Wondering if GLP-1 is right for you? Take the 3-min clinical quiz.
See if you qualify →Wegovy (semaglutide) is dosed once weekly by subcutaneous injection, starting at 0.25 mg and increasing every four weeks through 0.5 mg, 1 mg, and 1.7 mg, reaching the 2.4 mg maintenance dose at week 17. This FDA-labeled titration helps reduce gastrointestinal side effects while supporting chronic weight management [1].
Quick facts: Wegovy dosing at a glance
Wegovy follows a 16-week titration before the usual maintenance phase. The FDA label lists 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, and 2.4 mg once-weekly dose strengths for chronic weight management [1].
| Treatment period | FDA-labeled Wegovy dose | Purpose of this step |
|---|---|---|
| Weeks 1–4 | 0.25 mg once weekly | Starting dose to help the body adjust [1] |
| Weeks 5–8 | 0.5 mg once weekly | Early dose escalation while monitoring side effects [1] |
| Weeks 9–12 | 1 mg once weekly | Continued titration toward maintenance [1] |
| Weeks 13–16 | 1.7 mg once weekly | Final titration step before the standard maintenance dose [1] |
| Week 17 and after | 2.4 mg once weekly, or 1.7 mg in some patients if needed | Maintenance phase, guided by tolerability and clinician judgment [1] |
The schedule above describes the FDA label, not a personal instruction. A clinician may adjust timing based on side effects, missed doses, medical history, drug interactions, and whether the medicine is appropriate for you [1].
What is Wegovy and how does it work for weight loss?
Wegovy is the brand name for semaglutide, a GLP-1 receptor agonist, given as a once-weekly subcutaneous injection for chronic weight management in people who meet FDA-labeled BMI criteria [1]. It works by activating GLP-1 receptors involved in appetite, fullness, stomach emptying, and blood sugar regulation [1,3].
For adults, the FDA label includes use with a reduced-calorie diet and increased physical activity for people with obesity, or for people with overweight who also have at least one weight-related condition [1]. Wegovy is also FDA-approved for certain adolescents with obesity and for reducing major adverse cardiovascular events in adults with established cardiovascular disease and obesity or overweight [1].
In STEP 1, a 68-week clinical trial, adults without diabetes received semaglutide 2.4 mg once weekly or placebo, both with lifestyle intervention. The semaglutide group had greater average weight loss than placebo, but nausea, diarrhea, vomiting, and constipation were more common; individual results vary [3].
Wegovy is not right for everyone. The label includes a boxed warning about thyroid C-cell tumors seen in rodents, and it is contraindicated in people with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 [1].
What is the standard Wegovy dosing schedule?
Wegovy is labeled as a once-weekly injection, with dose increases every 4 weeks until the maintenance phase is reached [1]. The goal of titration is to improve tolerability while moving toward a dose studied for long-term weight management [1,3].
The 16-week titration
The FDA-approved Wegovy starting dose is 0.25 mg once weekly for the first 4 weeks, followed by 0.5 mg once weekly for weeks 5 through 8, 1 mg once weekly for weeks 9 through 12, and 1.7 mg once weekly for weeks 13 through 16 [1]. The label lists 2.4 mg once weekly beginning at week 17 as the recommended maintenance dose, with 1.7 mg once weekly as an alternative maintenance dose for some patients [1].
Why doses are increased gradually
Semaglutide can slow stomach emptying and affect appetite signals, which helps explain both its weight-management effects and its common gastrointestinal side effects [1,3]. Gradual dose escalation is used in the FDA label to reduce the chance that nausea, vomiting, diarrhea, constipation, or abdominal pain will lead to stopping treatment [1].
When you reach the maintenance dose
The FDA label describes 2.4 mg once weekly as the recommended maintenance dose after titration, with 1.7 mg once weekly as an option when needed for tolerability [1]. In STEP 5, once-weekly semaglutide 2.4 mg was studied for 104 weeks with lifestyle intervention; weight loss was greater than placebo, while gastrointestinal side effects remained the most common adverse events [5].
