Wegovy Dosage: The 5-Step Schedule and What to Expect

This page is a reference, not instructions. Everything below describes what the FDA-approved prescribing information for Wegovy publishes — public, verifiable fact. It is not a plan for you. Your prescriber decides your dose, when it moves, and whether it moves at all.

The direct answer

Wegovy (semaglutide) injection starts at 0.25 mg once weekly and climbs in five steps — 0.25, 0.5, 1, 1.7, then 2.4 mg — with four weeks at each step, reaching a maintenance dose at week 17. The label's recommended adult maintenance dose for weight reduction is 2.4 mg weekly, though 1.7 mg is also a listed maintenance option. The starting doses are not "too low to work"; they exist to let your gut adapt.

The 5-step schedule, as published

Two newer options now appear on the same label and most pages have not caught up. For adults who tolerate 2.4 mg for at least four weeks and still have clinical need, the label permits an increase to a maximum of 7.2 mg weekly ("Wegovy HD", approved March 2026). And there is now an oral Wegovy tablet (approved December 2025) with its own daily escalation — 1.5 mg, then 4 mg, then 9 mg, then 25 mg daily as maintenance, 30 days at each step, taken on an empty stomach in the morning. The label also notes that if someone cannot tolerate the 25 mg tablet, switching to the 1.7 mg injection is an option a clinician may consider.

Why the ramp exists at all

Semaglutide slows how fast the stomach empties and dampens appetite signalling in the brain. Both effects are dose-dependent, and so are the side effects: nausea, vomiting, diarrhoea, constipation. The step-up schedule is not a marketing device or a way to sell more pens — it is a tolerability ramp. Starting at the maintenance dose would leave a large share of people vomiting and quitting in week one.

That is also why the first two steps are described in the label as escalation doses, not treatment doses. If you are on 0.25 mg and the scale has not moved, nothing is wrong. You are in the on-ramp.

Going slower is common — and it is your prescriber's call

The label itself anticipates this. It states that if a patient does not tolerate a dose during escalation, the prescriber may consider delaying the escalation for 4 weeks. In practice, spending eight weeks at 0.5 mg instead of four, or pausing at 1 mg, is an ordinary clinical decision, not a failure. Some people also stay on 1.7 mg — or lower — as their long-term dose because it is working and they feel human on it. The label lists 1.7 mg as a legitimate maintenance dose for adults; more is not automatically better.

What you can do is report accurately: which day the nausea hits, how long it lasts, what you can and cannot eat, whether you are keeping fluids down. That is the information a prescriber needs to decide whether to hold, slow, or move.

The things not to do — stated plainly

• Do not self-adjust your dose. Not up because progress stalled, not down because you feel rough. Both are decisions for the person who prescribed it.
• Do not double up after a missed dose. The label gives prescribers specific missed-dose handling, and it never involves taking two doses to catch up. If you miss one, ask your prescriber or pharmacist what to do — do not improvise.
• Do not stretch a pen to make it last longer. This one deserves naming, because it is a cost-driven behaviour, not an ignorance-driven one: people who cannot afford the next box try to squeeze extra doses out of the pen they have, or split a higher-dose pen into smaller ones. Wegovy pens are designed to deliver a fixed number of fixed doses. Once you go past that, the amount you are actually injecting is not guaranteed, and neither is sterility. If the reason you are considering it is money, the cost section below is a better place to start than the pen.
• Do not restart at your old dose after a long gap. The label instructs prescribers to reinitiate at a lower dose after two or more consecutive missed doses. Tolerance to the gut effects fades. Coming back at your old dose is exactly how people end up in urgent care.

What it costs, checked 13 July 2026

Prices here move constantly, so treat these as a snapshot with a date on it, taken from Novo Nordisk's own NovoCare and Wegovy pricing pages on 13 July 2026:

One number worth knowing even though almost nobody writes a cheque for it: Novo Nordisk lists Wegovy at a package list price of $1,349.02. Few people pay that in cash — but if your plan puts Wegovy on a coinsurance tier rather than a flat copay, that is the figure your percentage is calculated from, which is how a "20% coinsurance" plan can end up costing you more than paying cash.

