The Wegovy Dosage Chart: From Starting Dose to Maintenance

What is the Wegovy dosage chart, from starting dose to maintenance?

The injection follows one ladder, and it's shorter than most people expect: five strengths, each held for at least four weeks before the next one starts. Nobody begins anywhere but the bottom, regardless of how much weight they eventually plan to lose, because that first dose exists to let the body adjust rather than to do the actual work.

Reaching 2.4mg takes at minimum 16 weeks, or four months, of stepping up — longer if a prescriber pauses on any level to let side effects settle. A newer, higher strength above 2.4mg also exists now; it's covered on its own further down, because it isn't part of the standard path most people follow.

What is the Wegovy starting dose, and why isn't it a treatment dose?

0.25mg is the number everyone starts at, and it's deliberately too low to produce the weight-loss effect Wegovy is prescribed for. Its only job is tolerability — giving the gut time to adjust to a GLP-1 receptor agonist before the dose climbs into a range that actually suppresses appetite. Four weeks is the label's minimum stay at this level; a prescriber can extend it if nausea or other early side effects haven't settled, but they can't shorten it below that floor.

What is the highest dose of Wegovy? The 7.2mg HD strength, confirmed

Yes — as of 2026, there's a dose above 2.4mg. The FDA cleared Wegovy HD, a 7.2mg once-weekly injection, in March 2026 through an accelerated review pathway, with the pen reaching US pharmacies the following month. It isn't a replacement starting point or a faster route to results; it's positioned specifically for people who've already reached and stayed on 2.4mg and plateaued there, giving a prescriber a further option before concluding semaglutide has done what it's going to do.

The trial data behind the approval, from the STEP UP program, reported an average weight change of roughly 21% at 7.2mg over 72 weeks. That's a meaningful step beyond what 2.4mg alone typically produces, but it comes with a trade-off: skin-related sensations — described as tingling, burning, or heightened sensitivity — were reported considerably more often at 7.2mg than at 2.4mg, which is part of why this dose is reached deliberately rather than defaulted to.

Wegovy pill dosage: how the tablet's schedule differs from the pen

This is the part that trips up people comparing the two formats side by side, because the tablet's numbers don't map onto the pen's at all. Approved in December 2025 as the first oral GLP-1 for weight management, the pill comes in four strengths — 1.5mg, 4mg, 9mg, and 25mg — increased roughly every four weeks as tolerated, with 25mg once daily as the maintenance dose. (This ladder is cross-checked against manufacturer materials but not a direct read of the FDA label text — confirm against the primary label before treating it as final.)

Don't try to convert between the two by milligram. Oral semaglutide absorbs far less efficiently through the gut than an injection delivers under the skin, so the tablet needs a much larger milligram amount to reach a comparable effect — 25mg by mouth isn't ten times stronger than 2.4mg by injection, it's roughly in the same therapeutic neighborhood, just measured on an entirely different scale. The tablet also comes with its own routine that has nothing to do with dose at all: it's taken once daily on an empty stomach, with a wait of about 30 minutes before food, drink, or other medications, to give the coating time to protect the drug through the stomach.

Can you stay on a lower dose of Wegovy instead of going all the way up?

You're not required to reach 2.4mg, let alone 7.2mg. The label itself recognizes 1.7mg as an appropriate maintenance dose for certain indications, not merely a step on the way to something higher, and a prescriber can hold a patient at any level — 1mg, 1.7mg — if that's where side effects are manageable and results are meaningful. The ladder is a ceiling built for flexibility, not a target everyone is expected to hit.

Whether a lower dose is the right long-term choice comes down to a conversation between you and whoever's prescribing: how you're tolerating it, what you're seeing, and what you're weighing against cost, since price does shift with dose on several pathways below.

What if you miss a dose, or can't tolerate a step?

For the injection, the rule is a 2-day window, not the 5-day window some people associate with Ozempic or the 4-day rule that governs tirzepatide — a detail worth getting right, since mixing them up means either taking a dose too late or skipping one you didn't need to. If your next scheduled dose is more than 2 days away, take the missed one as soon as you remember. If it's less than 2 days away, skip it entirely and resume on your regular day. Missing 2 or more weeks in a row is treated differently: the label's guidance is to either resume on schedule or call your prescriber about restarting the titration from a lower step, rather than picking back up where you left off.

The tablet's rule is simpler because it's a daily medication rather than a weekly one: skip the missed day's pill and take the next scheduled dose the following day, never doubling up. For either format, a step that isn't tolerated has the same built-in answer — hold at the current dose longer, or drop back to the last one that worked, rather than pushing forward on the calendar regardless.

Does the Wegovy dose or schedule differ in perimenopause or menopause?

No — there's no FDA-recognized separate ladder based on reproductive stage, for either the pill or the pen. What does exist is newer than most dosing guides account for: a post-hoc analysis of the STEP UP and SELECT trials, presented at the European Congress on Obesity in May 2026, that broke outcomes down specifically by menopausal stage. Premenopausal women averaged roughly 23% weight loss on the 7.2mg dose; perimenopausal and postmenopausal women averaged close to 20% each — all on the identical standard schedule, not a modified one. A separate look at cardiovascular outcomes from SELECT found meaningful risk reduction in both perimenopausal and postmenopausal women with existing heart disease, with the size of that reduction differing somewhat between the two groups.

That's a response question, not a dosing one — the analysis says how well the standard schedule tends to work across reproductive stages, and it doesn't suggest any group should be started or titrated differently. For how GLP-1s and hormone therapy fit together more broadly in midlife, see GLP-1 and menopause.

Does the price change as your Wegovy dose goes up?

On the manufacturer's own self-pay program, yes, in steps. The tablet starts at $149 a month for the two lowest strengths, then moves to $299 a month at 9mg and 25mg. The pen carries an introductory rate for new patients at the starting doses, then settles at $349 a month across the standard range through 2.4mg — with the newer 7.2mg HD strength priced separately above that, at $399 a month.

Compounded programs handle this differently. Henry Meds charges one flat number regardless of where you are in titration — $249 a month oral, $297 a month injection, with no separate membership fee, though labs aren't included and are arranged separately — and Mochi Health's roughly $178 a month all-in doesn't move whether you're four weeks in or at the ceiling. Neither is FDA-approved Wegovy; both are compounded semaglutide, the same active molecule prepared by a 503A pharmacy for an individual patient rather than manufactured by Novo Nordisk. For the fuller legal and pricing picture across every compounded provider, see compounded semaglutide, and for every brand-name pathway side by side, Wegovy cost and the cheapest ways to get Wegovy.

Who actually sets and adjusts your dose — and where to get prescribed

Every number on this page is a starting reference, not a self-directed plan. A prescriber decides where you begin, when you're ready to step up, and whether to hold or drop back — whether that's a doctor you already see or a telehealth clinician you're meeting for the first time. Bring this chart to that conversation as a cross-check against what they're proposing, not as a substitute for their judgment.

Telehealth has become a common route to a Wegovy or compounded semaglutide prescription, particularly for women navigating a menopause-related weight shift alongside everything else in their forties and fifties. Henry Meds offers both oral and injectable compounded semaglutide with prescriber-managed titration; Mochi Health pairs flat-rate dosing with ABOM-certified obesity-medicine physicians; Willow keeps intake straightforward in the states it covers. Each works from the same underlying dosing logic — what differs is price, format, and how closely a clinician stays involved as you move through it.