Semaglutide dosage chart: the approved escalation schedules
Semaglutide is escalated in fixed four-week steps, and the schedule differs between the weight-management product and the diabetes product. Below are the published schedules from the approved labels, what the numbers mean, and the missed-dose rule — with the full entry on the semaglutide library page.
Researched by DoseRoutine Research TeamReviewed for accuracy by Nicholas Alexander, RSE, SO, PMPLast updated Educational reference only — not medical advice. Always confirm dosing and safety decisions with a licensed clinician.
Wegovy (weight management) escalation
The approved schedule steps up every four weeks. Each step exists to let gastrointestinal side effects settle before the next increase.
- Weeks 1–4: 0.25 mg once weekly.
- Weeks 5–8: 0.5 mg once weekly.
- Weeks 9–12: 1 mg once weekly.
- Weeks 13–16: 1.7 mg once weekly.
- Week 17 onward: 2.4 mg once weekly as the maintenance dose.
- The label allows delaying an escalation by four weeks if a step is not tolerated.
Ozempic (type 2 diabetes) escalation
The diabetes schedule starts identically but tops out differently, because the endpoint being treated is blood glucose rather than weight.
- Weeks 1–4: 0.25 mg once weekly — a starting dose for tolerability, not a treatment dose.
- Week 5 onward: 0.5 mg once weekly.
- After at least four weeks at 0.5 mg, the dose may be increased to 1 mg once weekly.
- After at least four weeks at 1 mg, it may be increased to a maximum of 2 mg once weekly.
- Rybelsus, the oral form, uses 3 mg for 30 days, then 7 mg, then 14 mg — the tablet numbers are not interchangeable with the injection numbers.
How to read a dosage chart without misreading it
Charts circulate widely and are often screenshots of someone else's plan. Three things separate the label from the folklore.
- Milligrams per week, not units. Pens are marked in doses; converting to syringe units only applies to compounded vials, and those are not the product these schedules were written for.
- The schedule is a ceiling and a pace, not a target. Many people stay at a lower dose indefinitely because it is doing the job.
- Escalation is paused, not skipped, when side effects bite. Jumping a step to catch up is the most common reason a week goes badly.
- Compounded semaglutide is not the same product as the approved pens; the FDA has warned about dosing errors with compounded vials and syringes.
Keeping the schedule straight
A four-month escalation spans about eighteen injections. Recording each one turns a vague memory into something a clinician can use.
- Log the dose and the date of every increase, so a bad week can be matched to a step.
- Keep the same injection day each week and set the reminder for it rather than relying on memory.
- Note nausea, appetite and bowel changes on a consistent scale in the days after each increase.
- Record weight or HbA1c on a fixed day, so the trend is comparable across the escalation.
Frequently asked
What is the semaglutide dose schedule for weight loss?
The Wegovy label escalates every four weeks: 0.25 mg for weeks 1–4, 0.5 mg for weeks 5–8, 1 mg for weeks 9–12, 1.7 mg for weeks 13–16, then 2.4 mg once weekly as maintenance from week 17. If a step is not tolerated the label allows staying at the current dose for another four weeks.
What is the maximum dose of Ozempic?
The approved maximum for Ozempic is 2 mg once weekly, reached only after at least four weeks at 1 mg. Wegovy, the weight-management product, tops out at 2.4 mg once weekly.
What happens if you miss a weekly dose?
The labels state that a missed dose can be taken within five days of the scheduled day; if more than five days have passed, the missed dose is skipped and the next one is taken on the usual day. Confirm with your prescriber rather than doubling up.
Can you stay on a lower dose instead of escalating?
Many people do, and the label supports staying at a tolerated dose. The escalation schedule describes the maximum pace of increase, not a requirement to reach the top dose.
References
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DoseRoutine is educational and does not diagnose, prescribe, or recommend a dose. The schedules above are reproduced from approved FDA labeling. Your prescriber sets your dose and your escalation pace.