Wegovy (semaglutide) is dosed once weekly by subcutaneous injection, escalating through five fixed steps over 16 weeks before reaching the 2.4 mg maintenance dose. Use this page as a pocket reference before a dose; for deeper context on a specific step, see the linked articles at the bottom.
Dose ladder (subcutaneous, once weekly)
| Step | Week | Dose | Notes |
|---|---|---|---|
| 1 | Weeks 1–4 | 0.25 mg | Starting dose. Not a treatment dose — only to acclimate the gut. |
| 2 | Weeks 5–8 | 0.5 mg | First step where appetite suppression typically becomes noticeable. |
| 3 | Weeks 9–12 | 1.0 mg | Same dose used long-term for Ozempic in type 2 diabetes. |
| 4 | Weeks 13–16 | 1.7 mg | Maintenance-eligible. Some patients stay here if 2.4 mg is poorly tolerated. |
| 5 | Week 17+ | 2.4 mg | Full maintenance dose used in STEP-1, STEP-4, and SELECT. |
Source: DailyMed Wegovy SPL, SetID ee06186f-2aa3-4990-a760-757579d8f77b, revision May 5, 2026.
Quick facts
- Inject same day each week. Any time of day, with or without food. Switch the day of the week only if the last dose was at least 48 hours earlier.
- Each step is typically 4 weeks. Do not escalate sooner; the schedule exists to limit nausea, vomiting, and dehydration.
- Slowing the climb is allowed. If a step causes intolerable GI symptoms, stay another 4 weeks at the same dose or step back one level before re-trying.
- Maintenance is 2.4 mg for weight management. 1.7 mg is an accepted alternative if 2.4 mg is not tolerated.
- Do not double up to make up a skipped step. Resume the ladder from where it paused.
- Injection sites: abdomen, thigh, or upper arm. Rotate weekly. Do not inject into the same spot twice in a row.
- Storage: refrigerate unused pens at 36–46°F. Once in use, a pen can be kept at room temperature (up to 86°F) for up to 28 days, then discarded.
Missed-dose protocol
From the FDA label: if the next scheduled dose is more than 2 days (48 hours) away, administer the missed dose as soon as possible. If the next scheduled dose is less than 2 days away, do not administer the missed dose — resume on the regularly scheduled day. If more than two consecutive weekly doses are missed, contact the prescriber; a dose restart from a lower step may be required.
Call your doctor if...
- Severe, persistent abdominal pain — especially radiating to the back, with or without vomiting. Possible acute pancreatitis.
- Right-upper-quadrant pain, fever, jaundice, or clay-colored stools. Possible gallbladder disease (cholelithiasis incidence on Wegovy 1.6% vs 0.7% placebo).
- Vomiting that prevents fluid intake for more than 24 hours, or signs of dehydration (dizziness on standing, dark urine, low urine output). Acute kidney injury has been reported.
- A lump or swelling in the neck, hoarseness, or difficulty swallowing. Boxed warning: thyroid C-cell tumors in rodents; do not use with a personal or family history of medullary thyroid carcinoma or MEN 2.
- Hives, swelling of the face or throat, or trouble breathing. Anaphylaxis and angioedema have been reported — stop Wegovy immediately and seek emergency care.
- Hypoglycemia symptoms (shakiness, sweating, confusion) if you also take insulin or a sulfonylurea for type 2 diabetes. Dose reductions of the diabetes drug may be needed.
What this cheat sheet does not cover
This page is the dosing skeleton only. For interaction details (insulin, oral contraceptives, gastroparesis history), pregnancy guidance, the high-dose 7.2 mg adult option added to the 2026 label, the oral semaglutide tablet ladder (Rybelsus / Wegovy oral), or how Wegovy compares head-to-head with Zepbound and Mounjaro, see the deeper resources below.
Related on Weight Loss Rankings
- Wegovy drug overview — mechanism, trial data, pricing, and the latest 2026 label changes.
- GLP-1 Titration Planner — interactive week-by-week dose schedule with calendar export.
- GLP-1 Missed-Dose Guide — the 48-hour rule applied to every GLP-1, with worked examples.
- Top Semaglutide Weight-Loss Studies — STEP-1 through STEP-5, SELECT, and the long-term retention data behind the 2.4 mg target.