GLP-1 titration schedules compared
Approved GLP-1 medicines all start below their effective dose and escalate on a fixed interval. Semaglutide (Wegovy) runs 0.25 → 0.5 → 1 → 1.7 → 2.4 mg weekly, four weeks per step. Tirzepatide runs 2.5 → 5 mg, then 2.5 mg steps to a 15 mg maximum. Liraglutide escalates weekly to 3 mg daily. Every schedule below comes from approved prescribing information.
These schedules are what regulators approved for the labeled indications. Your prescriber may hold, slow or stop escalation based on tolerance and your history. Compounded GLP-1 products are not the medicines these schedules describe.
What a titration schedule is for
Every approved GLP-1 medicine starts below its effective dose on purpose. The gastrointestinal effects that cause people to stop treatment — nausea, vomiting, diarrhea, constipation — are dose-related and adaptation-related, so the labeling builds in four weeks at each step to let tolerance develop.
The tables below are drawn from approved prescribing information rather than from clinic protocols or community posts, so they show what the regulator actually authorized. Your prescriber may legitimately move slower, pause, or hold you at a lower dose.
Titration schedules compared
| Medicine | Start | Escalation | Maintenance | Maximum |
|---|---|---|---|---|
| Semaglutide (Wegovy, weight management) | 0.25 mg once weekly × 4 weeks | 0.5 mg × 4 wks → 1 mg × 4 wks → 1.7 mg × 4 wks | 2.4 mg once weekly from week 17 | 2.4 mg weekly |
| Semaglutide (Ozempic, type 2 diabetes) | 0.25 mg once weekly × 4 weeks | 0.5 mg; increase after ≥ 4 weeks at each step | 0.5–2 mg once weekly | 2 mg weekly |
| Semaglutide (Rybelsus, oral) | 3 mg once daily × 30 days | 7 mg once daily; may increase after ≥ 30 days | 7–14 mg once daily | 14 mg daily (standard labeling) |
| Tirzepatide (Zepbound / Mounjaro) | 2.5 mg once weekly × 4 weeks | 5 mg weekly, then 2.5 mg steps after ≥ 4 weeks each | 5, 10 or 15 mg once weekly | 15 mg weekly |
| Liraglutide (Saxenda, weight management) | 0.6 mg once daily × 1 week | 1.2 mg → 1.8 mg → 2.4 mg, one week at each step | 3 mg once daily | 3 mg daily |
| Liraglutide (Victoza, type 2 diabetes) | 0.6 mg once daily × 1 week | 1.2 mg daily; may increase after ≥ 1 week | 1.2–1.8 mg once daily | 1.8 mg daily |
| Dulaglutide (Trulicity) | 0.75 mg once weekly | 1.5 mg; then 3 mg and 4.5 mg after ≥ 4 weeks each | 1.5–4.5 mg once weekly | 4.5 mg weekly |
| Exenatide extended-release (Bydureon BCise) | 2 mg once weekly | No titration step | 2 mg once weekly | 2 mg weekly |
| Retatrutide (investigational) | No approved schedule | Trial arms used stepped weekly escalation | Not established | Not established |
How long each schedule takes
| Medicine | Weeks to maintenance | Dose steps | Frequency |
|---|---|---|---|
| Semaglutide (Wegovy) | 16 weeks | 5 steps | Once weekly |
| Tirzepatide (max 15 mg) | 20 weeks | 6 steps | Once weekly |
| Liraglutide (Saxenda) | 4 weeks | 5 steps | Once daily |
| Dulaglutide (max 4.5 mg) | 12 weeks | 4 steps | Once weekly |
Rules that apply across all of them
- The starting dose is for initiation only and is not intended to be effective on its own.
- Escalate no sooner than the labeled interval — four weeks for the weekly medicines, one week for liraglutide.
- If a step is not tolerated, staying longer at the current dose or stepping back is the labeled response, not pushing through.
- Once-weekly doses can be taken any time of day, with or without food, on a consistent day each week.
- A missed weekly dose can be taken within 4 days; after that, skip it and resume the schedule.
