div class="ondra-section"> <h2>Will side effects come back at a higher dose?</h2> <p>They can. A dose increase often produces a brief return of the effects you may have felt when starting — nausea, reduced appetite, fatigue — because your body is adapting again. For most patients this settles as it did initially.</p> <p>The same strategies help: smaller and more frequent meals, avoiding heavy or greasy food, consistent hydration, and not lying down right after eating. If side effects after an increase are severe, persistent, or interfering with daily life, message your provider rather than pushing through — they can slow your titration or hold you at the previous dose.</p> </div> <div class="ondra-section"> <h2>What if I don't want to increase my dose?</h2> <p>That's a legitimate conversation to have with your provider, and the time to have it is before the increase. If you're losing weight steadily and feeling well at your current dose, there may be no reason to move up — the lowest effective dose is a reasonable goal, and titration isn't mandatory.</p> <p>Message your provider through the patient portal and tell them you'd like to hold your current dose or titrate more slowly. Dose decisions are made by your provider at Wasef Health, PC, so this needs to go through them rather than being handled by adjusting doses on your own.</p> </div> <div class="ondra-section"> <h2>What should I tell my provider before the increase?</h2> <p>Useful things to report: how you've tolerated the current dose, any side effects and whether they resolved, how your appetite and eating have changed, your weight trend, and any new medications you've started. That's what your provider uses to decide whether increasing, holding, or slowing is right for you.</p> </div> <div class="ondra-section"> <h2>Frequently asked questions</h2> <div class="ondra-faq-item"><h3>Does my price increase when my GLP-1 dose increases?</h3><p>No. Ondra prices flat across all doses — cost is determined by your plan, not your dose. Compounded semaglutide is $149/month or $339/quarter (as low as $113/month); compounded tirzepatide is $219/month or $549/quarter (as low as $183/month). Moving to a higher dose doesn't raise your price.</p></div> <div class="ondra-faq-item"><h3>When does my refill ship?</h3><p>Refills are timed to your plan so your next shipment arrives before you run out. If the timing doesn't fit your injection schedule, request a refill-date change in the patient portal or by messaging your care team, ideally well before the current refill date.</p></div> <div class="ondra-faq-item"><h3>Will side effects return when my dose goes up?</h3><p>They can. A dose increase often brings a brief return of nausea, reduced appetite, or fatigue as your body adapts again, and it usually settles as it did initially. Smaller meals, avoiding heavy foods, and consistent hydration help. If side effects are severe or persistent, message your provider — they can slow titration or hold your dose.</p></div> <div class="ondra-faq-item"><h3>Can I stay at my current dose instead of increasing?</h3><p>Yes, and it's worth raising before the increase rather than after. If you're losing weight steadily and feeling well, there may be no reason to move up — the lowest effective dose is a reasonable goal. Message your provider through the portal; dose decisions are made by your provider at Wasef Health, PC.</p></div> <div class="ondra-faq-item"><h3>What happens after my Starter Pack ends?</h3><p>Your plan transitions to standard quarterly pricing — $339 per quarter for semaglutide or $549 per quarter for tirzepatide. Plans include your provider consultation, medication, supplies, and free shipping, with no membership fee.</p></div> </div> <p class="ondra-disclaimer">† This article is for informational purposes only and does not constitute medical advice. Ondra Health is a telehealth platform, not a medical provider, and does not prescribe or compound medication. This content does not establish a provider-patient relationship or replace personalized guidance from a licensed professional. All dose decisions are made by licensed providers at Wasef Health, PC, an independent practice — never change your dose without provider approval. Compounded medications are not FDA-approved and are not reviewed by the FDA for safety, effectiveness, or quality before marketing. Pricing is current as of publication and subject to change. Individual results vary.</p> </div> <aside class="ondra-article-sidebar" id="ondraSidebarCol"> <div class="ondra-sidebar-track" id="ondraSidebarTrack"> <div class="ondra-sidebar-card-wrap" id="ondraSidebarWrap"> <div class="ondra-sidebar-card" id="ondraSidebarCard"> <div class="ondra-sidebar-top"> <p class="ondra-sidebar-eyebrow">ONDRA HEALTH</p> <h3>Flat pricing, every dose</h3> </div> <div class="ondra-sidebar-bottom"> <div class="ondra-sidebar-item"><span>✔</span><p>Price never rises as your dose increases</p></div> <div class="ondra-sidebar-item"><span>✔</span><p>Refill dates can be adjusted in the portal</p></div> <div class="ondra-sidebar-item"><span>✔</span><p>Titration can be slowed or held</p></div> <div class="ondra-sidebar-item"><span>✔</span><p>Ongoing provider support</p></div> <a href="https://care.ondra.health/login" class="ondra-sidebar-button">Manage your plan <span aria-hidden="true">→</span></a> <p class="ondra-sidebar-note">Raise dose concerns before your next increase.</p> </div> </div> </div> </div> </aside> </div> </div> </section> <script type="application/ld+json"> {"@context":"https://schema.org","@type":"FAQPage","mainEntity":[{"@type":"Question","name":"Does my price increase when my GLP-1 dose increases?","acceptedAnswer":{"@type":"Answer","text":"No. Ondra prices flat across all doses — cost is determined by your plan, not your dose. 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