Semaglutide Dosage: How To Find The Right Dose

Not sure which is the right semaglutide dosage for weight loss? Our clinicians explain how it works.

What is semaglutide?

Semaglutide belongs to a group of drugs known as GLP-1 receptor agonists, and it's the active ingredient in Ozempic and Wegovy.

Ozempic is approved to treat type 2 diabetes, but it can also be prescribed off-label for chronic weight management*.

Wegovy, on the other hand, is an approved treatment for obesity, and it's been found to effectively support weight reduction. Clinical studies show people taking the maximum dose lose up to 14.9% of their body weight over 68 weeks. [1]

How it works

Semaglutide mimics GLP-1 (glucagon-like peptide-1), a naturally occurring hormone in your body. After eating, your body releases GLP-1 to promote insulin secretion, which helps regulate blood sugar levels. It also slows gastric emptying, or the rate at which food leaves your stomach, which helps with appetite control.

Initial dosage

Starting doses for Ozempic

The starting dose for Ozempic is 0.25 mg, administered by subcutaneous injection into the fatty layer of tissue under your skin. It's taken as a once weekly dose for 4 weeks. [2]

Starting doses for Wegovy

The starting dose for Wegovy is also 0.25 mg. Like Ozempic, this is administered as a weekly subcutaneous injection for 4 weeks. [3]

Titrating your dose

Dosage adjustments

It's important to start at a low dose so your body can adjust to the medication. Then, your dose is gradually increased once every 4 weeks — this method is called titration. It should help minimize any side effects, but you should keep a close eye on how you feel and get medical advice if you experience significant symptoms. 

Your dosage for Ozempic may increase until you reach the maintenance dosage. The maximum dose is 2 mg, which you may start after 13 weeks of treatment.

• Weeks 1-4: 0.25 mg once weekly
• Weeks 5-8: 0.5 mg once weekly
• Weeks 9-12: 1 mg once weekly
• Weeks 13-16: 2 mg once weekly (maximum dose)

Your dosage for Wegovy also increases every 4 weeks. 2.4 mg is the maximum dosage of Wegovy, which you may start after 17 weeks of treatment. Wegovy has a higher maintenance dose compared to Ozempic, as it's tailored to achieve more significant weight loss.

• Weeks 1-4: 0.25 mg once weekly
• Weeks 5-8: 0.5 mg once weekly
• Weeks 9-12: 1 mg once weekly
• Weeks 13-16: 1.7 mg once weekly
• Week 17 onwards: 2.4 mg once weekly (maintenance dose)

Before starting treatment

It's vital you inform your healthcare provider of any history of pancreatitis, stomach or intestinal disorders, kidney disease, or diabetic retinopathy before starting semaglutide.

Studies of semaglutide use in animals suggested an increased risk of thyroid tumours. This means you're ineligible for semaglutide treatment if you have a family history of medullary thyroid carcinoma, or if you have MEN2, a rare genetic disorder that heightens risk of thyroid tumors.

Semaglutide should not be used during pregnancy. If you're trying to conceive, you should stop your semaglutide treatment for 2 months beforehand.

You should only pursue semaglutide treatment under the supervision of a licensed healthcare professional.

Common side effects

Like all medications, semaglutide can cause some side effects. The most common ones are:

• Nausea and vomiting
• Diarrhea
• Constipation
• Stomach cramps or gastrointestinal issues (upset stomach)
• Headaches

Studies show up to 44% of people may experience nausea, while 30% experience diarrhea and 24% experience vomiting on the highest dose of semaglutide. [4]

Tips for injecting semaglutide

Remember, always follow the exact dosage instructions set out by your healthcare provider. Here are some semaglutide injection best practice recommendations:

Rotate weekly injection site

Don’t inject your dose into the same area 2 weeks in a row. Switch between your stomach, upper arm, and thigh each time to prevent skin irritation and scarring.

Inspect your medication before taking it

Semaglutide shouldn't look cloudy or have any solid particles in it. If you notice this, don't inject it and contact your prescriber for advice.

Create a consistent schedule

Try to take your dose at the same time each week for maximum effectiveness.

Ensure proper disposal

Safely dispose of used needles in a hard plastic container like a laundry detergent bottle. Never put them in household waste.

Follow missed dose guidelines

For Ozempic, you should take a missed dose as soon as possible if it is within 5 days. If more than 5 days pass, skip the missed dose and resume your regular dosing schedule.

For Wegovy, if you miss a dose and your next dose is over 48 hours (2 days) away, take your dose as soon as you remember. If your next dose is less than 48 hours (2 days) away, skip the missed dose and resume your regular dosing schedule.

Never take a double dose of semaglutide to make up for a missed one. If you miss 2 or more doses, contact your healthcare provider for advice on how to restart your treatment.

How to start semaglutide

Complete your online consultation today to see if you're eligible for a semaglutide treatment plan with ZipHealth.

*Ozempic is FDA-approved for type 2 diabetes, but may be prescribed off-label for obesity at the discretion of the prescribing physician.

References

1. Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, McGowan BM, Rosenstock J, Tran MTD, Wadden TA, Wharton S, Yokote K, Zeuthen N, Kushner RF; STEP 1 Study Group. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021 Mar 18;384(11):989-1002. doi: 10.1056/NEJMoa2032183. Epub 2021 Feb 10. PMID: 33567185.
2. HIGHLIGHTS OF PRESCRIBING INFORMATION [Internet]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/209637s020s021lbl.pdf
3. HIGHLIGHTS OF PRESCRIBING INFORMATION [Internet]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/215256s005lbl.pdf
4. Wharton S, Calanna S, Davies M, Dicker D, Goldman B, Lingvay I, et al. Gastrointestinal tolerability of once‐weekly semaglutide 2.4 mg in adults with overweight or obesity, and the relationship between gastrointestinal adverse events and weight loss. Diabetes, Obesity and Metabolism. 2021 Oct 4;24(1). Available from: https://pubmed.ncbi.nlm.nih.gov/34514682/