- The injection day can be changed if at least 3 days separate two doses.
What these tables deliberately do not tell you
They do not tell you which medicine suits you, whether you should be on one at all, or what to do about side effects — those depend on your history, other medicines, and contraindications including a personal or family history of medullary thyroid carcinoma or MEN 2.
They also say nothing about compounded versions. Compounded GLP-1 products are not the approved medicines these schedules come from, and their concentration and content are not verified by the same process.
Tracking a titration
The practical difficulty with a five-step schedule is remembering which week you are in, which dose you are on, and how the previous step went. A dated record of dose, injection day and side effects is what lets a prescriber decide whether to escalate on schedule or hold.
Frequently asked questions
- What is the standard semaglutide titration schedule?
- For Wegovy the approved schedule is 0.25 mg once weekly for 4 weeks, then 0.5 mg for 4 weeks, then 1 mg for 4 weeks, then 1.7 mg for 4 weeks, reaching a 2.4 mg weekly maintenance dose at week 17. For Ozempic the schedule starts at 0.25 mg weekly for 4 weeks, moves to 0.5 mg, and may be increased to 1 mg and then 2 mg at four-week intervals.
- How is tirzepatide titrated?
- Tirzepatide starts at 2.5 mg once weekly for 4 weeks, then increases to 5 mg weekly. Further increases are made in 2.5 mg steps after at least 4 weeks at the current dose, up to a maximum of 15 mg once weekly.
- Why is the first GLP-1 dose not a treatment dose?
- The starting dose exists to let the gut adapt. Nausea, vomiting and diarrhea are the dose-limiting effects, and the prescribing information states plainly that the initial dose is for treatment initiation and is not effective for glycaemic control or weight management on its own.
- What happens if I escalate faster than the schedule?
- Faster escalation increases gastrointestinal adverse effects without adding benefit, which is why the approved schedules are spaced at four-week intervals. If a dose is not tolerated, the labeling allows delaying escalation or stepping back to the previous dose rather than pushing through.
- What if I miss a weekly dose?
- For once-weekly semaglutide and tirzepatide, the approved instruction is to take the missed dose as soon as possible within 4 days (96 hours) of the scheduled day, and to skip it entirely if more than 4 days have passed, resuming the usual schedule. Never double up to catch up.
- Is retatrutide approved?
- No. Retatrutide is investigational, with phase 2 results published and phase 3 studies ongoing. There is no approved titration schedule, so any protocol circulating for it is derived from trial arms rather than from approved labeling.
References & evidence
Sources cited on this page. Last reviewed September 2026. Corrections: editorial policy.
- U.S. National Library of Medicine, DailyMed. Wegovy (semaglutide) injection — prescribing information. https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=wegovy
- U.S. National Library of Medicine, DailyMed. Ozempic (semaglutide) injection — prescribing information. https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=ozempic
- U.S. National Library of Medicine, DailyMed. Zepbound and Mounjaro (tirzepatide) — prescribing information. https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=tirzepatide
- U.S. National Library of Medicine, DailyMed. Saxenda and Victoza (liraglutide) — prescribing information. https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=liraglutide
- U.S. National Library of Medicine, DailyMed. Trulicity (dulaglutide) — prescribing information. https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=trulicity
- Jastreboff AM, et al. Triple-hormone-receptor agonist retatrutide for obesity — a phase 2 trial. N Engl J Med. 2023. https://pubmed.ncbi.nlm.nih.gov/37366315/
- U.S. Food and Drug Administration. Compounded GLP-1 products — safety communication. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/medications-containing-semaglutide-marketed-type-2-diabetes-or-weight-loss
Cite this page
Writers and clinicians are welcome to reproduce this comparison with attribution to DoseRoutine and a link to https://doseroutine.com/glp-1-dose-schedules. Each row is sourced to the medicine's approved prescribing information.
Start free in DoseRoutineEducational reference only, not medical advice. Talk to a qualified clinician before starting, stopping or combining any peptide, supplement or medication.