For weight management, semaglutide (brand name Wegovy) is started low and increased in steps: 0.25 mg → 0.5 mg → 1 mg → 1.7 mg → 2.4 mg once weekly, with about 4 weeks at each step. The 2.4 mg once-weekly dose is the standard maintenance (target) dose where most people stay; a higher-dose option (Wegovy HD, 7.2 mg once weekly) was FDA-approved in April 2026 for people who tolerate 2.4 mg and need more weight reduction. You climb slowly on purpose, it gives your stomach time to adjust and keeps side effects like nausea more manageable. Your prescriber sets your exact plan, so treat the chart below as a map, not a rule.
Key takeaways
- The standard Wegovy schedule is 0.25 → 0.5 → 1 → 1.7 → 2.4 mg once weekly, roughly one step every 4 weeks.
- You start low and go slow to lower the chance of stomach side effects, the low starter dose isn't really doing the weight-loss work yet.
- 2.4 mg once weekly is the standard maintenance dose where most people stay. If 2.4 mg is hard on you, a provider may keep you at 1.7 mg. A higher-dose Wegovy HD (7.2 mg once weekly) was FDA-approved in April 2026 for people who tolerate 2.4 mg and need additional weight reduction.
- If you miss a dose: take it if your next dose is more than 2 days (48 hours) away; skip it if it's less than 2 days away. Never take two doses at once.
- Compounded semaglutide dosing may be individualized by your provider and can differ from the branded schedule. Compounded medications are not FDA-approved.
What is the semaglutide dosage chart for weight loss?
For chronic weight management, Wegovy (semaglutide), which is FDA-approved for weight loss in eligible adults, follows a five-step escalation over about 16-17 weeks before you reach the standard maintenance dose. Here is the schedule from the FDA prescribing information.
| Step | Weekly dose | Typical timing | What it's for |
|---|---|---|---|
| 1 | 0.25 mg | Weeks 1-4 | Starter dose, not meant for weight loss yet; lets your body adjust |
| 2 | 0.5 mg | Weeks 5-8 | First real step up |
| 3 | 1 mg | Weeks 9-12 | Continued escalation |
| 4 | 1.7 mg | Weeks 13-16 | Near-target dose |
| 5 | 2.4 mg | Week 17 onward | Standard maintenance (target) dose, where most people stay |
| 6 (optional) | 7.2 mg | Only after tolerating 2.4 mg for ≥4 weeks | Higher maintenance option (Wegovy HD), FDA-approved April 2026 for additional weight reduction |
A quick note on the semaglutide you may have heard of by other names: Ozempic is also semaglutide, but it is FDA-approved for type 2 diabetes, not weight loss. Using it for weight loss is off-label, and its dose schedule is different (it tops out at 2 mg). This chart is for the weight-loss product, Wegovy.
Why do you increase the dose so slowly?
Because going slow is what keeps the ride tolerable. Semaglutide's most common side effects are gastrointestinal, nausea, vomiting, diarrhea, and constipation, and they're most likely when the dose first goes up. Stepping the dose gradually, instead of jumping to a high dose on day one, gives your gut time to adapt and makes those effects less intense for most people.
The starter dose (0.25 mg) is really an "adjustment" dose. It isn't expected to drive meaningful weight loss on its own, it's there to ease you in. Most of the appetite and fullness effects build as you move up toward the higher doses.
If you're wondering how much weight the full course leads to: in the STEP 1 trial, a 68-week study published in the New England Journal of Medicine in 2021, adults on semaglutide 2.4 mg plus lifestyle changes lost about 14.9% of their body weight on average, compared with about 2.4% on placebo. That's a trial average, individual results vary and depend on the whole program, including nutrition, activity, and dose. If your weight loss has stalled, our guide on why you might not be losing weight on semaglutide walks through the common reasons.
What is the standard maintenance semaglutide dose?
For weight management, the standard maintenance dose is 2.4 mg once weekly, that's the target of the usual weight-loss schedule, and where most people stay. Once you reach it, you generally stay there.
A higher-dose Wegovy HD (semaglutide 7.2 mg once weekly) was FDA-approved and launched in April 2026 for adults who have tolerated 2.4 mg for at least 4 weeks and need additional weight reduction; most people stay at 2.4 mg. Whether to step up to it is a decision for you and your prescriber.
The schedule is designed to be flexible if your body needs it:
- If a step-up is hard on you, your provider may keep you at your current dose longer, often delaying the increase by about 4 weeks, before trying again.
- If you can't tolerate 2.4 mg, the maintenance dose can be lowered to 1.7 mg once weekly. Some women do well staying at 1.7 mg long-term rather than pushing to 2.4 mg.
There is no reason to rush to a higher number. The "right" dose is the lowest one that helps you reach your goals with side effects you can live with, and that's a conversation for you and your prescriber.
Can you stay on a lower dose?
Yes, for some people, a lower dose is the plan, not a failure to progress. If you're getting good appetite control and steady results at 1 mg or 1.7 mg, there may be no need to climb higher. And if higher doses bring side effects that outweigh the benefit, staying lower is a legitimate, common choice a provider may recommend. What you shouldn't do is change your own dose up or down without talking to your provider.
What should you do if you miss a dose?
