Quick Answer
The standard semaglutide titration schedule for weight management is a 5-step escalation over about 16 weeks: 0.25 mg weekly (weeks 1 to 4), 0.5 mg (weeks 5 to 8), 1 mg (weeks 9 to 12), 1.7 mg (weeks 13 to 16), then 2.4 mg weekly as the maintenance dose from week 17. Doses increase roughly every 4 weeks so your body can adjust and side effects stay manageable. A prescribing clinician personalizes the pace, and compounded semaglutide dosing follows the same start-low principle but is set individually. Compounded medications are not FDA-approved as final products, and results may vary.
The standard semaglutide dosage chart (2026)
Semaglutide for weight management (sold as the brand Wegovy) uses a fixed, well-established escalation schedule. The whole point of the schedule is to start at a dose too low to do much, and climb slowly toward a dose that works, so the body adapts along the way.
| Phase | Weekly dose | Typical weeks | Purpose |
|---|---|---|---|
| Step 1 | 0.25 mg | Weeks 1 to 4 | Tolerability only, not a treatment dose. Lets your gut adjust. |
| Step 2 | 0.5 mg | Weeks 5 to 8 | First step toward an active dose. |
| Step 3 | 1.0 mg | Weeks 9 to 12 | Many patients begin to see appetite changes here. |
| Step 4 | 1.7 mg | Weeks 13 to 16 | Approaching maintenance. |
| Maintenance | 2.4 mg | Week 17 onward | Standard maximum maintenance dose. |
This is the schedule studied in the STEP clinical trial program (NEJM 2021), which is the evidence base behind the brand-name labeling. The 2.4 mg maintenance dose is the maximum approved dose for chronic weight management. Some people settle at a lower step and stay there. The best dose is the lowest one that gives a steady response with side effects you can tolerate.
Why semaglutide is titrated slowly
The most common semaglutide side effects, nausea, constipation, diarrhea, and reflux, come from the way the medication slows gastric emptying. They are usually worst in the first one to two weeks after each dose increase, then fade as the body adjusts.
Stepping up roughly every 4 weeks is a deliberate tolerability strategy. Escalating too fast is the single most common reason people experience severe nausea and quit. There is no medal for reaching 2.4 mg quickly. A slower climb that you can actually stay on beats a fast climb you abandon.
This is also why semaglutide is a prescription medication managed by a clinician rather than a fixed regimen anyone should self-direct. The clinician watches your response and side effects at each step and decides whether to hold, advance, or slow down.
How compounded semaglutide dosing compares
Compounded semaglutide contains the same active ingredient as the brand product, and follows the same core principle: start low, increase slowly under physician supervision. The practical difference is flexibility. Brand-name pens come in fixed dose increments, while a compounded preparation in a vial allows a clinician to set intermediate doses and adjust more granularly for an individual patient.
That flexibility is a clinical tool, not a license to freelance. Exact compounded starting doses, step sizes, and timing are determined by the prescribing clinician together with the compounding pharmacy, and you should follow the specific instructions provided with your preparation. Compounded medications are not FDA-approved as final products, even when prepared by a state-licensed pharmacy. For more on how the two compare, see our guide on compounded semaglutide vs Wegovy.
Missed doses and restarting
Semaglutide is taken once weekly, ideally on the same day each week. General guidance is:
Always confirm missed-dose handling with your own prescriber, since the right step depends on your dose and history.
Semaglutide versus tirzepatide dosing
Semaglutide and tirzepatide use different dose ladders because they are different molecules. Tirzepatide (brand Zepbound and Mounjaro) titrates from 2.5 mg weekly up to a maximum of 15 mg weekly, also in roughly 4-week steps. The numbers are not comparable milligram for milligram, since the two drugs have different potencies. For a full side-by-side, see tirzepatide vs semaglutide.
