Dosage guide
Ozempic dose escalation schedule
Week-by-week titration for Ozempic (semaglutide) — starting dose, step-up schedule, maintenance, maximum, and what to do if you miss a dose.
Starting dose
0.25 mg once weekly
Maintenance
0.5 mg, 1 mg or 2 mg once weekly, set by blood sugar control (1 mg for type 2 diabetes with chronic kidney disease)
Maximum dose
2 mg once weekly
Dose form & administration
- Dose form
- Multi-dose prefilled pen, subcutaneous injection
- Dosing frequency
- Once weekly, same day each week, any time of day, with or without meals
Titration timeline
FDA-labeled step-up schedule. Most clinicians follow this exactly, but may pause at a step for an additional 4 weeks if side effects are intolerable.
- 1
Weeks 1–4
0.25 mg/week
Starting dose, meant to limit stomach side effects.
- 2
Weeks 5–8
0.5 mg/week
- 3
After 4+ weeks on 0.5 mg
1 mg/week
Only if blood sugar needs more control.
- 4
After 4+ weeks on 1 mg
2 mg/week
Maximum dose, only if more control is needed.
If a step-up is poorly tolerated
Each increase comes after at least 4 weeks on the current dose and only if blood sugar needs more control. 0.5 mg, 1 mg and 2 mg are all maintenance doses.
Missed-dose protocol
Max skip window
5 days
Inject the missed dose as soon as possible within 5 days of the missed day. If more than 5 days have passed, skip it and inject on your usual day.
When to contact your prescriber
- You have missed several doses in a row: ask whether to restart at a lower dose.
- Severe stomach side effects after a dose increase.
- New abdominal pain, vision changes, or signs of pancreatitis.
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