Semaglutide is once weekly, and its half-life is about 7 days, so a late dose usually isn't a crisis, but the timing matters. Here's what the FDA label advises for the Wegovy injection.
| Your situation | What to do |
|---|---|
| Your next scheduled dose is more than 2 days (48 hours) away | Take the missed dose as soon as you can |
| Your next scheduled dose is less than 2 days (48 hours) away | Skip the missed dose; take your next one on the regular day |
| It's been 2 weeks or more since your last dose | Don't guess, check with your provider; you may need to restart at a lower dose and re-titrate |
| Any missed dose | Never take two doses at once to "catch up" |
The two-day rule exists so you don't accidentally stack doses too close together, which can amplify side effects. If you've been off semaglutide for a couple of weeks or more, your tolerance can drop, which is why restarting sometimes means stepping back down and building up again.
How is compounded semaglutide dosing different?
Compounded semaglutide is prepared by a state-licensed compounding pharmacy and prescribed by a licensed clinician when it's appropriate for you. Because it's made to a prescriber's order rather than a single fixed product, the dosing your provider sets may be individualized and can differ from the branded Wegovy schedule, for example, in the units used or the pace of titration. Follow the specific plan your clinician gives you, not a generic chart you find online.
Compounded medications are not FDA-approved and are not reviewed by the FDA for safety, effectiveness, or quality.
What are the risks and safety cautions?
Every semaglutide article should include the safety basics, because the dose schedule only matters if the medication is right for you in the first place.
Semaglutide carries a boxed warning for thyroid C-cell tumors. It is contraindicated if you or a close family member has had medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Other important cautions include pancreatitis, gallbladder problems, and severe gastrointestinal effects, and a higher risk of low blood sugar if you also take insulin or a sulfonylurea. GLP-1 medications are not recommended in pregnancy or while breastfeeding.
None of this is the full list. Read the FDA prescribing information for your specific medication and talk to a licensed provider about your history before starting or changing a dose. Side effects like burping are common early on, too, here's why semaglutide causes sulfur burps and how to ease them, and what to eat on semaglutide to keep nausea and constipation in check.
How Elara helps
Elara is a women's telehealth program built around GLP-1 care, and a licensed provider reviews every patient before anything is prescribed. If semaglutide is appropriate for you, your provider sets your titration plan and adjusts it based on how you respond, you're not left to decode a chart on your own. You can learn more about how semaglutide works for women on our main guide.
Elara offers compounded semaglutide from $247/month, all-in, the provider visit, the medication, and shipping are included, with ongoing access to the medical team, the app, and 7-day-a-week human support. Cash-pay, so there are no insurance hurdles.
See Elara's compounded semaglutide plans, from $247/month, all-in. A licensed provider reviews every patient.
Compounded medications are not FDA-approved and are not reviewed by the FDA for safety, effectiveness, or quality.
Frequently asked questions
What is the semaglutide dosage for weight loss?
The FDA-approved weight-loss product, Wegovy, uses a stepwise weekly schedule: 0.25 mg, then 0.5 mg, 1 mg, 1.7 mg, and 2.4 mg, with about four weeks at each step. The 2.4 mg once-weekly dose is the usual maintenance dose. Your prescriber decides the right dose and pace for you.
How fast do you increase the semaglutide dose?
The standard schedule raises the dose about once every four weeks, reaching the 2.4 mg maintenance dose around week 17. If a step-up causes side effects you can't tolerate, a provider often holds your current dose longer, commonly about four extra weeks, before trying the increase again.
What is the maximum semaglutide dose?
The standard maintenance dose for weight management is 2.4 mg once weekly, where most people stay. In April 2026 the FDA approved a higher-dose Wegovy HD (7.2 mg once weekly) for adults who have tolerated 2.4 mg for at least 4 weeks and need more weight reduction. If 2.4 mg is too much, the dose can be kept at 1.7 mg.
What if I miss a dose of semaglutide?
If your next scheduled dose is more than two days (48 hours) away, take the missed dose as soon as you can. If it's less than two days away, skip it and take your next dose on your regular day. Never take two doses at once. After two or more weeks off, ask your provider before restarting.
Can you stay on a lower semaglutide dose?
Yes. If a lower dose controls your appetite and gives steady results, or if higher doses cause too many side effects, a provider may keep you there rather than escalating. Don't change your dose on your own, dose decisions depend on your response, side effects, and health history.
The bottom line
The standard semaglutide weight-loss schedule steps up from 0.25 mg to a 2.4 mg once-weekly maintenance dose over about four months, going slowly to keep side effects manageable. If you miss a dose, the two-day rule tells you whether to take it or skip it. And because compounded dosing can be individualized, the most important number is the one your own licensed provider gives you.
References
- DailyMed (U.S. National Library of Medicine). WEGOVY (semaglutide) injection, solution, Dosage and Administration, including dose escalation and missed-dose instructions. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b
- Wilding JPH, Batterham RL, Calanna S, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1). New England Journal of Medicine. 2021;384:989-1002. https://www.nejm.org/doi/full/10.1056/NEJMoa2032183
- U.S. Food and Drug Administration. FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize. https://www.fda.gov/drugs/drug-alerts-and-statements/fda-clarifies-policies-compounders-national-glp-1-supply-begins-stabilize
- U.S. Food and Drug Administration. FDA Approves Fourth Product Under National Priority Voucher Program, Higher Dose Semaglutide (Wegovy HD, semaglutide 7.2 mg once weekly), April 2026. https://www.fda.gov/news-events/press-announcements/fda-approves-fourth-product-under-national-priority-voucher-program-higher-dose-semaglutide
This article is for general education and is not medical advice. Talk to a licensed clinician about your situation.