Semaglutide Dosage: The Full Schedule Explained (2026)

What is the semaglutide dosage schedule? The short answer by brand

Each form of semaglutide has its own FDA-approved schedule. Each one steps up slowly to limit side effects. Here is the summary. The details and the missed-dose rules follow below.

• Wegovy pen, for weight management: starts at 0.25 mg a week and reaches 2.4 mg after at least 16 weeks. 1.7 mg is another maintenance option. A 7.2 mg pen, Wegovy HD, is a step above 2.4 mg.
• Wegovy pill, for weight management: a daily tablet from 1.5 mg up to 25 mg, over about three months.
• Ozempic pen, for type 2 diabetes: 0.25 mg a week up to a 2 mg ceiling. Most people stay at 1 mg or 2 mg, guided by blood sugar.
• Ozempic pill, formerly Rybelsus, for type 2 diabetes: a daily tablet from 1.5 mg up to a 9 mg ceiling.
• Compounded semaglutide, from a vial: you draw the dose in syringe units, and the math depends on the vial strength.

The Wegovy dose escalation schedule, step by step

Wegovy is the semaglutide brand approved for long-term weight management. It is for adults with a BMI of 30 or more. It is also for a BMI of 27 or more with a weight-related condition, such as high blood pressure or type 2 diabetes. The slow step-up gives your body time to adjust. It limits nausea and vomiting, the most common reasons people cut back or stop.

If a step doesn't agree with you, the label lets your prescriber delay the next one by about four weeks. That is not a failure. It is an option built into the label. The goal is to reach a maintenance dose, not to keep to a calendar.

The label recommends 2.4 mg for maintenance and also allows 1.7 mg. The 0.25 mg, 0.5 mg and 1 mg steps are only for starting and stepping up. The label does not approve them as long-term doses on their own.

Above 2.4 mg sits Wegovy HD, a 7.2 mg weekly pen approved in March 2026. It is not the next step for everyone. The label keeps it for people who have handled 2.4 mg for at least four weeks and still need more weight loss. In the STEP UP trial, 7.2 mg led to about 21% weight loss on average over 72 weeks. On 2.4 mg, the figure was about 18%. The gain came with more stomach side effects. Our Wegovy dosage guide covers the higher dose in full.

Oral Wegovy pill dosing schedule, approved December 2025

In December 2025, the FDA approved a pill version of Wegovy. It was the first GLP-1 pill for weight management in the US. A GLP-1 is a type of medicine that slows digestion and quiets appetite. The pill follows its own ladder, with the dose going up every 30 days.

Take it each morning on an empty stomach with a sip of plain water, up to 4 ounces. Then wait at least 30 minutes before food, other drinks or other pills. In the OASIS 4 trial, people who took the 25 mg pill as directed lost about 17% of their weight over 64 weeks. It is a needle-free option if you would rather not inject.

Where to get semaglutide, and what each version costs

Every version needs a prescription. After that, your price depends on the brand, the dose and your insurance. Novo Nordisk, the maker, sells its brands for cash through its own pharmacy, NovoCare.

• Wegovy pen: about $350 a month at every standard dose · First 2 months $199 for new patients, through Dec 31, 2026 · About $400 for the 7.2 mg HD pen
• Wegovy pill: about $150 a month at 1.5 mg · About $200 at 4 mg · About $300 at 9 mg and 25 mg
• Ozempic pen: about $350 a month up to 1 mg · About $500 at 2 mg · First 2 months $199 for new patients, through Dec 31, 2026
• Ozempic pill: about $150 a month at 1.5 mg · About $200 at 4 mg · About $300 at 9 mg
• With commercial insurance that covers the drug: as little as $25 a month with the maker's savings offers
• Compounded semaglutide: about $140 to $270 a month at Mochi Health, by dose, membership included · First month $60 · From about $300 a month for injections at Henry Meds

Commercial insurance means a plan from your employer or one you buy yourself. Compounded semaglutide is not Wegovy or Ozempic. A pharmacy mixes the same active ingredient for one patient, and the result is not FDA-approved.

Semaglutide dose in units: how to convert mg to syringe units

The Wegovy and Ozempic pens deliver a fixed dose in milligrams. You set the pen, not a syringe. Compounded semaglutide from a vial is different. You draw it with an insulin syringe, which is marked in units. This is where the vial's strength matters most, and where dosing mistakes happen.

The math is simple. Divide your dose in milligrams by the vial strength in milligrams per milliliter. Then multiply by 100. The result is the number of units on a standard U-100 insulin syringe.

Conversion table at 5 mg/mL, the most common compounded strength

• 0.25 mg = 5 units
• 0.5 mg = 10 units
• 1.0 mg = 20 units
• 1.7 mg = 34 units
• 2.4 mg = 48 units

Conversion table at 2.5 mg/mL, less common but in use

• 0.25 mg = 10 units
• 0.5 mg = 20 units
• 1.0 mg = 40 units
• 1.7 mg = 68 units
• 2.4 mg = 96 units

How many mg is 40 units of semaglutide?

It depends entirely on your vial's strength. At 2.5 mg/mL, 40 units equals 1.0 mg. At 5 mg/mL, 40 units equals 2.0 mg. The same syringe mark can mean two very different doses. This is one of the most common causes of taking too little or too much from a compounded vial. Never assume the strength. Read the label on your own vial.

A simple check: your prescriber's instructions should give both the dose in milligrams and the number of units for your vial. If they don't, ask before you inject.

