Dosing Guide
Wegovy Dose Schedule Guide
Quick Answer: Wegovy treatment begins at 0.25 mg once weekly and increases every four weeks through 0.5 mg, 1.0 mg and 1.7 mg before reaching the 2.4 mg maintenance dose at around week 17. The gradual escalation minimises side effects and allows the body to adapt to semaglutide.5 stepsin the dose escalation schedule
16 weeksto reach the 2.4 mg maintenance dose
2.4 mgtarget maintenance dose — continued long term
Full Escalation Chart
Wegovy Dose Escalation Chart
The table below summarises the complete Wegovy dosing schedule from first injection to maintenance, as recommended in the MHRA-approved Summary of Product Characteristics (SmPC) and NICE guidance (TA875).
| Dose | Timeline | Purpose | Side Effects | Key Advice |
|---|---|---|---|---|
| 0.25 mg | Weeks 1–4 | Starting dose | Mild nausea possible | Do not increase early |
| 0.5 mg | Weeks 5–8 | Escalation | Nausea may increase | Monitor GI tolerance |
| 1.0 mg | Weeks 9–12 | Escalation | Peak nausea period | Eat smaller meals |
| 1.7 mg | Weeks 13–16 | Escalation | Nausea easing | Appetite markedly reduced |
| 2.4 mg | Week 17+ | Maintenance | Side effects settle | Long-term dose |
Key Stages
What Happens at Each Dose Step
The 0.25 mg starting dose is a tolerability dose rather than a therapeutic dose — the goal in the first four weeks is adjustment, not maximal weight loss. Many patients are surprised to find that appetite may begin to reduce even at this starting dose. The step to 1.0 mg at weeks 9–12 is frequently the most challenging — nausea peaks here for many patients, but typically eases within two to three weeks.
The escalation schedule is designed to minimise discomfort. If side effects at any stage are intolerable, speak to your prescribing pharmacist before adjusting your dose.
| Scenario | What to Do |
|---|---|
| Missed dose — 5 days or fewer | Take the missed dose as soon as you remember, then resume your usual weekly injection day. |
| Missed dose — more than 5 days | Skip the missed dose entirely. Take your next dose on your usual scheduled day. Do not double up. |
| Missed multiple doses (1–2 weeks) | Resume on your normal schedule. You may experience a temporary return of side effects. |
| Extended break (4+ weeks) | Contact your prescribing clinician — a dose reduction and re-escalation may be required. |
FAQs
Frequently Asked Questions
The starting dose of Wegovy is 0.25 mg once weekly. This is a tolerability dose rather than a full therapeutic dose, designed to allow the body to adjust to semaglutide before the dose is increased. It is taken for the first four weeks of treatment.
Wegovy is injected once weekly, on the same day each week. The day can be chosen by the patient and changed if needed, provided the gap between doses is at least five days.
No. The four-week intervals between dose increases are clinically necessary to allow your body to adapt and minimise side effects. Attempting to escalate faster carries a significant risk of severe nausea, vomiting and dehydration.
The maximum licensed dose of Wegovy is 2.4 mg once weekly. This is also the maintenance dose. There is no higher dose option within the approved prescribing framework.
Yes. If side effects at any dose step are intolerable, your prescribing clinician may recommend pausing at your current dose for a further four weeks before attempting to escalate, or reducing back to the previous dose temporarily.
Yes, in some circumstances. However, the 2.4 mg maintenance dose consistently produces the best clinical outcomes. A slower escalation schedule — spending six or eight weeks at each step rather than four — is often a better option than remaining on a sub-maintenance dose long term.
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Wilding JPH et al. STEP 1. N Engl J Med. 2021;384:989–1002. MHRA. Semaglutide prescribing information. 2023. NICE TA875. 2023. Happy Pharmacy (GPhC No. 9012585). This page is for educational purposes only and does not constitute medical advice.