Semaglutide is not a drug you start at the dose that works. You start well below it and climb over about four months.
Below is the standard schedule for each approved product. Your prescriber may vary it — that is normal and expected.
The dosage charts
Wegovy® · Weekly injection
Approved for chronic weight management
Why the ramp is so slow
Two reasons, and only one of them is about side effects.
Tolerance. Nausea, vomiting and diarrhoea concentrate during dose increases. Stepping up gradually gives the gut time to adapt. Starting at 2.4 mg would put most people off the drug entirely within a fortnight.
The starting doses do not do much. The 0.25 mg step is not a treatment dose. It exists to get your body used to the molecule. If you feel nothing in month one, that is the schedule working as designed, not a sign it will not work.
Wegovy® dosing schedule
The full escalation for chronic weight management:
| Weeks | Dose | Phase |
|---|---|---|
| 1–4 | 0.25 mg | Start |
| 5–8 | 0.5 mg | Escalation |
| 9–12 | 1 mg | Escalation |
| 13–16 | 1.7 mg | Escalation |
| 17+ | 2.4 mg | Maintenance |
There is also a higher-dose Wegovy® HD at 7.2 mg. Escalation to that is a separate clinical decision.
Ozempic® dosing schedule
Ozempic® is semaglutide approved for type 2 diabetes, and the schedule tops out lower:
| Weeks | Dose | Phase |
|---|---|---|
| 1–4 | 0.25 mg | Start |
| 5–8 | 0.5 mg | Escalation |
| 9–12 | 1 mg | Maintenance |
| 13+ | 2 mg | If needed |
Clinicians do prescribe Ozempic off-label for weight. If weight is the goal, Wegovy is the labelled product and the one insurers are more likely to cover.
Oral semaglutide dosing
The Wegovy® pill, launched in January 2026, uses completely different numbers because oral absorption is far less efficient than injection:
| Weeks | Dose | Phase |
|---|---|---|
| 1–4 | 1.5 mg | Start |
| 5–8 | 4 mg | Escalation |
| 9–12 | 9 mg | Escalation |
| 13+ | 25 mg | Maintenance |
Do not map these onto the injection numbers. 25 mg orally is not ten times 2.4 mg injected. They are different routes with different bioavailability, and comparing the figures directly is meaningless.
The pill is also taken daily rather than weekly, and the cost changes as you escalate — see our cheapest semaglutide guide for what each tier costs.
What if a step is rough?
The usual answer is hold, do not stop.
Staying at your current dose for an extra four weeks before stepping up is standard practice, not failure. Most people who abandon semaglutide do so during escalation, when the drug has not yet reached the dose that works.
Things that reliably help: eating smaller meals, stopping at the first sign of fullness, staying hydrated, and easing off high-fat food on injection day.
Things that require a conversation with your prescriber: vomiting that stops you keeping fluids down, severe abdominal pain, or symptoms that do not settle within a few days of a dose change.
What “units” means, and why we do not convert them
Some compounded semaglutide is supplied in vials, drawn with an insulin syringe marked in units rather than milligrams. That is why people search for conversions between units and mg.
We do not publish that conversion, and you should be careful with anyone who does.
The reason is simple: the answer depends entirely on the concentration of your specific vial. A conversion that is correct for one product is a serious overdose with another. There is no universal number, and a chart that implies otherwise is dangerous.
Federal regulators have documented adverse events linked to compounded GLP-1 products where dosing errors — people drawing their own doses from multidose vials without supervision — were the cause.
If you have been prescribed a compounded product in a vial, the concentration and the exact volume to draw come from your prescriber or the dispensing pharmacy. Not from a chart on the internet, including this one.
Missed a dose?
For weekly injections, the general guidance is to take it as soon as you remember if you are within a few days of the scheduled day, then return to your normal schedule. If you are close to your next dose, skip the missed one.
Do not double up. Confirm the specifics with your prescriber, because it depends on how far into the week you are.
Common questions
Does everyone reach 2.4 mg? No. Some people respond well at 1 mg or 1.7 mg and stay there. The maintenance dose is the dose that works for you with tolerable side effects, not the highest number on the chart.
How long until it works? Appetite effects often show up in the first few weeks. Meaningful weight change typically takes months, and the trial results people quote come from 68–72 week studies.
Can I escalate faster? That is a prescriber decision, and the usual answer is no. Faster escalation buys you side effects, not results.
Educational information about published dosing schedules, not medical advice. Your dose, your schedule, and any change to either belong to you and a licensed clinician.
Common questions