If you are exploring medical weight loss options, you have likely heard of semaglutide. But understanding how the dosing works—and why it changes over time—can feel a bit confusing.
The standard maintenance dose for weight loss is 2.4 milligrams (mg) a week. However, you will not start at that dose. Here is a straightforward guide to everything you need to know about your semaglutide dosing schedule, how to handle missed days, and what to expect along the way.
Understanding Semaglutide
Semaglutide belongs to a class of medications called GLP-1 receptor agonists. It works by mimicking a hormone that targets areas of the brain that regulate appetite, effectively reducing hunger and increasing your sense of fullness.
It is the active ingredient in several well-known medications:
- Wegovy: FDA-approved specifically for weight loss and long-term weight management.
- Ozempic: FDA-approved to treat Type 2 diabetes, but frequently prescribed off-label for weight loss.
- Rybelsus: A daily oral tablet form of semaglutide for Type 2 diabetes.
- Compounded Semaglutide: A custom-mixed version prescribed by healthcare providers for personalized dosing.
Note: Healthcare providers prescribe these medications alongside essential lifestyle changes, including a reduced-calorie diet and increased physical activity.
The Semaglutide Dosing Schedule
To minimize side effects, your healthcare provider will start you on a low dose and gradually increase it every four weeks. This process is known as dose escalation.
Here is the standard dosing schedule for the injectable pens:
| Treatment Timeline | Wegovy® Dose | Ozempic® Dose |
| Month 1 | 0.25 mg weekly | 0.25 mg weekly |
| Month 2 | 0.5 mg weekly | 0.5 mg weekly |
| Month 3 | 1.0 mg weekly | 1.0 mg weekly (if necessary) |
| Month 4 | 1.7 mg weekly | 1.0 mg weekly |
| Month 5 & Beyond | 2.4 mg weekly | 1.0 mg weekly |
You may not need to reach the maximum dose. If you are successfully losing weight and feeling good at a lower dose (like 1.0 mg), your doctor may recommend staying there. This becomes your maintenance dose.
What About Compounded Semaglutide?
Unlike brand-name pens that come with fixed doses, compounded semaglutide comes in a vial and is drawn with a syringe. This allows for highly personalized micro-dosing (e.g., starting at 0.15 mg) for patients who are highly sensitive to the medication.
How to Take Your Medication
Semaglutide is administered once a week via a subcutaneous injection, meaning it goes into the fatty tissue just under your skin—not into a muscle or vein.
The approved injection sites are:
- Your stomach (at least two inches away from the belly button)
- Your upper thighs
- The back of your upper arms
Pro Tip: Always rotate your injection sites each week to prevent skin irritation or hard lumps from forming.
What to Do If You Miss a Dose
Life happens. If you forget your weekly injection, follow these simple rules:
- If your next dose is MORE than 2 days away: Take the missed dose as soon as you remember.
- If your next dose is LESS than 2 days away: Skip the missed dose entirely. Just take your next dose on your regularly scheduled day.
- Never double up: Do not take extra medication to make up for a missed week.
If you miss two or more consecutive doses, contact your prescribing provider. They may want you to restart at a lower dose to prevent severe gastrointestinal distress.
Managing Side Effects
Because semaglutide slows down your digestion, the most common side effects are gastrointestinal. These typically peak when you increase your dose and subside as your body adjusts. Common symptoms include:
- Nausea and vomiting
- Constipation or diarrhea
- Abdominal pain and bloating
If your side effects are severe or interfering with your daily life, speak to your doctor. They can lower your dose, prescribe an anti-nausea medication like Ondansetron (Zofran), or switch you to a different weight loss medication like Tirzepatide.
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