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Semaglutide Dosing Chart: The Full Weekly Schedule
Semaglutide is taken once weekly and is increased in stages rather than started at its full dose. The semaglutide dosing chart below shows every step for both approved uses — chronic weight management and type 2 diabetes — along with how long each step lasts, what to do if you miss a dose, and why the schedule moves as slowly as it does.
Semaglutide dosing chart for weight management
This is the schedule for semaglutide prescribed for chronic weight management, sold under the brand name Wegovy. It runs through five steps over roughly four months before reaching the maintenance dose.
| Timing | Weekly dose | Stage | Notes |
|---|---|---|---|
| Weeks 1–4 | 0.25 mg | Starting dose | Initiation only. This step is not intended to produce weight reduction — it exists to let the body adjust to the medication. |
| Weeks 5–8 | 0.5 mg | Escalation | First increase. Nausea, if it appears, is most common in the days after a step up. |
| Weeks 9–12 | 1 mg | Escalation | Some patients see meaningful appetite change at this step. |
| Weeks 13–16 | 1.7 mg | Escalation | The last step before the full maintenance dose. |
| Week 17 onward | 2.4 mg | Maintenance dose | The dose studied in the pivotal weight-management trial. Not everyone reaches or needs it. |
Your schedule may differ. Clinicians commonly hold patients longer at a step, or stop escalating entirely, based on how someone is responding. Follow the plan your prescriber gave you rather than this chart.
Semaglutide dosing chart for type 2 diabetes
Semaglutide prescribed for type 2 diabetes, sold as Ozempic, follows the same first two steps but has a different ceiling. Both 0.5 mg and 1 mg function as maintenance doses here — many patients never go higher.
| Timing | Weekly dose | Stage | Notes |
|---|---|---|---|
| Weeks 1–4 | 0.25 mg | Starting dose | Initiation only, not intended for glycemic control on its own. |
| Weeks 5–8 | 0.5 mg | First maintenance dose | Many patients remain here if blood glucose targets are met. |
| Week 9 onward | 1 mg | Maintenance dose | Increase after at least 4 weeks at 0.5 mg if additional control is needed. |
| After 4+ weeks at 1 mg | 2 mg | Maximum dose | The highest approved Ozempic dose. Note this differs from Wegovy's 2.4 mg maximum. |
Why the semaglutide dosing chart escalates so slowly
The 0.25 mg starting dose does almost nothing therapeutically. That is deliberate. Gastrointestinal side effects with GLP-1 medications are closely tied to the rate of increase rather than the absolute dose, so the schedule spends its first month building tolerance rather than pursuing results.
The practical consequence is that the first month can feel like nothing is happening. That is expected. Escalating faster to compensate tends to produce nausea and vomiting without improving the eventual outcome, and dehydration from severe vomiting is one of the more common reasons people end up needing medical attention on these medications.
Side effects at each step of the dosing chart
The most common side effects are gastrointestinal: nausea, vomiting, diarrhea, constipation, and abdominal discomfort. These cluster in the days following a dose increase and often settle as the body adapts to a given step.
- Boxed warning. Semaglutide carries a boxed warning regarding thyroid C-cell tumors observed in rodents, and is contraindicated in people with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2.
- Serious risks include pancreatitis, gallbladder disease, kidney injury from dehydration, diabetic retinopathy complications, and hypersensitivity reactions.
- When to call. Severe or persistent abdominal pain, vomiting that prevents keeping fluids down, or signs of an allergic reaction warrant prompt medical attention rather than waiting for the next check-in.
What to do about a missed dose
If your next scheduled dose is more than two days away, take the missed dose as soon as you remember. If it is less than two days away, skip it and resume your normal weekly schedule — do not double up.
If more than two consecutive weeks have been missed, contact your clinician before resuming. Tolerance fades, and restarting at your previous dose after a long gap can bring back the side effects you had already worked through. Restarting titration from a lower step is often the safer path.
Does the chart apply to compounded semaglutide?
Not directly. Compounded semaglutide is prepared by a licensed pharmacy to fill an individual prescription and is not FDA-approved, which means it has no approved labeling and therefore no official dosing chart. Clinicians prescribing a compounded preparation typically reference the approved schedule as a framework, but the specific plan is set for the individual patient.
