Wegovy starts low and steps up slowly. This is deliberate. The slow ramp is the main reason most people can tolerate the medication, and skipping the titration would mean weeks of unnecessary nausea.
The Standard Titration
The schedule starts at 0.25 mg weekly and steps up every four weeks until reaching the 2.4 mg maintenance dose, or stopping at a lower dose if that produces the desired effect.
Total time from starting to reaching 2.4 mg is around 16 to 20 weeks (four to five months).
Why The Slow Ramp Matters
The early side effects of GLP-1 medications come primarily from slowed gastric emptying. Food sits in your stomach longer than it is used to. This produces nausea, sometimes vomiting, and a feeling of fullness that arrives quickly and lingers.
The body adapts. Receptors downregulate. The gut adjusts to the new pace. By the end of four weeks at one dose, the side effects of that dose are usually much milder than they were in week one.
Stepping up restarts some of the adjustment, but from a lower baseline. So the side effects of going from 0.25 mg to 0.5 mg are less than they would have been going straight to 0.5 mg from nothing.
Slowing The Schedule If Needed
The four week interval between dose increases is standard, not a rule. If you are still struggling with side effects at the end of four weeks on a given dose, the doctor may keep you there for another four weeks before stepping up. This is common and does not affect the long term outcome.
The principle: get to the dose that works for you. Not necessarily the highest dose.
Talk To A Doctor About Your Schedule
An online consultation determines your starting plan and follow up reviews ensure each step is appropriate.
Start ConsultationChoosing Your Maintenance Dose
Not everyone goes all the way to 2.4 mg. The right dose depends on:
- What you are treating (weight management, cardiovascular risk reduction)
- How well you respond at each dose
- How well you tolerate each dose
- Your other medical conditions
Many people respond well at 1 mg or 1.7 mg and stay there. The 2.4 mg dose is used when additional effect is needed.
Missing A Dose
Semaglutide has a long half life, around seven days. This makes it forgiving of occasional missed doses.
- Less than five days late. Take it as soon as you remember. Resume your normal schedule the following week.
- More than five days late. Skip the missed dose. Take your next regular weekly dose. Do not double up.
If you miss two consecutive doses, restart at the previous lower dose for a few weeks before titrating up again. Speak to the prescribing doctor.
Changing Injection Day
To switch days, take the new day's dose at least two days after your last injection. For example, if you have been injecting on Sunday and want to switch to Wednesday, you could take the new dose on the following Wednesday (three days later).
What Happens At Maintenance Dose
Once at 2.4 mg (or your selected maintenance dose), the medication is taken at that dose ongoing. There is no cycling, no breaks. Treatment for the chronic condition continues as long as it remains appropriate and is producing benefit.
Discussions about long term continuation, eventual tapering, or in some cases discontinuation happen with the treating doctor over time. See what happens when you stop.
Related Reading
Frequently Asked
The 0.25 mg starting dose is below the therapeutic level. It exists to let the body adapt to slowed gastric emptying and reduce early nausea. Skipping the titration would significantly worsen side effects.
Yes. If you respond well at 1 mg or 1.7 mg and tolerate it, your doctor may keep you there rather than stepping up to 2.4 mg. The right dose is the one that works for you.
If you remember within five days of your usual day, take it and resume your normal schedule. If more than five days have passed, skip the missed dose and take the next dose on your normal day. Do not double up.
Yes. To change days, the next dose should be taken at least two days after the previous one. Most people pick a quiet day, often a weekend day.