Wegovy is semaglutide, and it now comes two ways: an injection you take once a week, and a tablet you take every morning. They share a name and nothing else about their schedules — different ladders, different timescales, different rules for a dose you miss. Keep this open before you dose rather than after.
The weekly injection, step by step
Four steps up, four weeks each, then you are at maintenance. Sixteen weeks from the first pen to the target dose.
| Step | Week | Dose | What it is for |
|---|---|---|---|
| 1 | Weeks 1–4 | 0.25 mg | Not a treatment dose. It exists to let your gut meet the drug slowly. |
| 2 | Weeks 5–8 | 0.5 mg | Where most people first notice appetite genuinely changing. |
| 3 | Weeks 9–12 | 1 mg | The dose many people stay on indefinitely under the Ozempic label. |
| 4 | Weeks 13–16 | 1.7 mg | Already a legitimate place to stop if the next rung is rough. |
| 5 | Week 17 onward | 2.4 mg | The usual maintenance dose, and the one the headline trials ran on. |
Above 2.4: the HD strength
The label carries a 7.2 mg single-dose pen, sold as WEGOVY HD. It is not a step everyone climbs to. It is available for weight reduction when someone has tolerated 2.4 mg for at least four weeks and their clinician judges that more weight loss is still worth pursuing. Treat it as a decision, not as the top of a staircase you are expected to finish.
Worth knowing about the hardware too: alongside the single-dose pens and syringes there is a multi-dose FlexTouch pen holding 9.6 mg, which delivers four separate 2.4 mg doses from one device.
Maintenance depends on why you were prescribed it
There is no longer a single maintenance figure, because Wegovy now holds several indications and they do not all land in the same place.
| Why you are taking it | Maintenance | Notes |
|---|---|---|
| Weight reduction, adults | 2.4 mg weekly, or 1.7 mg | 7.2 mg is available above this where tolerated and clinically justified. |
| Cardiovascular risk reduction, adults | 2.4 mg weekly, or 1.7 mg | Which one depends on how well you tolerate it and how you respond. |
| Weight reduction, ages 12–17 | 2.4 mg weekly, or 1.7 mg | Same sixteen-week climb as adults. |
| Noncirrhotic MASH with moderate-to-advanced fibrosis | 2.4 mg weekly | A liver indication. May step down to 1.7 mg if 2.4 is not tolerated, with a view to going back up. |
The tablet is a different drug schedule
Wegovy tablets are approved for adults, for weight reduction or cardiovascular risk reduction. They are not approved for the pediatric weight indication or for MASH — those two remain injection territory.
| Stage | Days | Dose |
|---|---|---|
| Start | 1–30 | 1.5 mg daily |
| Step up | 31–60 | 4 mg daily |
| Step up | 61–90 | 9 mg daily |
| Maintenance | 91 onward | 25 mg daily |
The tablet has requirements the injection does not, and they are not optional garnish — semaglutide is a peptide, and getting it through the stomach intact is the whole problem the instructions are solving.
- Morning, nothing eaten, water and nothing else — four ounces at most, and nothing else.
- Whole. Not split, not crushed, not chewed, not dissolved.
- Then wait half an hour before food, before any other drink, and before any other tablet you take.
- If 25 mg does not suit you, the label offers a route out: switch to the 1.7 mg weekly injection instead.
- Storage is easy — original bottle, room temperature, keep moisture away. Nothing goes in the fridge.
Moving between the two forms
- Injection to tablet: wait a week after your last 2.4 mg shot, then begin 25 mg daily. You do not climb the tablet ladder again.
- Tablet to injection: begin 2.4 mg weekly the day that follows your final tablet. If the 25 mg tablet was the problem, 1.7 mg is the sensible landing point instead.
A dose you missed
The rule turns on one number, and it is the gap to your next scheduled dose rather than the time since the one you skipped.
- Next dose more than 2 days off? Take the missed one now.
- Next dose less than 2 days off? Let it go. Carry on with your normal day.
- Missed two or more in a row? The label says to restart the escalation at a lower dose, specifically to avoid walking back into the gastrointestinal side effects the ladder was built to prevent. Talk to whoever prescribes for you before you resume.
⛔ There is no version of this where you take two doses to catch up. The tablet is simpler: miss one, skip it, take tomorrow's as normal.
Things that are allowed, and often assumed not to be
- Any time of day, food or no food — for the injection. It is the day that is fixed, not the hour.
- You can move your injection day, provided at least 48 hours have passed since the last one.
- You can stay put. If a step is making you miserable, another four weeks at the same dose is a legitimate choice, and so is dropping back one and trying again later.
- Belly, thigh or upper arm, moving on each week. Not the same patch of skin twice running.
- Unused pens live in the fridge at 36–46°F. Once you have started one it may be kept out of the fridge, no warmer than 86°F, for 28 days — after that it goes in the bin regardless of what is left in it.
Stop reading this page and call someone
- Severe abdominal pain that will not settle, particularly if it bores through to your back, with or without vomiting. Pancreatitis presents this way.
- Pain under the right ribs, fever, yellowing skin or pale stools. Gallbladder disease turned up more often on Wegovy than on placebo in trials.
- Vomiting that has stopped you keeping fluids down for a day, or the signs that follow it — dizzy on standing, dark urine, barely passing any. Kidney injury has been reported from exactly this route.
- A lump in your neck, a hoarse voice, or trouble swallowing. This sits behind the boxed warning, and the drug is off the table entirely if medullary thyroid carcinoma runs in your family or you have MEN 2.
- Hives, a swelling face or throat, breathing trouble. Stop and get emergency help.
- Shaking, sweating or confusion in anyone whose diabetes is treated with insulin or a sulfonylurea. Those doses often need to come down when a GLP-1 goes in.
What this page deliberately leaves out
This is the dosing skeleton and nothing more. Interactions, pregnancy, and how Wegovy actually compares with the alternatives are all separate questions with more to them than a table can hold.
Where to go next
- The Wegovy overview — how it works, what the trials found, and what it costs.
- Titration planner — your ladder mapped week by week, exportable to a calendar.
- Missed-dose guide — the 48-hour rule worked through for every GLP-1, with examples.
- Alcohol and GLP-1s — what the label says about drinking, which turns out to be nothing at all.