What we cannot tell you is what your plan will do. Coverage for weight-loss indications is decided formulary by formulary, and the same drug can be covered for one person and denied for the neighbour on a different plan. The exact questions worth asking your insurer: Is Wegovy on the formulary for chronic weight management, or only for cardiovascular risk reduction? What is the prior-authorisation requirement, and does it require a documented BMI or a failed lifestyle programme first? Is there a step-therapy rule, and what am I required to try first? Is my share a flat copay or coinsurance? Get the answers in writing. Our cost and coverage estimator can help you map the routes before you call.

On compounded semaglutide: compounded drugs are not FDA-approved. The agency does not review them for safety, effectiveness or manufacturing quality, so a compounded "semaglutide" is not the same regulated product as the pen, whatever the website says. The FDA declared the semaglutide shortage resolved in February 2025, and the enforcement windows that let compounders mass-produce it closed later that year; on 30 April 2026 the agency proposed excluding semaglutide — along with tirzepatide and liraglutide — from the list of bulk substances outsourcing facilities may compound at all. The harm here is documented, not theoretical. In a July 2024 alert the FDA described adverse events, some requiring hospitalisation, caused by dosing errors with compounded semaglutide supplied as a vial and a syringe: patients and clinicians converted milligrams into "units" or millilitres incorrectly and administered five to ten times the intended dose. A pen delivers a fixed dose. A vial and a syringe put arithmetic between you and your dose, usually at 10pm in a bathroom. We are not telling you to use or avoid compounded product — but if someone is offering it to you cheaply, you are entitled to ask what legal basis they are compounding it under, and who is checking the dose you draw up.

What happens when you stop

Most pages bury this. The honest version: weight regain after stopping is the norm, not a personal failure. In the STEP 1 trial extension, participants who had lost an average of 17.3% of body weight on 2.4 mg semaglutide regained about two-thirds of that loss within a year of stopping — settling at roughly 5.6% below where they started. Appetite comes back, because the drug that was suppressing it is gone.

That is what "chronic condition, chronic treatment" means in practice. It does not mean stopping is wrong — people stop for cost, side effects, pregnancy plans, or because they have had enough. It means that if you stop, the sensible move is to have a conversation about what happens next before you take the last injection, not after the weight starts returning. Protecting muscle with resistance training and adequate protein matters more than usual here — see GLP-1s and muscle loss.

Talk to your prescriber — and when to call sooner

Book a conversation, don't wait for the next scheduled refill, if any of this applies:

• Vomiting or diarrhoea you cannot keep ahead of, or you cannot keep fluids down. Dehydration on a GLP-1 can injure the kidneys.
• Severe, persistent abdominal pain, especially pain that bores through to your back, with or without vomiting — this needs urgent assessment for pancreatitis.
• Pain in the upper right abdomen, fever, jaundice or clay-coloured stools — gallbladder problems are a known risk with rapid weight loss.
• You are pregnant, might be, or are planning pregnancy. Semaglutide is not for use in pregnancy, and it should be discussed well in advance.
• You have a personal or family history of medullary thyroid carcinoma or MEN 2 — the label carries a boxed warning about thyroid C-cell tumours seen in rodents.
• You take insulin or a sulfonylurea, or you have diabetic retinopathy — dose changes there need active management.
• You cannot afford the next box. Say it out loud, in those words. It is a clinical problem, not an embarrassing one, and it changes what your prescriber can do for you.

If you are choosing a telehealth route, judge it on whether it will tell you no: does a licensed clinician review you and take your history, will they hold or slow your escalation when you report side effects rather than escalating on autopilot, is the medication dispensed as the FDA-approved product, and can you reach a human between refills? A service that escalates you on a calendar regardless of what you report is not managing your treatment. See how to evaluate online GLP-1 care.

Disclosure: VidaBeacon may earn a commission if you use some of the care or product links on this site. That never changes what we write, and we do not accept payment to recommend a specific prescriber, pharmacy or telehealth service. No brand paid for this page.

Related reading

• Wegovy vs Ozempic — same molecule, different labels, different doses
• Semaglutide side effects — what tends to fade and what does not
• Zepbound vs Wegovy
• Menopause and weight gain — why midlife changes the maths
• Semaglutide drug page and the weight & metabolism hub