What is the semaglutide maintenance dose, and can it be lower than 2.4 mg?

The recommended maintenance dose for Wegovy is 2.4 mg a week. That is the dose used in the STEP 1 trial, where people lost about 15% of their body weight over 68 weeks. The label also allows 1.7 mg as a maintenance dose.

Some telehealth services keep people on lower doses for longer. That can help with side effects and cost. Some people do get good results below 2.4 mg. But the main weight-loss trials were built around 2.4 mg, so the evidence for long-term lower doses is thinner.

What to do if you miss a semaglutide dose

Missing a dose now and then is common and easy to handle. The rules differ between Wegovy and Ozempic, and between shots and pills.

Wegovy pen missed dose rule

Look at when your next dose is due. If it is more than 2 days away, take the missed dose as soon as you remember. If it is less than 2 days away, skip the missed dose and inject on your usual day. Never inject two doses at once to catch up.

Ozempic pen missed dose rule

Ozempic gives you a longer window. If no more than 5 days have passed since the missed dose, take it as soon as you can. If more than 5 days have passed, skip it and take your next dose on your usual day.

Wegovy pill or Ozempic pill missed dose rule

For a daily tablet, skip the missed dose. Take the next tablet the following day at your usual time. Don't take two the next day to make up for it.

Missing several doses in a row

Say you miss two or more weekly Wegovy shots in a row. The label says to resume on your usual day or, if needed, restart the ladder from a lower dose. Restarting lower helps keep stomach side effects from coming back. Your prescriber guides this restart.

Semaglutide dosing chart: Ozempic for type 2 diabetes

Ozempic has the same active ingredient as Wegovy. It is approved to control blood sugar in adults with type 2 diabetes. It also lowers the risk of heart problems in some of those adults. Its top dose is lower than Wegovy's, and its steps differ slightly.

The 2 mg dose was added to the Ozempic label in 2022. With Wegovy, most people aim for 2.4 mg. With Ozempic, the step-up follows your blood sugar, so not everyone needs 2 mg. The Ozempic dosage guide covers the diabetes schedule in depth. It also explains why 2.4 mg is not an Ozempic dose.

Can a prescriber write Ozempic for weight loss without diabetes? Yes, they may use their judgment. That is called off-label use. But Wegovy is the version approved for weight loss. Heavy off-label use of Ozempic also caused shortages for people with diabetes who rely on it.

Ozempic pill, formerly Rybelsus: oral semaglutide for diabetes only

Rybelsus was the first semaglutide pill, approved in 2019 for type 2 diabetes. In the US, it has now been renamed the Ozempic pill. The FDA approved the new name in January 2026, and the pill reached pharmacies on May 4, 2026. It uses a new tablet that the body absorbs better, so the doses are lower.

The old Rybelsus doses map straight onto the new ones. 3 mg became 1.5 mg, 7 mg became 4 mg, and 14 mg became 9 mg. The Ozempic pill is not approved for weight management. That role belongs to the Wegovy pill.

The daily routine is strict. Swallow it with no more than 4 ounces of plain water. Then wait at least 30 minutes before food, other drinks or other pills. Coffee, tea or juice in that window cuts how much of the drug you absorb.

Why the semaglutide dosing schedule for weight loss differs from the diabetes schedule

Wegovy and Ozempic share the same ingredient and the same slow step-up. Their goals differ. The Wegovy schedule aims for 2.4 mg, the dose proven for weight management. The Ozempic schedule follows blood sugar. Some people do well at 0.5 mg and never go higher.

The pens also differ. Each Wegovy pen holds a single, preset dose that matches one step of the ladder. Ozempic pens hold several doses, and you dial the dose. You can't swap one pen for the other and assume the dose is the same.

Semaglutide dosage in perimenopause and menopause: what the evidence shows

The Wegovy schedule is the same at every stage of menopause. The FDA label has no separate plan for perimenopause or postmenopause. But research is starting to show how GLP-1 medicines work across these years.

A 2024 study in the journal Menopause looked at postmenopausal women on semaglutide. Those also using hormone therapy lost about 16% of their weight at 12 months. Those on semaglutide alone lost about 12%. That hints that hormones may affect the response. It does not change the dose schedule, but it helps explain why results vary.

Midlife weight gain is tied to falling estrogen in perimenopause. That shift moves fat toward the belly and reduces muscle. GLP-1 medicines work on appetite and digestion. They don't replace estrogen. The two treatments can go together, and more providers now discuss both at once.

Compounded semaglutide syringe dosage: current legal status

Through 2023 and 2024, compounded semaglutide was easy to find. That was because semaglutide was on the FDA shortage list. The FDA took it off that list in February 2025. That set wind-down deadlines for copies of the brand-name drug.

• 503A pharmacies, which mix drugs for one patient at a time: deadline of April 22, 2025.
• 503B outsourcing facilities, which make larger batches: deadline of May 22, 2025.

Compounded semaglutide can still be made in narrow cases. A prescriber must document a medical need the approved drug can't meet. An allergy to an inactive ingredient in Wegovy or Ozempic is one example. In April 2026, the FDA also proposed keeping semaglutide off the list of bulk ingredients 503B facilities may use. That proposal is still moving through the rule-making process.

If you were on compounded semaglutide, your provider should have moved you to a brand-name version or recorded why you still need a compounded one. The unit math on this page still applies if you have a proper compounded prescription. But broad access to compounded semaglutide has narrowed a lot.