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. For eligible patients seeking greater weight loss, the dose can be further increased to 7.2 mg after a minimum of four weeks on 2.4 mg using a single-dose device. The gradual escalation minimises side effects and allows the body to adapt to semaglutide.6 stepsin the dose escalation schedule
16 weeksto reach the 2.4 mg maintenance dose
2.4–7.2 mgtarget maintenance dose range
Full Escalation Chart
Wegovy Dose Escalation Chart
The complete Wegovy dosing schedule from first injection to maintenance, including the optional 7.2 mg higher dose, as recommended in the MHRA-approved Summary of Product Characteristics 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 standard dose |
| 7.2 mg | Week 21+ | Higher-dose option | GI symptoms may return briefly | Eligible patients only — single-dose device |
7.2 mg Higher Dose
The 7.2 mg Option — STEP UP Evidence
The 7.2 mg dose is an optional step for eligible patients who have been on 2.4 mg for a minimum of four weeks and want greater weight loss. It is delivered via a single-dose device rather than the FlexTouch® pen used for lower doses. The STEP UP phase 3b trial demonstrated approximately 19–21% average weight loss over 72 weeks at this dose, compared with ~2.4% on placebo — with more than 9 in 10 patients achieving at least 5% weight loss.
GI side effects (nausea, diarrhoea) may temporarily return when stepping up from 2.4 mg to 7.2 mg, mirroring the pattern seen at earlier escalation steps. These typically ease within 2–3 weeks. Returning to 2.4 mg is clinically appropriate if symptoms are significant.
Missed Dose Guide
| Scenario | What to Do |
|---|---|
| Missed dose — 5 days or fewer | Take the missed dose as soon as you remember, then resume your usual weekly day. |
| Missed dose — more than 5 days | Skip the missed dose entirely. Take next dose on usual scheduled day. Do not double up. |
| Missed multiple doses (1–2 weeks) | Resume on normal schedule. Expect a temporary return of side effects. |
| Extended break (4+ weeks) | Contact your prescribing clinician — a dose reduction and re-escalation may be required. |
Dose flexibility: For patients who find the standard 4-week escalation intervals too fast, spending 6–8 weeks at each dose step is a recognised clinical approach that improves tolerability while still reaching full maintenance dose.
FAQs
Frequently Asked Questions
Wegovy begins at 0.25 mg once weekly, increasing every four weeks through 0.5 mg, 1.0 mg and 1.7 mg before reaching the 2.4 mg maintenance dose at approximately week 17. Eligible patients may then escalate to 7.2 mg after a minimum of four weeks on 2.4 mg using the single-dose device.
The 7.2 mg dose is an optional higher-dose step available to eligible patients after a minimum of four weeks on 2.4 mg. It uses a single-dose device rather than the FlexTouch® pen. The STEP UP trial showed approximately 19–21% average weight loss at 72 weeks — meaningfully more than the ~14.9% achieved at 2.4 mg in STEP 1.
No. The four-week intervals are clinically necessary to allow your body to adapt and to minimise side effects. Attempting to escalate faster carries significant risk of severe nausea, vomiting and dehydration.
The standard maintenance dose is 2.4 mg once weekly. For eligible patients, the dose can be increased to 7.2 mg once weekly after a minimum of four weeks on 2.4 mg. The 7.2 mg dose is delivered via a single-dose device rather than the FlexTouch® pen.
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, reducing back to the previous dose temporarily, or — for patients who have escalated to 7.2 mg — returning to 2.4 mg.
If fewer than five days have passed since your scheduled injection, take the missed dose as soon as you remember. If more than five days have passed, skip it and resume on your usual day. Never take two doses in one week.
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Wilding JPH et al. STEP 1. N Engl J Med. 2021. Wharton S et al. STEP UP. Lancet Diabetes Endocrinol. 2025. MHRA. Semaglutide prescribing information. 2023. NICE TA875. 2023. Novo Nordisk. Wegovy SmPC. 2023/2025. Happy Pharmacy (GPhC No. 9012585). Educational purposes only — not medical advice.