A week-by-week semaglutide dosing chart, based on the product labels

If you have searched for a semaglutide dosing chart, you have probably found several versions that do not quite match. The most reliable reference is the one in the FDA-approved product labels. This guide lays out the week-by-week dose steps from the Wegovy and Ozempic prescribing information, explains why doses step up gradually, and covers the highest dose currently on a label.

This is educational content, not medical advice, and it is not a dosing plan for you. Your dose, and whether semaglutide fits you at all, is decided by a licensed provider who reviews your history.

How semaglutide titration works and why doses step up

Semaglutide is a once-weekly GLP-1 receptor agonist. Instead of starting at the full dose, the labels begin low and increase in steps, a process called titration. The Wegovy label states that the step-up schedule is meant to reduce the risk of gastrointestinal side effects [1].

Those side effects are common. In the Wegovy weight-reduction trials, nausea, vomiting, and diarrhea were reported most often during dose escalation [1]. If a step is not tolerated, the label says a prescriber may consider delaying the next increase by four weeks [1].

Timing matters too. Semaglutide has an elimination half-life of about one week [1], so each new dose level builds up over several weeks rather than all at once. Four-week steps give the body time to adjust before the next change.

Semaglutide dosing chart for weight loss

The chart below follows the Wegovy injection label for adults [1]. It is the schedule studied in the trials that supported the product's approval.

Source: Wegovy prescribing information [1].

For weight reduction in adults, the label lists 2.4 mg once weekly as the recommended maintenance dose, with 1.7 mg as an alternative [1]. It tells prescribers to weigh treatment response and tolerability when choosing between them [1].

Wegovy also comes as a once-daily tablet with its own schedule. The label starts at 1.5 mg daily for 30 days, then steps to 4 mg and 9 mg at 30-day intervals, reaching a 25 mg maintenance dose from day 91 [1]. Tablet and injection doses are not interchangeable milligram for milligram.

The 0.25 mg starting dose: What it is for

Both the Wegovy and Ozempic labels begin at 0.25 mg once weekly for four weeks [1, 2]. This first step is about tolerability, not results. The Ozempic label states that the 0.25 mg dose is intended for treatment initiation and is not effective for glycemic control [2].

Some people worry that nothing seems to be happening on 0.25 mg. That is consistent with what the label describes. The low starting dose gives the digestive system time to adjust before higher doses follow.

How the Ozempic schedule differs

Ozempic and Wegovy contain the same molecule, semaglutide, but they are separate FDA-approved products with different indications. Ozempic is approved for adults with type 2 diabetes, including to improve blood sugar control [2]. It is not approved for weight management.

Source: Ozempic prescribing information [2].

Two differences stand out. First, Ozempic increases are tied to blood sugar control rather than a fixed calendar, so many people stay at 0.5 mg or 1 mg [2]. Second, the missed-dose rules differ between the two labels, as the questions below explain [1, 2].

What the highest labeled dose is

As of March 2026, the highest labeled weekly dose of semaglutide is 7.2 mg. The FDA approved this higher-dose Wegovy injection, called Wegovy HD, that month [3]. Under the label, a prescriber may increase to this maximum only for adults who have tolerated 2.4 mg for at least four weeks and for whom additional weight reduction is clinically indicated [1].

"Highest" here describes the label, not a goal. Higher doses carry their own side effect profile. In the 7.2 mg trials, altered skin sensations such as tingling or burning (dysesthesia) were reported by 22% of people on 7.2 mg, compared with 6% on 2.4 mg and 0.3% on placebo [1]. For Ozempic, the highest labeled dose is 2 mg weekly [2].

What counts as a maintenance dose, and why it is not always the highest dose, is covered in our separate guide to GLP-1 maintenance doses.

Compounded formulations: Why this chart is a reference, not a protocol

Everything in the charts above describes FDA-approved branded products. Compounded semaglutide products are not FDA-approved and do not undergo FDA review for safety, effectiveness, or quality before they are marketed [4]. FDA recommends that compounded drugs be used only when a patient's medical needs cannot be met by an available FDA-approved drug. Federal and state laws also restrict when commercially available medications may be compounded. A compounded product should not be considered a generic or FDA-approved equivalent of Wegovy or Ozempic. Whether compounding is clinically appropriate and legally permissible depends on the individual patient and applicable compounding requirements. Data from clinical trials of Wegovy and Ozempic should not be assumed to establish the safety, effectiveness, quality, potency, or bioequivalence of a compounded product.

Compounded products may come in different concentrations and containers than branded pens. The FDA has received reports of dosing errors with compounded semaglutide, including mix-ups between units, milliliters, and milligrams [4]. For that reason, the label chart cannot be applied directly to a compounded vial.

If you have been prescribed a compounded formulation, follow the instructions on your pharmacy label and from your provider. Our semaglutide and tirzepatide dosing guide explains how milligrams, milliliters, and units relate. For background, see compounded semaglutide: everything you need to know and the important safety information for compounded semaglutide.

When a provider may slow, pause, or adjust titration

The label schedule is a default, not a fixed track. A licensed provider may hold a dose, step back down, or move more slowly. Common reasons include:

• Side effects. Nausea, vomiting, diarrhea, or constipation that is hard to manage. Practical ideas are in our article on semaglutide nausea.
• Missed doses. The Wegovy label says that after two or more consecutive missed doses, escalation should restart at a lower dose [1].
• Other medications. Taking semaglutide with insulin or a sulfonylurea raises the risk of low blood sugar, and those doses may need adjusting [1].
• Upcoming procedures. The label notes rare reports of pulmonary aspiration during anesthesia or deep sedation and asks patients to tell providers about planned procedures [1].
• Pregnancy plans. The Wegovy label advises stopping at least two months before a planned pregnancy because of semaglutide's long half-life [1].

Semaglutide is a prescription medication with real risks. The labels carry a boxed warning about thyroid C-cell tumors seen in rodents, along with warnings about pancreatitis, gallbladder disease, kidney problems linked to dehydration, and severe gastrointestinal reactions [1, 2]. A provider reviews these with you before deciding anything. These are not comprehensive lists of risks or contraindications; patients should review the prescribing information and discuss their medical history with their clinician.

Common questions

Can I skip a step in the chart?

The labels build in four-week steps to reduce side effects [1]. Any change to that pace is a provider's decision. Speeding up on your own is not something the labels support.

What if I miss a dose?

It depends on the product. For Wegovy injection, if the next scheduled dose is more than two days away, the label says to take the missed dose as soon as possible; if it is less than two days away, skip it [1]. For Ozempic, the label allows the missed dose within five days [2]. Your provider determines what applies to your prescription, especially for a compounded formulation.

Is the compounded dose the same as the branded dose?

No equivalence should be assumed. A compounded product should not be considered a generic or FDA-approved equivalent of Wegovy or Ozempic, and it may come in a different concentration or container than a branded pen [4]. Your pharmacy label and your provider determine your dose and how to measure it.

How long until the maintenance dose?

On the Wegovy injection label, the maintenance phase starts at week 17 [1]. On the tablet label, it starts at day 91 [1]. Whether you reach a maintenance dose, and which one, depends on how you respond and what your provider decides.

Next steps

If you are trying to understand where semaglutide might fit for you, the next step is a conversation with a licensed provider who can review your history and decide whether treatment makes sense for you. Nothing is prescribed or shipped without that review. Any medication preference you indicate is only a starting point for discussion. A licensed clinician independently determines whether prescription treatment is medically appropriate and, if so, which medication, dose, and treatment plan are appropriate based on your clinical evaluation.

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