Dosage guide
Wegovy dose escalation schedule
Week-by-week titration for Wegovy (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
2.4 mg subcutaneous once weekly
Maximum dose
2.4 mg/week (FDA approved maximum)
Dose form & administration
- Dose form
- Single-dose prefilled pen, subcutaneous injection
- Dosing frequency
- Once weekly, same day each week, with or without food
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
Initiation dose — minimize GI side effects.
- 2
Weeks 5–8
0.5 mg/week
First step-up.
- 3
Weeks 9–12
1.0 mg/week
Second step-up.
- 4
Weeks 13–16
1.7 mg/week
Third step-up.
- 5
Week 17+
2.4 mg/week
Maintenance dose.
If a step-up is poorly tolerated
If a dose escalation is not tolerated, hold the current dose for an additional 4 weeks rather than rushing forward. Some patients maintain effective weight loss on 1.7 mg without reaching 2.4 mg.
Missed-dose protocol
Max skip window
5 days
If less than 5 days since the missed dose, inject it as soon as possible. If more than 5 days, skip the missed dose entirely and resume the regular weekly schedule.
When to contact your prescriber
- Missed 2 or more consecutive weekly doses — prescriber may want to re-initiate from a lower dose.
- Severe GI side effects make any dose escalation intolerable.
- Pregnancy is confirmed or planned — discontinue and discuss alternatives.
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