Semaglutide Dosing Schedule: 0.25mg to 2.4mg Week by Week

Semaglutide is not started at its effective dose. Both Ozempic and Wegovy use a titration approach — starting low and increasing gradually over weeks to months. The schedules differ between the two products because their maximum approved doses differ, but the principle is the same: slow escalation to minimise side effects and allow your body to adapt.

Ozempic dosing schedule (type 2 diabetes)

The standard Ozempic titration:

• Weeks 1–4: 0.25 mg once weekly — this is a tolerance-building dose, not a therapeutic one. Do not expect significant appetite changes or glucose improvements at this stage.
• Weeks 5+: 0.5 mg once weekly — the first therapeutic dose for diabetes. Many patients remain here if glucose control is achieved.
• If additional control is needed: Increase to 1 mg after at least 4 weeks on 0.5 mg.
• Maximum dose: 2 mg weekly (after at least 4 weeks on 1 mg). Not all patients need or reach this dose.

Ozempic dose increases are driven by clinical response — blood sugar targets, tolerability, and your prescriber's judgment. There is no automatic schedule requiring you to increase if you are doing well at a lower dose.

Wegovy dosing schedule (weight management)

Wegovy has a more structured 5-step titration over 16 weeks before reaching the maintenance dose:

• Weeks 1–4: 0.25 mg — tolerance-building only
• Weeks 5–8: 0.5 mg
• Weeks 9–12: 1 mg
• Weeks 13–16: 1.7 mg
• Week 17 onwards: 2.4 mg — the approved maintenance dose

Each step lasts a minimum of four weeks. If side effects are significant at any step, your prescriber may recommend staying at that dose longer before advancing. The 2.4 mg dose is the maintenance target, but some patients stabilise at a lower dose with acceptable results.

Why the titration exists

Semaglutide slows gastric emptying, and the gastrointestinal system needs time to adapt to this effect. The low starting dose minimises nausea, vomiting, and other GI side effects during adjustment. Patients who self-escalate doses faster than recommended typically experience significantly worse side effects and are more likely to discontinue.

What to expect at each dose level

• 0.25 mg: Most people feel little to nothing. Mild appetite changes possible. This is normal.
• 0.5 mg: Appetite suppression begins to be noticeable. Some nausea after injection in the first day or two.
• 1 mg: Meaningful appetite reduction for most patients. Food noise noticeably quieter. GI side effects usually settling.
• 1.7 mg / 2 mg: More pronounced appetite suppression. Patients prone to nausea may have more symptoms at this step.
• 2.4 mg: Maximum approved dose for weight management. Strongest appetite suppression. Side effects are usually well-tolerated by this point in most patients who have titrated correctly.

Missing a dose

If you miss a weekly dose by less than 5 days, take it as soon as you remember. If more than 5 days have passed, skip it and resume your regular schedule the following week. Never take two doses within 48 hours of each other. Always follow the specific instructions in your medication guide — they take precedence over general advice.

Dosing decisions, titration pace, and any modifications should be directed by your prescriber. Do not self-adjust your semaglutide dose without clinical guidance.