Wegovy Dosing Schedule (2026 Guide)
Week-by-week titration from 0.25 mg starter to 2.4 mg standard maintenance, plus the 7.2 mg Wegovy HD high-dose option. Verified against the current Novo Nordisk label.
Wegovy (semaglutide) starts at 0.25 mg once weekly for the first 4 weeks (a starter dose, not a treatment dose). The dose is then escalated every 4 weeks: 0.5 mg, 1.0 mg, 1.7 mg, then 2.4 mg as the standard maintenance dose. The full titration to 2.4 mg takes 16 weeks. Patients who tolerate 2.4 mg but want additional weight loss may move to the Wegovy HD 7.2 mg dose, FDA-approved in 2025. The Wegovy oral pill follows a separate titration: 1.5 mg, 4 mg, 9 mg, then 25 mg as the highest approved dose.
Wegovy titration schedule, week by week
Six pen strengths total. Two of them (2.4 mg, 7.2 mg (Wegovy HD)) are FDA-approved as maintenance doses. The others are titration steps to get there.
| When | Dose | Purpose | What to expect |
|---|---|---|---|
| Weeks 1-4 | 0.25 mg | Starter dose | Body adjusts to semaglutide. Mild nausea is most common in the first 1 to 2 weeks. This dose is not intended to produce meaningful weight loss on its own. |
| Weeks 5-8 | 0.5 mg | Titration step | Appetite suppression starts to feel real. Side effects often peak briefly after the dose increase, then settle within 1 to 2 weeks. |
| Weeks 9-12 | 1.0 mg | Titration step | Most patients see noticeable weight loss by this dose. Some clinicians hold here longer if side effects are pronounced. This is the highest dose approved for Ozempic, but is a stepping stone for Wegovy. |
| Weeks 13-16 | 1.7 mg | Titration step | Final step before the standard maintenance dose. Some patients land here long-term if they cannot tolerate the 2.4 mg dose. |
| Week 17+ | 2.4 mg | Standard maintenance doseMaintenance | FDA-approved long-term dose. STEP-1 showed about 14.9% mean body weight reduction at 68 weeks. Most patients on Wegovy land here long-term. |
| After 2.4 mg, optional | 7.2 mg (Wegovy HD) | High-dose maintenance optionMaintenance | Approved in 2025 for patients who tolerate 2.4 mg but want additional weight loss. STEP-UP trial showed about 20.7% mean body weight reduction at 72 weeks. Side effects are more frequent at this dose. |
Most patients land at 2.4 mg long-term. Some hold at 1.7 mg if 2.4 mg is not tolerated. The 7.2 mg Wegovy HD dose is reserved for patients who tolerate 2.4 mg but want additional weight loss.
Mean weight loss by maintenance dose
From the pivotal STEP-1 trial and the 2025 STEP-UP trial for the 7.2 mg dose:
STEP trials, when used as a titration step, not a maintenance target
STEP-1, 68 weeks, adults with obesity
STEP-UP, 72 weeks, adults with obesity
Individual results vary widely. Trial populations were adults with obesity (BMI ≥30) or overweight (BMI ≥27) with at least one weight-related condition.
How to take Wegovy
- Abdomen (at least 2 inches from the navel)
- Front of thigh
- Back of upper arm
Rotate the injection site each week.
Pen: once weekly, any day. Pill: once daily, same time each day, on an empty stomach.
Pen can be taken with or without food, any time of day. Pill must be taken on an empty stomach with a small sip of plain water (4 ounces or less), then no food, drink, or other oral medication for at least 30 minutes.
If you miss a dose
Take the missed dose as soon as you remember.
Skip the missed dose. Take your next dose on your regularly scheduled day.
If your next scheduled dose is within 2 days, skip the missed dose. Do not double up.
Never take two doses to make up for a missed one. Doubling the dose can cause severe nausea and vomiting and does not improve outcomes.
When prescribers adjust the schedule
If side effects at a new dose are pronounced, your prescriber may keep you on the previous dose for an additional 4 weeks before stepping up.
If 1.7 mg gives you the appetite suppression and weight loss you want, there is no clinical requirement to escalate to 2.4 mg. Some patients land at 1.7 mg long-term.
If side effects at a higher dose become unmanageable, your prescriber may step you back down. This is sometimes called maintenance microdosing when used long-term after weight goal is reached. See our GLP-1 microdosing guide for the maintenance-microdose context.
Common side effects, with frequency
From the prescribing information at maintenance doses (2.4 mg and the 7.2 mg high-dose). Side effects tend to peak briefly after each dose increase, then settle.
| Side effect | Frequency | Practical notes |
|---|---|---|
| Nausea | Up to 44% | Most common in the first 4 weeks of each dose increase. Smaller meals and avoiding fatty or spicy foods helps. |
| Diarrhea | Up to 30% | Often occurs in the first weeks. Hydration is important. |
| Vomiting | Up to 24% | More common at higher doses (2.4 mg and 7.2 mg). Worth raising with your clinician if persistent. |
| Constipation | Up to 24% | Adequate fiber and fluid intake helps. |
| Decreased appetite | Common | This is often the desired effect, but ensure you still eat enough nutrient-dense food daily. |
| Abdominal pain | Up to 20% | Persistent or severe abdominal pain warrants immediate clinical attention. |
| Fatigue | Up to 11% | Usually transient, settles within the first month at a new dose. |
Storage
- Refrigeration: Refrigerate at 36 to 46 degrees Fahrenheit (2 to 8 degrees Celsius) in the original carton, protected from light.
- Room temperature: Can be stored at room temperature up to 86 degrees Fahrenheit (30 degrees Celsius) for up to 28 days. Do not put back in the refrigerator after that.
- Do not freeze: Do not freeze. Discard if frozen.
- Handling: Do not shake the pen vigorously.
Frequently asked questions
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Dosing schedule, available strengths, missed-dose guidance, storage, and administration come directly from the Wegovy (semaglutide) Prescribing Information from Novo Nordisk. Trial outcomes are from STEP-1 (NEJM 2021) and STEP-UP (2025) for the 7.2 mg Wegovy HD dose. Side effect frequencies reflect rates reported in the prescribing information at maintenance doses.