Semaglutide Dosage Chart (2026): Wegovy & Ozempic Titration Ladder + Maintenance Doses

Semaglutide is titrated slowly and on a fixed schedule, and the schedule is different for each brand. Wegovy (semaglutide for chronic weight management) escalates once weekly over five steps — 0.25 mg → 0.5 mg → 1.0 mg → 1.7 mg → 2.4 mg maintenance — spending four weeks at each dose, so the earliest you reach the full 2.4 mg dose is week 17.^[1] Ozempic (semaglutide for type 2 diabetes, often used off-label for weight loss) follows a different, lower ladder: 0.25 mg → 0.5 mg → 1.0 mg → 2.0 mg, with the 0.25 mg starting dose being explicitly non-therapeutic — it exists only to reduce gastrointestinal side effects, not to treat anything.^[2] Every dose in this chart is administered once weekly by subcutaneous injection. This guide reproduces the full ladder for both brands, explains why the four-week steps exist, covers how compounded semaglutide dosing can diverge from the brand schedule, and walks through missed doses and titration pauses. All dosing here is illustrative of the FDA labels — your prescriber sets your actual schedule. See our Wegovy drug page and Ozempic drug page for the live data, and the GLP-1 titration planner to map your own dates.

The full semaglutide dose ladder (Wegovy + Ozempic)

Here is the complete once-weekly subcutaneous titration for both FDA-approved injectable semaglutide brands, side by side. The defining rule for both: you stay at each dose for four weeks before stepping up, and you start at a deliberately sub-therapeutic 0.25 mg dose whose only job is to let your gut adjust.^[1][2]

Read the table by brand, not just by row. Wegovy is a five-rung ladder (0.25 → 0.5 → 1.0 → 1.7 → 2.4 mg) because it climbs to a higher final dose for weight loss. Ozempic is a four-rung ladder (0.25 → 0.5 → 1.0 → 2.0 mg) with a lower ceiling because its job is glycemic control in type 2 diabetes. The 1.7 mg rung exists only on the Wegovy schedule.^[1][2]

The Wegovy dose ladder (weight loss)

Wegovy (semaglutide, Novo Nordisk) is the FDA-approved semaglutide for chronic weight management, approved June 2021. Per the Wegovy label §2.2, the recommended maintenance dosage is 2.4 mg injected subcutaneously once weekly, reached through a mandatory 16-week escalation:^[1]

• Weeks 1-4: 0.25 mg once weekly
• Weeks 5-8: 0.5 mg once weekly
• Weeks 9-12: 1.0 mg once weekly
• Weeks 13-16: 1.7 mg once weekly
• Week 17 onward: 2.4 mg once weekly — the maintenance dose

So the full 16-week escalation means the earliest a patient on the standard schedule reaches the 2.4 mg maintenance dose is week 17. The label notes that if a patient does not tolerate a dose during escalation, the prescriber may delay the next step up — or, if 2.4 mg is not tolerated, a maintenance dose of 1.7 mg once weekly may be used instead.^[1] In the pivotal STEP 1 trial, adults on semaglutide 2.4 mg lost a mean of 14.9% of body weight at 68 weeks versus 2.4% on placebo.^[3] You can map your own escalation dates with the GLP-1 titration planner and visualize the climb with the GLP-1 dose plotter.

The Ozempic dose ladder (type 2 diabetes, used off-label)

Ozempic (semaglutide, Novo Nordisk) is FDA-approved for type 2 diabetes — not weight loss — though it is widely prescribed off-label for weight management. Per the Ozempic label §2.2, the escalation is:^[2]

• Weeks 1-4: 0.25 mg once weekly — a starting dose intended to reduce GI side effects, not for glycemic control
• Weeks 5-8: increase to 0.5 mg once weekly (the first therapeutic dose)
• After ≥4 weeks at 0.5 mg: if more glycemic control is needed, increase to 1.0 mg once weekly
• After ≥4 weeks at 1.0 mg: if more glycemic control is needed, increase to the maximum 2.0 mg once weekly

Two structural differences from Wegovy: Ozempic's maximum dose is 2.0 mg (not 2.4 mg), and Ozempic has no 1.7 mg step — it goes 1.0 mg straight to 2.0 mg. The label is also explicit that the 0.25 mg starting dose is non-therapeutic.^[2] Because Ozempic and Wegovy are the same molecule (semaglutide), people sometimes assume the doses are interchangeable; they are not — the brands have different approved ladders and ceilings. See the Ozempic drug page for full details, and our ranking of the best semaglutide providers for where to get a legitimate prescription.