Compounded preparations are not reviewed by the FDA for safety, effectiveness, or quality before they are marketed, and a compounded preparation is not established as equivalent to the branded product. If you are prescribed one, your dosing schedule comes from your prescriber, not from this page.
What results the maintenance dose produced in trials
STEP-1 was the pivotal 68-week trial of semaglutide 2.4 mg for weight management. Both groups received lifestyle intervention; the difference between them is the medication.
Two caveats worth holding onto. These averages conceal a wide spread — some participants lost far more, others far less. And weight regain after stopping is common: a 2025 systematic review and meta-analysis in Lancet eClinicalMedicine pooling 18 randomized controlled trials and 3,771 adults found average regain of 5.63 kg following GLP-1 receptor agonist discontinuation.
Semaglutide dosing chart: frequently asked questions
What is the standard semaglutide dosing chart?
For weight management, semaglutide begins at 0.25 mg once weekly for four weeks, then increases through 0.5 mg, 1 mg, and 1.7 mg at four-week intervals, reaching a 2.4 mg maintenance dose at around week 17. For type 2 diabetes, the schedule starts the same way but tops out at 2 mg, with 0.5 mg and 1 mg both serving as maintenance doses.
Why does semaglutide start at such a low dose?
The 0.25 mg starting dose is not a treatment dose. Gastrointestinal side effects are strongly related to how quickly the dose rises, so the schedule builds tolerance gradually. Starting higher or escalating faster increases the likelihood of nausea, vomiting, and dehydration without improving the eventual result.
How long should I stay at each dose?
At least four weeks. The approved schedule allows an increase only after four weeks at the current dose. Staying longer at a step is common and clinically reasonable — a clinician may extend a step if side effects are still settling or if the current dose is producing an adequate response.
What if I miss a dose of semaglutide?
If the next scheduled dose is more than two days away, take the missed dose as soon as you remember. If it is less than two days away, skip the missed dose and resume your normal schedule. If you miss doses for more than two consecutive weeks, contact your clinician — you may need to restart titration rather than resume at your previous dose.
Do I have to reach 2.4 mg?
No. The maintenance dose is a ceiling, not a target. If a lower dose produces an adequate response and is well tolerated, many clinicians hold a patient there. Dose escalation is guided by response and tolerability, not by a schedule that has to be completed.
Is the dosing chart different for compounded semaglutide?
Compounded semaglutide is not FDA-approved and has no approved labeling, so there is no official dosing chart for it. Clinicians prescribing a compounded preparation generally reference the approved schedule, but the specific plan is set for the individual patient. Compounded preparations are not reviewed by the FDA for safety, effectiveness, or quality before marketing.
What is the difference between Wegovy and Ozempic dosing?
Both contain semaglutide and both begin at 0.25 mg weekly. Wegovy is approved for chronic weight management and escalates to a 2.4 mg maintenance dose through an additional 1.7 mg step. Ozempic is approved for type 2 diabetes and has a 2 mg maximum, with 0.5 mg and 1 mg commonly used as maintenance doses.
How much weight loss should I expect on the semaglutide dosing chart?
Individual results vary. In STEP-1, the pivotal 68-week trial, adults taking 2.4 mg semaglutide alongside lifestyle intervention had a mean body-weight reduction of about 14.9 percent, compared with about 2.4 percent on placebo. Those figures come from the FDA-approved product and are averages, not a promise of individual outcome.
Find out which dose is right for you
A dosing chart shows the standard path. Where you actually start, how fast you move, and where you stop are decisions a clinician makes with you. Complete an online evaluation and a licensed clinician will review your history.
Start your evaluationNot everyone qualifies. Treatment is prescribed only when a licensed clinician determines it is appropriate.
Sources
- FDA-approved prescribing information for semaglutide (Wegovy and Ozempic).
- STEP-1: once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine, 2021.
- Weight regain after discontinuation of GLP-1 receptor agonists: systematic review and meta-analysis of 18 randomized controlled trials. Lancet eClinicalMedicine, 2025.