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, but their schedules have little in common: each has its own ladder, its own timescale and its own rule for a missed dose. Check this page before you dose, not after.
The weekly injection, step by step
You spend four weeks on each of four starting doses, so the target dose arrives sixteen weeks after the first pen.
| 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. Not everyone moves up to it. For weight reduction, it becomes an option only after four weeks or more on 2.4 mg without trouble, and only when your clinician judges that more weight loss is still worth pursuing. Moving up is a separate decision you make with your clinician.
Besides 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
Wegovy now has several indications, and the maintenance dose depends on which one you were prescribed it for.
| 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 are still injection-only.
| 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 comes with rules the injection does not have, and each one matters. Semaglutide is a peptide, and the instructions exist to get it through the stomach intact.
- Take it in the morning, with water only, while your stomach is empty. Four ounces at most.
- Swallow it whole. Never split, crush, chew or dissolve the tablet.
- 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 another option, switching to the 1.7 mg weekly injection.
- Storage is simple. Store the tablets at room temperature in their original bottle, away from moisture. They do not go 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 depends on how long it is until your next scheduled dose, not on how long ago you missed one.
- Next dose more than 2 days off? Take the missed one now.
- Next dose less than 2 days off? Skip it. Your next dose stays on your usual day.
- Missed two or more in a row? The label sends you back down the ladder to a lower dose, so you do not walk straight back into the gastrointestinal side effects the ladder was built to prevent. Talk to whoever prescribes for you before you resume.
Never take two doses to catch up. The tablet rule is simpler: if you miss one, leave it out and take your next tablet the following day.
Things that are allowed, and often assumed not to be
- Food and the hour of the day don't matter for the injection. Only the day of the week is fixed.
- 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 to a different spot with each dose so you never use the same patch of skin twice in a row.
- Unused pens live in the fridge at 36–46°F. Before its cap comes off, a single-dose pen or syringe may be kept out of the fridge, no warmer than 86°F, for up to 28 days. Once you have started a FlexTouch pen, it lasts 56 days whether you keep it in the fridge or out of it, so long as it stays at or below 86°F. After that, throw it away, whatever 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: dizziness on standing, dark urine, or passing very little. Kidney injury has been reported after exactly this kind of fluid loss.
- 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 page covers dosing only. Interactions, pregnancy and how Wegovy compares with the alternatives each need more room than a table gives them.
Where to go next
- The Wegovy overview covers how it works, what the trials found and what it costs.
- The titration planner maps your ladder week by week and exports it to a calendar.
- The missed-dose guide works through each GLP-1's missed-dose window, with examples.
- Alcohol and GLP-1s covers what the label says about drinking, which turns out to be nothing at all.