Why the 4-week escalation matters (tolerability and GI side effects)

The four-week step schedule is not arbitrary, and it is not optional padding — it is the mechanism that makes semaglutide tolerable. Semaglutide's most common side effects are gastrointestinal: nausea, vomiting, diarrhea, and constipation. These are dose-related and most intense when the dose increases. Starting at a sub-therapeutic 0.25 mg and holding each rung for four weeks lets the gut adapt before the next increase, which is why both labels build the 0.25 mg "tolerability-only" dose into week 1.^[1][2]

The practical consequence: skipping a rung or rushing the schedule predictably worsens nausea and vomiting and is a documented source of dosing errors, especially with non-standardized compounded product. If a dose is not tolerated, the correct move under the label is to delay the next step up — staying longer at the current dose — rather than push through. Persistent severe GI symptoms also warrant a check for dehydration-related complications such as acute kidney injury. None of this is a reason to fear the drug; it is the reason the ladder is shaped the way it is.

Compounded semaglutide dosing differs (mg may not map 1:1)

A critical caveat for anyone on compounded semaglutide: the mg numbers in this chart describe the FDA-approved Wegovy and Ozempic products, and they do not necessarily map 1:1 to a compounded prescription. Compounded semaglutide is not an FDA-approved drug — it is prepared by a compounding pharmacy under a separate regulatory pathway, and its concentration, vial sizing, and titration schedule are set by the prescribing clinician and pharmacy, not by the brand label.

• Units vs milligrams. Compounded semaglutide is frequently dosed in units on an insulin syringe or in mL drawn from a vial of a specific concentration. A "20-unit" dose means nothing without knowing the vial concentration — the same volume can deliver very different milligram amounts.
• Non-standard escalation. A compounding clinic's titration may not match the 0.25 → 0.5 → 1.0 → 1.7 → 2.4 mg Wegovy steps. Some use different increments or hold points.
• Salt-form differences. The FDA has warned about compounded products using salt forms (semaglutide sodium/acetate) that differ from the base molecule in the approved drugs — another reason a milligram on a compounded label may not behave like a milligram of Wegovy.

Missed dose and titration pauses

Because semaglutide is once weekly, the brand labels give specific missed-dose guidance:^[1][2]

• If you miss a dose and the next scheduled dose is more than 2 days (48 hours) away: take the missed dose as soon as you remember, then resume your regular weekly schedule.
• If the next scheduled dose is less than 2 days away: skip the missed dose and resume on your regular dosing day. Do not double up.
• If you miss doses for two or more consecutive weeks: contact your prescriber. Per the labels, after a prolonged gap a prescriber may have you resume at your current dose or re-escalate from a lower dose, because tolerance to the GI effects can fade — restarting at the full dose after a long pause can bring the nausea back.

Titration pauses are normal and expected. Staying longer at a given rung — or stepping back down — because of side effects is a label-sanctioned strategy, not a failure. A pause simply pushes your timeline to the maintenance dose later; it does not mean the medication is not working. The GLP-1 titration planner can re-map your dates if you hold or repeat a dose.

When you reach maintenance

For Wegovy, the maintenance dose is 2.4 mg once weekly, reached at week 17. If 2.4 mg is not tolerable, the label permits a maintenance dose of 1.7 mg once weekly instead.^[1] For Ozempic, there isn't a single "maintenance" dose in the weight-loss sense — the prescriber stops escalating once glycemic targets are met, which may be at 0.5 mg, 1.0 mg, or the 2.0 mg maximum.^[2]

Maintenance is not a finish line you graduate from — semaglutide is a chronic therapy. The STEP trials and subsequent extension data show that weight tends to be regained when semaglutide is stopped, which is why the labels frame it as ongoing treatment rather than a course you complete.^[3] Once at maintenance, the cadence is simply your one weekly injection at the same dose, with periodic prescriber follow-up to monitor tolerability, weight or glycemic response, and any need to adjust. To find a provider for ongoing prescriptions, compare the best semaglutide providers, or read our reviews of Found and Ro.