Semaglutide Dosage Chart by Week
The FDA-labeled titration schedule for semaglutide (Wegovy and Ozempic), week by week, with the rationale for each step.
Educational tool — not medical advice. This calculator provides estimates based on population averages and published trial data. Outputs are not clinical recommendations and do not replace evaluation by a qualified prescriber. Do not start, stop, or change a peptide therapy based on the result of this tool.
Semaglutide is FDA-approved as Wegovy (chronic weight management) and Ozempic (type 2 diabetes). Both use a slow titration schedule designed to minimize gastrointestinal side effects — nausea, vomiting, constipation — that drive most early discontinuations. The schedules below are taken directly from the FDA prescribing information for each indication. Many compounding pharmacies follow the same ladder.
Semaglutide at a Glance
| Indications (FDA-labeled) | Chronic weight management (Wegovy), type 2 diabetes (Ozempic) |
|---|---|
| Route | Subcutaneous injection — abdomen, thigh, or upper arm |
| Frequency | Once weekly, same day each week |
| Wegovy max dose | 2.4 mg/week |
| Ozempic max dose | 2 mg/week (typical) — depends on glycemic response |
| Total titration time (Wegovy) | 16 weeks to reach 2.4 mg maintenance |
| FDA status | FDA-approved (Wegovy 2021, Ozempic 2017). Compounded versions also available. |
Semaglutide Dose Escalation Schedule
| Weeks | Dose | Notes |
|---|---|---|
| Weeks 1–4 | 0.25 mg | Starting dose. Not for blood-sugar or weight effect — this dose is for tolerability. |
| Weeks 5–8 | 0.5 mg | First step up. Some patients hold here for diabetes-only management. |
| Weeks 9–12 | 1.0 mg | Common Ozempic maintenance dose. Wegovy continues escalating. |
| Weeks 13–16 | 1.7 mg | Wegovy intermediate step. Ozempic max dose for many patients is 1.0 mg. |
| Week 17+ | 2.4 mg | Wegovy maintenance dose. Continue indefinitely as long as benefit and tolerability hold. |
Most providers will hold a patient at a dose for an extra 4 weeks rather than escalate if nausea, vomiting, or constipation has not stabilized. Slow is normal — skipping steps is the most common reason patients quit.
Semaglutide Dosing by Use Case
Commonly cited protocols vary by what Semaglutide is being used for. The table below summarizes typical ranges reported in clinical practice and published literature.
| Use case | Typical dose | Frequency | Cycle length | Notes |
|---|---|---|---|---|
| Weight management (Wegovy label) | 2.4 mg | Once weekly | Continuous, indefinite | Reach maintenance via the 16-week titration above. |
| Type 2 diabetes (Ozempic label) | 0.5–2.0 mg | Once weekly | Continuous, indefinite | Many patients hold at 0.5 or 1.0 mg if HbA1c targets are met. |
| Compounded semaglutide (off-label weight loss) | 0.25–2.4 mg | Once weekly | Continuous while on therapy | Compounded sources should follow the same titration schedule as the FDA-labeled product. |
Stacking Semaglutide
Semaglutide is not commonly stacked with other peptides for weight loss. Some clinics combine it with low-dose AOD-9604 or 5-Amino-1MQ for adjunctive metabolic effects, but the evidence for these combinations is limited. Tirzepatide is a separate, more potent dual-receptor option rather than a stack-mate.
Semaglutide is well-studied with an extensive safety record, but it carries a black box warning for thyroid C-cell tumors and requires careful titration to manage GI side effects.
- •FDA black box warning: thyroid C-cell tumors observed in rodent studies. Contraindicated in patients with personal or family history of medullary thyroid carcinoma or MEN 2.
- •Most common side effects: nausea, vomiting, diarrhea, constipation, abdominal pain. Worst during titration steps; usually improve with time at dose.
- •Pancreatitis is a rare but serious adverse event — discontinue and seek evaluation for severe abdominal pain.
- •Risk of hypoglycemia is low with semaglutide alone but increases when combined with insulin or sulfonylureas.
- •Not approved for type 1 diabetes or diabetic ketoacidosis.
- •Personal or family history of medullary thyroid carcinoma
- •Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- •History of pancreatitis (relative contraindication)
- •Pregnancy or planning to become pregnant within 2 months of last dose
Semaglutide Dosing FAQ
The FDA labels do not recommend skipping titration steps. Even patients who tolerate the starting dose well are kept on the standard schedule because side effects often emerge at higher doses, not the starting dose. Going faster increases the chance of severe nausea and treatment discontinuation.
Per the FDA label: if the missed dose is within 5 days, take it as soon as possible. If more than 5 days have passed, skip the missed dose and resume on your next regular weekly schedule. Do not double up.
Compounded semaglutide is not FDA-approved and is produced by 503A/503B pharmacies. The active ingredient is the same molecule, but compounded products are not subject to the same manufacturing controls as branded drugs. The titration schedule is typically the same.
Indefinitely, as long as benefit and tolerability continue. Both Wegovy and Ozempic are designed for chronic use. Stopping leads to weight regain or HbA1c rise in most patients within months.
Sources
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See Semaglutide guideMedical Disclaimer: This content is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare provider before beginning any peptide therapy treatment.