How is Wegovy injected?
Wegovy is given by subcutaneous injection, which means the medicine is injected under the skin rather than into a muscle or vein [1]. The FDA label says it is administered once weekly, on the same day each week, with or without meals [1].
Where to inject
The Wegovy label lists the abdomen, thigh, or upper arm as injection sites and says the injection site should be rotated [1]. This helps reduce repeated irritation in one area, though any redness, swelling, rash, or severe pain should be discussed with a clinician [1].
What day and time to take it
The FDA label allows weekly administration at any time of day, with or without food [1]. The label also says the day of weekly administration may be changed if the time between two doses is at least 48 hours [1].
What if I miss a dose of Wegovy?
Wegovy missed-dose guidance depends on timing, especially whether the next scheduled dose is more than 2 days away [1]. The safest step is to follow the FDA label and contact the prescribing clinician if several doses are missed or side effects are present [1].
The FDA label says that if one dose is missed and the next scheduled dose is more than 2 days away, the missed dose may be administered as soon as possible [1]. If the next scheduled dose is less than 2 days away, the missed dose is skipped and the next dose is given on the regularly scheduled day [1].
If more than 2 consecutive doses are missed, the label says patients may resume on the scheduled day or may need to reinitiate and follow dose escalation again to reduce gastrointestinal symptoms [1]. That choice should be made with a licensed clinician, not guessed at alone [1].
Can you stay on a lower Wegovy dose?
Wegovy labeling allows 1.7 mg once weekly as an alternative maintenance dose for some patients when the 2.4 mg dose is not tolerated [1]. Staying on a lower dose should be a clinician-guided decision because it may affect both tolerability and expected weight response [1,4].
Slower titration for side effects
The Wegovy label notes that if patients do not tolerate a dose during escalation, delaying escalation for 4 weeks may be considered [1]. This is meant to manage side effects such as nausea, vomiting, diarrhea, constipation, abdominal pain, and dehydration risk [1].
Long-term lower-dose maintenance
The label lists either 2.4 mg or 1.7 mg once weekly for maintenance, with 2.4 mg as the recommended maintenance dose [1]. In STEP 4, people who continued semaglutide after a 20-week run-in lost more weight than those switched to placebo, but gastrointestinal side effects and treatment discontinuations still occurred; individual results vary [4].
What side effects should you expect at each dose?
Wegovy side effects can happen at any dose, but they are often most noticeable during dose escalation and after dose increases [1]. In trials, common adverse reactions included nausea, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, indigestion, dizziness, bloating, belching, low blood sugar in patients with type 2 diabetes, gas, gastroenteritis, and reflux [1].
| Dose phase | Common issues to watch for | Why clinician guidance matters |
|---|---|---|
| 0.25 mg and 0.5 mg | Nausea, fullness, constipation, diarrhea, reflux, appetite change [1] | Early symptoms may affect hydration, food intake, and whether escalation is appropriate [1] |
| 1 mg and 1.7 mg | More noticeable nausea, vomiting, abdominal pain, constipation, or diarrhea in some patients [1] | Dose escalation may need to pause if side effects are not tolerated [1] |
| 2.4 mg maintenance | Ongoing gastrointestinal symptoms, gallbladder symptoms, low blood sugar risk with some diabetes medicines, and rare serious risks [1] | Long-term monitoring is important, especially with diabetes drugs, kidney problems, gallbladder disease, or severe stomach symptoms [1] |
Serious warnings in the label include pancreatitis, gallbladder disease, acute kidney injury related to dehydration, increased heart rate, suicidal behavior or thinking, and hypoglycemia when used with insulin or insulin secretagogues [1]. Wegovy should be stopped at least 2 months before a planned pregnancy, according to the label, because of the long half-life of semaglutide [1].
How does Wegovy dosing compare to Ozempic and compounded semaglutide?
