Semaglutide Dosing in a Clinic Program: Schedule, Chart and Units

Titration is the fixed step-up schedule printed on a drug's label: you begin at a low dose, and the dose rises in set stages, each held for several weeks, until you reach a maintenance dose.

On the Wegovy injection label, the starting dosage is 0.25 mg once weekly, and every step in the escalation runs for four weeks before the next increase.

The reason for the slow climb is side-effect control.

In Wegovy's adult weight trials, 73% of patients on the injection reported gastrointestinal side effects, compared with 47% on placebo, and the label notes these reactions were most frequently reported during dosage escalation — which is the reason the label titrates slowly.

The label also builds in a pause: if a dose is not tolerated during escalation, it says to consider delaying escalation for 4 weeks.

The chart below is the Wegovy injection schedule for weight reduction in adults.

Each dose is a once-weekly injection under the skin, and the 0.25 mg entry is the label's starting dose.

2.4 mg once weekly is the recommended maintenance dose, and 1.7 mg is the label's lower maintenance alternative.

Above the 2.4 mg dose, the label now allows one more step: Wegovy HD, a maximum dose of 7.2 mg once weekly, for adults who have tolerated 2.4 mg for at least 4 weeks when more weight reduction is clinically indicated.

In the label's Study 8 over 72 weeks, adults with obesity without diabetes on 7.2 mg had a mean weight change of -18.8%, versus -15.5% on 2.4 mg and -3.9% on placebo.

Those figures are trial averages for the study group as a whole, not what any one patient should expect.

Wegovy also comes as a daily tablet, and the tablets titrate on their own schedule: 1.5 mg once daily for days 1 through 30, 4 mg for days 31 through 60, 9 mg for days 61 through 90, then 25 mg daily from day 91.

The tablet is approved for weight reduction and cardiovascular risk reduction in adults, with the label's indications updated in December 2025.

Per the label, the tablet is taken in the morning on an empty stomach with up to 4 oz of water, waiting 30 minutes before food, drink or other oral medicines.

One scope note: Ozempic contains the same active ingredient but is approved for type 2 diabetes, not weight loss; the schedules on this page are the Wegovy label's.

Per FDA, compounded GLP-1 vials are often dosed in units on an insulin (U-100) syringe rather than in milligrams.

On that syringe, a unit is a volume mark, not a drug amount: FDA explains that 5 units is 0.05 mL, and how much semaglutide is in that volume depends on the concentration the compounding pharmacy used — which varies between compounders.

That is why there is no valid universal units-to-mg conversion, and why this page does not include one.

The only conversion that counts for your vial is the one between the pharmacy's concentration and your prescription, and that mapping belongs to your prescriber and the dispensing pharmacy.

The errors this confusion produces are documented.

FDA's July 2024 alert describes compounded semaglutide dosing errors, some requiring hospitalization: patients drew up 5 to 20 times the intended dose from multi-dose vials, clinicians miscalculated mg-to-units conversions by 5 to 10 times the intended dose, and confusion between milliliters, milligrams and units contributed.

In one example FDA cites, a provider meant to prescribe 0.25 mg — 5 units — but prescribed 25 units, five times the intended dose, and the patient experienced severe vomiting; in another, a provider prescribed 20 units instead of 2.

FDA also recommends discarding a compounded GLP-1 multi-dose vial within 28 days of first use, even if medication remains and even if the compounder's instructions say longer, and using a new sterile needle and syringe for every dose.

The Wegovy label writes different missed-dose rules for the injection and the tablets.

For the injection: if your next dose is more than 2 days away, take the missed dose as soon as possible; if it is less than 2 days away, skip the missed dose.

If 2 or more consecutive doses are missed, the label says to restart the titration at a lower dose, to reduce the risk of gastrointestinal side effects.

For the tablets, the rule is simpler: skip a missed dose and take the next one the following day.

These are the branded label's instructions.

A compounded vial comes with the compounder's own instructions, so the label on your vial and your prescriber's directions are what govern your case.

Wegovy is a prescription-only drug, per FDA: it requires a valid prescription from a licensed prescriber, and the dose on that prescription is the prescriber's decision, adjusted to how you have tolerated each step.

The label's own answer to a rough step is to delay the next increase, not to skip ahead.

Self-directed changes run against that design: a larger dose, more frequent doses, or a faster climb through the schedule is dosing beyond what the label describes.

A supervised program is one where a licensed prescriber sets the starting dose, sees you between steps, and owns every change to the schedule.

Who that prescriber can legally be — for example, whether a nurse practitioner may prescribe independently — depends on the state: see our guide to who can prescribe GLP-1s for how the rules work.

Before you commit, ask how the program handles titration: what starting dose it uses, how long it holds each step, and what its written plan is if a step is not tolerated.

For the full picture of the treatment — what it is, what it costs and how it is supervised — start with our semaglutide guide.