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Guide

Restarting after a break

Cost, stock, holidays and life all cause treatment breaks. Coming back is common and straightforward, but the one thing you must not do is pick up where you left off without a prescriber.

Last checked 3 Nov 2026

Short answer: after a break of multiple weeks, do not self restart at your previous dose. Book a fresh consultation, state the exact gap length and your last dose step, and expect the prescriber to restart lower and re titrate. Side effect tolerance fades during a gap, and restarting high risks severe nausea, vomiting and dehydration.

Why lower is the standard restart

The step up schedule from 0.25mg exists to build tolerance to digestive effects gradually. That adjustment is not permanent: during a break of several weeks it fades, and a body that comfortably handled a maintenance dose in the spring can react to the same dose after a summer off as if it were the first injection. So prescribers commonly restart one or more steps down and rebuild. This is a safety step. The exact restart point is clinical judgement based on your gap length, previous tolerance and history. See the dose steps guide for how the ladder fits together.

Getting restarted in practice

  • Be precise about the gap: the consultation needs your last injection date and last dose step, not a rough guess. Check your order history if unsure.
  • Expect the side effect window again: nausea and digestive effects behave like a first titration. The side effects guide covers management and the urgent help signs.
  • Budget the upside: lower steps usually cost less per pen, so restart months are often cheaper. Compare current prices on the price comparison and check discount codes before ordering.
  • Fix the cause of the break: if supply or price forced the gap, the switching pharmacy guide and maintenance pharmacies page exist for exactly that.
Never use leftover pens to jump back in at a high step, and never combine old supply with a new prescription at a different step without telling the prescriber the full picture. If a restart dose causes severe or persistent vomiting, stomach pain or dehydration signs, seek urgent advice via NHS 111 or 999 in an emergency.
Independence note: iGovy is a price information website and does not sell, prescribe or dispense medicines. Restart decisions belong to your prescriber. This page explains what that conversation usually covers so you arrive prepared.

Restart questions

Can I just restart at my old dose?

No. Tolerance to digestive side effects fades during a break, and restarting high can cause severe nausea, vomiting and dehydration. Restarting is a prescriber decision made at a fresh consultation, not a leaflet rule to apply yourself.

Why do prescribers restart lower?

The step up schedule exists to build tolerance gradually. After a gap of several weeks the body loses that adjustment, so a lower restart with a re titration back up is the standard safety approach.

How long a break matters?

There is no single public threshold. One missed dose has its own leaflet rule, while multiple missed weeks puts you in prescriber territory. Be exact about your gap length at the consultation and let the clinician decide.

Does a restart cost more?

Lower dose steps are usually cheaper per pen, so a restart month often costs less than your previous maintenance month. Compare current step prices across verified UK pharmacies before ordering.

Sources referenced on this page

Standing primary references for every iGovy page: