Wegovy dosage: the step-by-step titration schedule, explained

What this guide covers

The FDA-label Wegovy dosage schedule for semaglutide, step by step: the five doses, why it climbs slowly over about 16 to 20 weeks, what the label says about a dose you cannot tolerate, missed doses, and restarting after a gap. This is patient education, not a substitute for the prescriber who knows your case. Generic names sit next to brand names throughout: semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro, Zepbound).

Key points

• The short answer: start low, climb slowly. Wegovy is semaglutide dosed for weight management, and its schedule follows one principle: start at a low dose that is not really meant to do much, then step up on a fixed monthly rhythm until you reach the maintenance dose. The FDA label lays out five doses reached over roughly 16 to 20 weeks, and the whole point of that slow ladder is to keep the nausea and other digestive effects manageable, because they cluster around each increase. Wegovy is injected once weekly under the skin, on the same day each week, with or without food. The schedule below is the standard one from the prescribing information; it is the shape of the plan, not a personal prescription, and your prescriber sets and adjusts your actual dose.
• The five-step schedule. The FDA label steps Wegovy up roughly every four weeks through five set doses. It begins at 0.25 mg once weekly for the first four weeks, a starter dose meant to build tolerance rather than to do the main work. At week five it goes to 0.5 mg, then to 1.0 mg around week nine, then to 1.7 mg around week thirteen, and finally to the 2.4 mg maintenance dose usually reached around week seventeen. So the ladder is 0.25, then 0.5, then 1.0, then 1.7, then 2.4 mg, with each step normally held for about four weeks before the next. The 2.4 mg dose is the maintenance target the STEP weight-management trials used, and it is where most people are meant to settle once they have climbed the ladder.
• Why it climbs so slowly. The gradual schedule is not caution for its own sake; it is the main tool for keeping side effects tolerable. Nausea, diarrhea, and the other digestive effects of semaglutide are always heaviest in the first weeks and right after each dose increase, then settle as the body adapts to that level. Climbing one step at a time, with about four weeks between increases, gives your gut the runway to adjust before the next jump. It is why a rough few days after a step up is usually a temporary, expected part of the process rather than a sign something is wrong, and why rushing the ladder tends to backfire into worse symptoms rather than faster results.
• If a dose is too hard to tolerate. The calendar is a guideline, not a command, and the Wegovy label builds in flexibility. If a scheduled increase is not tolerated, the prescribing information allows delaying that step for about four weeks to give your body more time before trying again. And if the full 2.4 mg maintenance dose itself is not tolerated, the label permits staying on the 1.7 mg dose as maintenance instead. A common, normal pattern is spending an extra month at a lower dose before moving up, or settling at a step below the top. This is a prescriber conversation rather than a do-it-yourself change, but slowing the climb or holding lower is an accepted, expected part of Wegovy dosing, not a failure.
• Missed a dose, or a longer gap. The FDA label has specific guidance for a missed weekly dose: if the next scheduled dose is more than about 48 hours away, take the missed dose as soon as you can; if it is sooner than that, skip it and go back to your regular weekly day. You can also change which day of the week you inject as long as at least 48 hours have passed since your last dose. A longer gap is different: if you miss doses for a stretch, the label advises that treatment may need to be restarted at a lower dose and re-titrated up, because tolerance fades when the drug clears. If you have been off Wegovy for more than a couple of weeks, check with your prescriber before simply resuming your old dose.

Frequently asked questions