Every semaglutide dosage chart follows the same shape: start tiny, climb slowly, settle at a maintenance dose. The FDA-approved schedule for Wegovy steps from 0.25 mg to 2.4 mg once weekly over about 16 weeks, raising the dose every 4 weeks so your body can adapt. This guide lays out that schedule week by week, shows how Ozempic’s ladder differs, and walks through the messiest part of dosing in 2026 — converting milligrams to syringe units when your semaglutide comes from a compounded vial instead of a pre-filled pen.
Semaglutide Dosage Chart: The FDA Titration Schedule
The official schedule comes straight from the Wegovy prescribing information. The dose increases every 4 weeks in five steps, and the full climb takes 16 weeks.
| Phase | Weeks on medication | Weekly dose |
|---|---|---|
| Step 1 (starter) | Weeks 1–4 | 0.25 mg |
| Step 2 | Weeks 5–8 | 0.5 mg |
| Step 3 | Weeks 9–12 | 1 mg |
| Step 4 | Weeks 13–16 | 1.7 mg |
| Maintenance | Week 17 onward | 2.4 mg |
A few details from the label are worth knowing. The 0.25 mg starter dose is for treatment initiation only — it is not the dose that produced the trial results. You inject once weekly, any day, any time, with or without food, under the skin of the abdomen, thigh, or upper arm. Keep the same day each week; if you need to switch days, the label says to leave at least 48 hours between two doses.
The schedule is also allowed to flex — downward, never upward. If a step causes rough side effects, the label says escalation can be delayed by 4 weeks. And if the 2.4 mg maintenance dose proves hard to tolerate, it can be dropped back to 1.7 mg for up to 4 weeks before trying again. Only your prescriber makes those calls.
Why the Dose Climbs Every 4 Weeks
Semaglutide is a GLP-1 receptor agonist. Per the Cleveland Clinic, drugs in this class mimic a gut hormone — they trigger insulin release, slow how fast your stomach empties, and dial down appetite signals in the brain. That stomach-slowing effect is the whole reason the ramp exists.
Jump straight to a high dose and your digestive system revolts. Per the Mayo Clinic, the most common side effects are nausea, vomiting, diarrhea, and constipation, and they cluster in the days after each dose increase. Four weeks at each step gives your body time to adjust before the next bump.
This is why the number one rule of any titration schedule is boring but absolute: never change your dose on your own. Not to speed up results, not to stretch a vial, not to soften side effects. Every adjustment — up, down, or pause — goes through your prescribing clinician.
Wegovy vs Ozempic: Two Ladders, Different Tops
Both products are semaglutide made by Novo Nordisk, and both start at the same 0.25 mg step. They separate at the top. Wegovy, approved for chronic weight management, climbs to 2.4 mg. Ozempic, approved for type 2 diabetes, moves from a 0.25 mg starter to 0.5 mg, then 1 mg and a 2 mg maximum — but only as needed for blood sugar control, not on a fixed timeline.
The practical takeaway: Wegovy’s 1.7 mg and 2.4 mg steps do not exist on an Ozempic pen. If your goal is weight management, the 2.4 mg Wegovy schedule is the one with the trial evidence behind it.
How to Read a Compounded Semaglutide Dosage Chart (Units and mL)
Brand-name Wegovy ships in single-use pens with the dose pre-set — no measuring, no math. Compounded semaglutide is different. It usually arrives as a multi-dose vial plus insulin syringes, and you draw each dose yourself. Two things to know up front: compounded semaglutide is not FDA-approved, and its concentration varies from pharmacy to pharmacy, so a units number that is correct for one vial can be dangerously wrong for another.
The math itself is simple. A standard U-100 insulin syringe holds 100 units per 1 mL. Divide your dose in mg by the vial’s concentration in mg/mL to get the volume, then multiply by 100 to get units. Here is how the same prescribed doses translate at two example concentrations:
| Prescribed dose | Vial concentration (example) | Volume to draw | U-100 syringe units |
|---|---|---|---|
| 0.25 mg | 1 mg/mL | 0.25 mL | 25 units |
| 0.25 mg | 2.5 mg/mL | 0.10 mL | 10 units |
| 0.5 mg | 2.5 mg/mL | 0.20 mL | 20 units |
| 1 mg | 2.5 mg/mL | 0.40 mL | 40 units |
| 2.4 mg | 2.5 mg/mL | 0.96 mL | 96 units |
These rows are examples only — your vial’s label and your pharmacy’s instructions override any chart on the internet, including this one.
The stakes here are real. The FDA has warned about dosing errors with compounded semaglutide, including reports of patients drawing the wrong volume and injecting 5 to 20 times more than intended, some of whom needed medical attention. Mixing up units, mL, and mg is the classic failure. Before your first injection, get the exact unit count for your current step in writing from the pharmacy, and use only the syringes it supplied. Our how to inject semaglutide guide covers the full draw-and-inject process step by step. And if you are still choosing a provider, favor ones that send clear per-dose instructions with every vial — our roundup of the best compounded semaglutide providers is a good place to start comparing.
What If You Miss a Dose?
The Wegovy label has a clean rule. Missed dose and 5 or fewer days have passed? Take it as soon as possible, then return to your normal day. More than 5 days? Skip it entirely and take the next dose on schedule. Never inject two doses close together to catch up.
Longer gaps are a different situation. If you have missed two or more weekly doses, call your prescriber before restarting. Semaglutide leaves your system gradually, and after a multi-week break many clinicians restart patients at a lower step to avoid a fresh wave of nausea. That is a judgment call only your clinician should make.
What to Expect at Each Step of the Schedule
The first 4 weeks are quiet by design — 0.25 mg is a warm-up dose, and many people feel only mild appetite changes. Side effects tend to peak in the days following each increase, then fade as your body adapts. If a step is miserable, tell your prescriber; holding at a dose for an extra month is explicitly allowed by the label and beats quitting.
Set your expectations on the trial clock, not the titration clock. In the STEP 1 trial, adults taking weekly 2.4 mg semaglutide alongside diet and exercise lost an average of 14.9% of body weight over 68 weeks — that is nearly 16 months, of which only the first 4 were the dose ramp. Weight loss builds gradually through the maintenance phase, and individual results vary widely around that average. Nothing about any dosage schedule guarantees a result.
How the Semaglutide Schedule Compares to Tirzepatide
If you are weighing both GLP-1 medications, the ladders look similar but the numbers differ. Tirzepatide (Zepbound for weight management) starts at 2.5 mg weekly and climbs in 2.5 mg steps — each held at least 4 weeks — toward a 15 mg maximum. In the SURMOUNT-1 trial, the highest dose produced up to 20.9% average weight loss over 72 weeks. Our tirzepatide dosage chart lays out that full schedule the same way this page does for semaglutide.
Pens, Vials, and Where Your Chart Comes From
Where you get semaglutide determines what your dosage chart looks like in practice. Brand-name Wegovy (about $1,300+ per month at retail without insurance) arrives as pens matched to your current step — the pharmacy handles the escalation, you handle one click per week. Compounded programs ($99 to $299 per month through most telehealth providers, per the pricing we track) put more of the schedule in your hands: the vial, the syringe, and the units math above.
Telehealth providers also differ in how they run the ladder itself — some raise your dose automatically each month unless you object, others require a check-in before every increase, and monthly prices at some companies rise with your dose. Our comparison of semaglutide online providers breaks down those dosing and pricing policies side by side. Whichever route you take, the schedule on this page is the clinical backbone — and every change to it runs through your prescriber, not a website.