Wegovy (semaglutide) is FDA-approved in two forms: a once-weekly subcutaneous injection, escalating through four fixed steps over 16 weeks before reaching an indication-specific maintenance dose, and — new to the 2026 label — a once-daily oral tablet with its own 90-day titration. 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 — injection (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 June 30, 2026 (SPL version 19) — the label now covers both the WEGOVY injection and the new WEGOVY tablet.
Maintenance dose (varies by indication)
| Indication | Recommended maintenance | Notes |
|---|---|---|
| Cardiovascular risk reduction (adults) | 2.4 mg (recommended) or 1.7 mg once weekly | Dose selected based on tolerability and treatment response. |
| Weight reduction (adults) | 1.7 mg or 2.4 mg (recommended) once weekly | If 2.4 mg is tolerated for at least 4 weeks and more weight loss is clinically indicated, the dose may be increased to 7.2 mg once weekly (Wegovy HD) — added to the label in 2026. |
| Weight reduction, ages 12–17 | 2.4 mg (recommended) or 1.7 mg once weekly | Same 16-week titration schedule as adults. |
| Noncirrhotic MASH with moderate-to-advanced liver fibrosis (adults) | 2.4 mg once weekly | New 2026 indication. May de-escalate to 1.7 mg if not tolerated, with consideration to re-escalate. |
New in 2026: Wegovy tablets (oral)
Wegovy is no longer injection-only. The FDA-approved label now also covers a once-daily oral tablet for cardiovascular risk reduction or weight reduction in adults — the tablet is not approved for pediatric weight reduction or for MASH, which remain injection-only.
| Step | Days | Dose |
|---|---|---|
| Starting | Days 1–30 | 1.5 mg once daily |
| Escalation | Days 31–60 | 4 mg once daily |
| Escalation | Days 61–90 | 9 mg once daily |
| Maintenance | Day 91+ | 25 mg once daily |
- Take on an empty stomach in the morning with up to 4 ounces of water only — no other liquids.
- Swallow whole. Do not split, crush, chew, or dissolve the tablet.
- Wait at least 30 minutes after taking the tablet before eating, drinking anything besides the initial water, or taking other oral medications.
- Missed tablet dose: skip it and take the next dose the following day — do not double up. This is simpler than the injection's 2-day rule below.
- If 25 mg is not tolerated, the label allows switching to Wegovy 1.7 mg injection once weekly instead.
- Storage: keep tablets in the original bottle, at room temperature, away from moisture — no refrigeration needed.
Switching between the injection and the tablet
- Injection → tablet: one week after the last 2.4 mg injection dose, start 25 mg tablets once daily — no re-titration needed.
- Tablet → injection: the day after the last 25 mg tablet dose, start 2.4 mg injection once weekly. If the 25 mg tablet wasn't tolerated, the label suggests starting at 1.7 mg injection instead.
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 varies by indication (see the table above) — it is no longer a single 2.4 mg figure now that Wegovy covers weight reduction, cardiovascular risk reduction, and MASH.
- 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 (injection)
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, or how Wegovy compares head-to-head with Zepbound and Mounjaro, see the deeper resources below.