How a clinician personalizes your schedule
The chart above is the standard template, not a rule that fits everyone. A prescribing clinician adjusts based on:
This individualization is exactly why GLP-1 treatment runs through a licensed clinician and ongoing check-ins rather than a one-size dose. If you want to understand the full treatment arc, our GLP-1 treatment timeline walks through what to expect month by month.
The bottom line
The standard semaglutide dosage chart is a slow, 5-step climb from 0.25 mg to 2.4 mg weekly over about four months, built around tolerability rather than speed. Compounded semaglutide follows the same start-low principle with more dosing flexibility, set individually by a clinician. The doses and figures here describe the medication and its clinical schedule, they are not a promise of results, which vary from person to person. Compounded medications are not FDA-approved as final products. Any dosing decision belongs with a licensed prescriber who knows your history.
This article is educational and is not medical advice. It does not replace consultation with a licensed healthcare professional. Brand names are the property of their respective manufacturers. Wegovy is an FDA-approved product; compounded semaglutide is not FDA-approved as a final product.
Frequently Asked Questions
What is the standard semaglutide dosage schedule?
For weight management, the standard semaglutide (Wegovy) titration is a 5-step escalation: 0.25 mg weekly for weeks 1 to 4, 0.5 mg for weeks 5 to 8, 1 mg for weeks 9 to 12, 1.7 mg for weeks 13 to 16, then 2.4 mg weekly as the maintenance dose from week 17 onward. Each step lasts about 4 weeks. The 0.25 mg starting dose is a tolerability dose, not a treatment dose. A prescribing clinician may move faster or slower based on how you respond and tolerate it.
Why does semaglutide dose increase so slowly?
Slow titration is the single most effective way to reduce gastrointestinal side effects like nausea, which are most common in the first weeks at each new dose. Stepping up roughly every 4 weeks gives the digestive system time to adjust. Escalating too quickly is the most common reason patients experience severe nausea. The schedule is designed for tolerability, not speed.
Is compounded semaglutide dosed the same as Wegovy?
The active ingredient and the titration principle (start low, increase slowly under physician supervision) are the same. Exact starting doses and escalation steps for a compounded preparation are set by the prescribing clinician and the compounding pharmacy, and can differ from the fixed Wegovy pen increments because compounded vials allow flexible dosing. Compounded medications are not FDA-approved as final products. Always follow the specific dosing your clinician provides.
What happens if I miss a dose of semaglutide?
General guidance for once-weekly semaglutide is that if you miss a dose and the next scheduled dose is more than 2 days (48 hours) away, take it as soon as you remember. If it is less than 48 hours away, skip the missed dose and resume your normal schedule. If you miss doses for more than 2 weeks, your clinician may have you restart at a lower dose to re-titrate. Always confirm missed-dose steps with your own prescriber.
What is the maximum dose of semaglutide for weight loss?
The maximum FDA-approved Wegovy dose for chronic weight management is 2.4 mg once weekly. Many patients reach an effective dose below the maximum and stay there. The right maintenance dose is the lowest one that produces a steady response with tolerable side effects, which a clinician determines individually. These figures describe the medication, not a promised outcome, and results may vary.
All Majesta Health medical content is clinically reviewed before publication by US-licensed physicians affiliated with our clinical infrastructure partner, MD Integrations (MDI). Reviewers hold active state medical licenses, are board-certified in primary care or obesity medicine, and specialize in GLP-1 receptor agonist therapy for chronic weight management. MDI is LegitScript certified and SOC 2 Type II accredited.
- US-licensed physicians affiliated with our clinical partner MD Integrations (LegitScript certified, HIPAA, SOC 2 Type II, ISO certified)
- Board-certified in primary care and obesity medicine
- Active state medical licensure required for every prescribing clinician
- Active DEA registration where applicable (note: GLP-1 medications are not controlled substances)
- Telehealth practice across all 50 US states and DC through the MD Integrations Medical Services Organization
- Dispensing pharmacy partner: Belmar Pharma Solutions (LegitScript certified, NABP accredited, 503A and 503B compounding)