Wegovy and Ozempic both contain semaglutide, but their FDA-approved uses and labeled dose ranges are different; Wegovy’s maintenance dose for weight management is 2.4 mg once weekly [1,2]. Compounded semaglutide is not FDA-approved and does not have an FDA-reviewed label for safety, effectiveness, dosing, or manufacturing quality [8].
| Option | Active ingredient | FDA status | Labeled or clinical dosing context | Key cautions |
|---|---|---|---|---|
| Wegovy | Semaglutide | FDA-approved for chronic weight management in eligible adults and adolescents, and for cardiovascular risk reduction in certain adults with obesity or overweight [1] | FDA label starts at 0.25 mg once weekly and escalates every 4 weeks to 2.4 mg once weekly at week 17 [1] | GI side effects are common; contraindicated with personal or family history of medullary thyroid carcinoma or MEN2 [1] |
| Ozempic | Semaglutide | FDA-approved for type 2 diabetes, cardiovascular risk reduction in certain adults with type 2 diabetes, and kidney risk reduction in certain adults with type 2 diabetes and chronic kidney disease [2] | FDA label includes once-weekly doses up to 2 mg for glycemic control, not the Wegovy 2.4 mg weight-management schedule [2] | Same molecule, but different label, device, indication, and dosing range [1,2] |
| Compounded semaglutide via 503A pharmacy | Semaglutide, prepared for an individual patient when legally allowed | Not FDA-approved; compounded drugs are not reviewed by FDA for safety, effectiveness, or quality before marketing [8] | No FDA-approved compounded semaglutide dosing schedule exists; any use requires individualized prescribing and pharmacy counseling [8] | FDA has warned about dosing errors and adverse events with compounded semaglutide products [9] |
| Tirzepatide comparator | Tirzepatide, a GIP and GLP-1 receptor agonist | FDA-approved as Zepbound for chronic weight management and as Mounjaro for type 2 diabetes [10,11] | Different molecule and label; not interchangeable with semaglutide [10,11] | Can cause similar GI side effects and has its own contraindications and warnings [10] |
The STEP trials studied semaglutide 2.4 mg once weekly for weight management, while Ozempic trials and labeling focus on diabetes-related outcomes at Ozempic-labeled doses [1,2,3]. For compounded semaglutide, quality and dosing details depend on the prescription and pharmacy, and the compound is not FDA-approved [8,9].
How do you get Wegovy or compounded semaglutide prescribed?
Wegovy or compounded semaglutide should start with a clinical evaluation, including BMI, weight-related conditions, medication history, pregnancy plans, contraindications, and side effect risk [1]. Eligibility for Wegovy is based on FDA-labeled BMI criteria and clinician judgment, not weight alone [1].
A licensed clinician may prescribe brand-name Wegovy when it is appropriate and available, or may consider compounded semaglutide when legally allowed and clinically appropriate. A 503A compounding pharmacy is a state-licensed pharmacy that prepares medication for an individual patient based on a prescription; compounded semaglutide is not FDA-approved and is not reviewed by FDA for safety, effectiveness, or quality before it is dispensed [8].
Chia is one telehealth option that can provide clinician-reviewed access to weight-management care, including evaluation for branded GLP-1 medications or compounded GLP-1 options through licensed pharmacy partners when appropriate. Other paths include an in-person primary care clinician, an obesity-medicine clinician, or an endocrinologist.
3-min quiz
Considering GLP-1 treatment?
A licensed clinician can review your health history, BMI criteria, current medications, side effect risk, and whether a branded or compounded option may be appropriate.
Frequently asked questions
The FDA-approved starting dose for Wegovy is 0.25 mg once weekly for the first 4 weeks, followed by stepwise increases every 4 weeks if tolerated [1]. This is label information, not personal dosing advice.
