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The 2.5mg starting dose is the initiation dose used in all SURMOUNT trials

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N Engl J Med 373(23):22472257 Muskiet MHA, Tonneijck L, Huang Y, Liu M, Saremi A, Heerspink HJL et al (2018) Lixisenatide and renal outcomes in patients with type 2 diabetes and acute coronary syndrome: an exploratory analysis of the ELIXA randomised, placebo-controlled trial

Most symptoms are mild to moderate and improve significantly within 4-8 weeks of starting treatment or after dose adjustments