Your First Refill and Dose Increase: What Changes and What to Expect
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.
Key takeaways
Your price stays flat as your dose increases — Ondra prices by plan, not by dose.
Side effects can briefly return after a dose increase, similar to when you first started. This is common and usually eases.
If you'd rather hold your current dose or titrate slower, tell your provider before the increase, not after.
Does my price change when my dose increases?
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, $339 every 3 months (about $113 per month), $649 for 6 months (about $108 per month), or $1,149 for 12 months (about $96 per month) — the same price across all available doses. Compounded tirzepatide is $219 per month, $549 every 3 months (about $183 per month), $999 for 6 months (about $167 per month), or $1,699 for 12 months (about $142 per month) — the same price across all available doses. Moving from a starting dose to a higher dose doesn't raise your price.
When does my refill ship?
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 patient portal or by messaging your care team — ideally well before the current refill date so the change takes effect in time.
If you're running low
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.
Will side effects come back at a higher dose?
They can. A dose increase may produce a brief return of the effects you felt when starting, such as nausea, reduced appetite, or fatigue, because your body is adapting again. For many patients, these effects improve as the body adjusts.
The same general strategies may help: smaller and more frequent meals, avoiding heavy or greasy food, consistent hydration, and not lying down immediately after eating. If side effects after an increase are severe, persistent, or interfering with daily life, message your provider rather than pushing through. Your provider can determine whether slowing your titration or holding your previous dose is appropriate.
What if I don't want to increase my dose?
That's a legitimate conversation to have with your provider, and the time to have it is before the increase. If you're making progress and tolerating your current dose well, your provider may determine that remaining at that dose or titrating more slowly is appropriate.
Message your provider through the patient portal and explain that you'd like to discuss holding your current dose or titrating more slowly. Dose decisions are made by your provider at Wasef Health, PC, so you should not adjust your prescribed dose on your own.
What should I tell my provider before the increase?
Useful information includes how you've tolerated the current dose, any side effects and whether they resolved, how your appetite and eating patterns have changed, your weight trend, and any new medications you've started. Your provider uses this information to determine whether increasing, holding, or slowing your titration is appropriate.
Frequently asked questions
Does my price increase when my GLP-1 dose increases?
No. Ondra prices flat across all doses — cost is determined by your plan, not your dose. Compounded semaglutide is $149 per month, $339 every 3 months (about $113 per month), $649 for 6 months (about $108 per month), or $1,149 for 12 months (about $96 per month) — the same price across all available doses. Compounded tirzepatide is $219 per month, $549 every 3 months (about $183 per month), $999 for 6 months (about $167 per month), or $1,699 for 12 months (about $142 per month) — the same price across all available doses. Moving to a higher dose doesn't raise your price.
When does my refill ship?
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 through the patient portal or by messaging your care team, ideally well before the current refill date.
Will side effects return when my dose goes up?
They can. A dose increase may bring a brief return of nausea, reduced appetite, or fatigue as your body adapts again. Smaller meals, avoiding heavy foods, and staying hydrated may help. If side effects are severe or persistent, message your provider so they can determine whether your titration should be slowed or your dose held.
Can I stay at my current dose instead of increasing?
You can ask your provider about remaining at your current dose or titrating more slowly. Whether that is appropriate depends on your progress, side effects, and individual treatment plan. Message your provider through the portal before your scheduled increase, and do not adjust your dose without provider approval.
† 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.