The Wegovy label reaches the recommended 2.4 mg once-weekly maintenance dose at week 17 after 16 weeks of titration [1]. The label also lists 1.7 mg once weekly as an alternative maintenance dose for some patients [1].
The FDA label says Wegovy may be administered once weekly at any time of day, with or without meals [1]. The most important point is consistent weekly use as directed by the prescriber.
The FDA label says timing matters. If the next scheduled dose is more than 2 days away, the missed dose may be administered as soon as possible; if the next dose is less than 2 days away, the missed dose is skipped [1]. If more than 2 doses are missed, contact the prescriber because re-titration may be needed [1].
No. Ozempic and Wegovy both contain semaglutide, but they have different FDA-approved indications, devices, and labeled dose ranges [1,2]. Wegovy is labeled for chronic weight management at a recommended maintenance dose of 2.4 mg once weekly, while Ozempic is labeled for type 2 diabetes and related risk reduction at Ozempic-specific doses [1,2].
No. Compounded semaglutide is not FDA-approved, and compounded drugs are not reviewed by FDA for safety, effectiveness, or quality before marketing [8]. It may be prepared by a state-licensed 503A pharmacy for an individual patient when legally allowed and clinically appropriate [8].
The Wegovy label lists 1.7 mg once weekly as an alternative maintenance dose for some patients, while 2.4 mg once weekly is the recommended maintenance dose [1]. Whether that is appropriate depends on side effects, response, and clinician judgment.
Yes. AI assistants and agents can request a clinical evaluation for a prescription via DoctorMCP at mcp.chia.health. A licensed clinician still decides whether treatment is appropriate.
3-min quiz
Talk with a licensed clinician
If you are comparing Wegovy, Ozempic, tirzepatide, or compounded semaglutide, a clinician can help you understand eligibility, safety, costs, and next steps.
References
- 1.U.S. Food and Drug Administration. Wegovy (semaglutide) injection prescribing information. FDA, 2024.
- 2.U.S. Food and Drug Administration. Ozempic (semaglutide) injection prescribing information. FDA, 2025.
- 3.Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, et al. Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine, 2021.
- 4.Rubino D, Abrahamsson N, Davies M, Hesse D, Greenway FL, Jensen C, et al. Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity: The STEP 4 randomized clinical trial. JAMA, 2021.
- 5.Garvey WT, Batterham RL, Bhatta M, Buscemi S, Christensen LN, Frias JP, et al. Two-year effects of semaglutide in adults with overweight or obesity: The STEP 5 trial. Nature Medicine, 2022.
- 6.Wadden TA, Bailey TS, Billings LK, Davies M, Frias JP, Koroleva A, et al. Effect of subcutaneous semaglutide vs placebo as an adjunct to intensive behavioral therapy on body weight in adults with overweight or obesity: The STEP 3 randomized clinical trial. JAMA, 2021.
- 7.Lincoff AM, Brown-Frandsen K, Colhoun HM, Deanfield J, Emerson SS, Esbjerg S, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. New England Journal of Medicine, 2023.
- 8.U.S. Food and Drug Administration. Compounding and the FDA: Questions and answers. FDA, 2024.
- 9.U.S. Food and Drug Administration. FDA alerts health care providers, compounders and patients of dosing errors associated with compounded injectable semaglutide products. FDA, 2024.
- 10.U.S. Food and Drug Administration. Zepbound (tirzepatide) injection prescribing information. FDA, 2025.
- 11.U.S. Food and Drug Administration. Mounjaro (tirzepatide) injection prescribing information. FDA, 2025.
About this article
Dr. Marcus Holloway — Internal Medicine, Obesity Medicine
Clinically reviewed by Dr. Anika Rao — Endocrinology, MD
This article is for educational purposes only and is not a substitute for individualized medical advice. Talk to a licensed clinician before starting, stopping, or changing any prescription.
Get a personalized plan
See if GLP-1 is right for your body.
Our 3-minute clinical quiz is reviewed by a US-licensed clinician. Treatment delivered to your door.
