Semaglutide Dosing Chart: 0.25 to 7.2 mg Schedule

Medically reviewed by Amber Patel, MD · Last updated July 15, 2026. Nouri content is reviewed by licensed clinicians and updated as guidance changes.

What is the standard semaglutide dosing schedule?

Semaglutide is a GLP-1 receptor agonist taken as a once-weekly injection, and every version of its schedule follows the same logic: start low, climb slowly. The low starting dose isn't there to cause weight loss — it exists to let your gut adapt, because nausea and other GI effects cluster around dose increases. The FDA-approved escalation for weight management (the Wegovy label, revision June 2026) looks like this:

Weeks	Once-weekly dose	Purpose
1–4	0.25 mg	Treatment initiation — a tolerance-building dose, not a therapeutic one
5–8	0.5 mg	Escalation
9–12	1 mg	Escalation
13–16	1.7 mg	Escalation — also an approved maintenance dose
17+	1.7 mg or 2.4 mg	Maintenance (2.4 mg recommended for adults)
Optional, adults only	7.2 mg	Maximum — only after tolerating 2.4 mg for ≥4 weeks, when additional weight reduction is clinically indicated

Two details in that table do a lot of work. First, every step is a minimum of four weeks — the label tells clinicians to consider delaying an increase by another four weeks when a dose isn't sitting well. Second, maintenance is a range, not a destination. Plenty of people hold at 1.7 mg indefinitely because it's working and it's comfortable.

What changed in 2026: the 7.2 mg maximum

In March 2026 the FDA approved a higher-dose semaglutide (marketed as Wegovy HD) at 7.2 mg once weekly — the first change to the top of the ladder since 2021. The step is direct: there is no intermediate dose between 2.4 mg and 7.2 mg. The label sets two gates — the patient must have tolerated 2.4 mg for at least four weeks, and additional weight reduction must be clinically indicated.

In the STEP UP trial that supported the approval, adults on semaglutide 7.2 mg lost on average about 20.7% of their body weight, with roughly one in three losing 25% or more. (Those are results for the branded molecule studied in the trial — not for compounded semaglutide, which is not FDA-approved or shown to be equivalent.) The higher dose carried a new tolerability signal worth knowing about: dysesthesia — unusual skin sensations like tingling or heightened sensitivity — was reported by 22% of participants at 7.2 mg versus 6% at 2.4 mg.

If you're reading dosing charts elsewhere, check the date. Pages last updated before spring 2026 still describe 2.4 mg as the ceiling.

How long do you stay at each dose?

At least four weeks — that's the label minimum at every step, and it's a floor, not a target. The escalation schedule exists to serve tolerability, so moving slower is normal and sanctioned: if a dose increase brings side effects you can't live with, the playbook is to hold the current dose (or step back down) and reassess in four weeks.

It's also worth repeating because the "always be climbing" framing on social media gets this wrong: escalation past 1.7 mg is optional. The question your prescriber is actually asking at each step isn't "can we go higher?" — it's "is the current dose delivering enough benefit to justify its side effects?" Sometimes the answer is to climb. Often it's to stay put.

How is Ozempic's schedule different?

Ozempic is the same molecule with a type 2 diabetes label, and its ladder tops out lower: 0.25 mg for four weeks, then 0.5 mg, with optional increases to 1 mg and a 2 mg maximum — each after at least four weeks, and only if more glycemic control is needed. The label frames 0.25 mg the same way Wegovy's does: an initiation dose, not an effective one. One practical difference hides in the missed-dose fine print, covered next.

What happens if you miss a dose of semaglutide?

The Wegovy label's rule is built around one question — how far away is your next scheduled dose?

• More than 2 days (48 hours) away: take the missed dose as soon as possible, then resume your normal day.
• Less than 2 days away: skip it. Don't double up — just take the next dose on schedule.
• Two or more consecutive doses missed: the current label (revised June 2026) says to reinitiate escalation at a lower dose to reduce the risk of GI side effects — in practice, your prescriber may restart you partway down the ladder rather than resuming where you left off.

Ozempic's window is looser — take a missed dose within 5 days, otherwise skip — and the new oral semaglutide tablets are simpler still: skip the missed day, take the next day's dose as normal. If you're unsure which rule applies to your prescription, that's a message to your care team, not a judgment call to make alone.

Changing your injection day is allowed, by the way — any day works, as long as two doses are at least 48 hours apart.

Compounded semaglutide dosing: vials, units, and where people get hurt

Compounded semaglutide programs generally mirror the branded ladder — 0.25 mg start, four-week steps, maintenance somewhere between 1 and 2.5 mg — but the format is different, and the format is where the risk lives. Brand pens are fixed-dose: click, done. Compounded semaglutide usually arrives as a multi-dose vial, and you draw your dose with a U-100 insulin syringe. That means converting milligrams to syringe units, and the conversion depends entirely on your vial's concentration:

Prescribed dose	2.5 mg/mL vial	5 mg/mL vial
0.25 mg	10 units (0.1 mL)	5 units (0.05 mL)
1 mg	40 units (0.4 mL)	20 units (0.2 mL)
2.4 mg	96 units (0.96 mL)	48 units (0.48 mL)

This is not a place to guess. In July 2024 the FDA published an alert documenting hospitalizations from compounded semaglutide dosing errors — including patients who drew 50 units when they meant 5, a tenfold overdose, because units, milliliters, and milligrams got tangled. Our free semaglutide dose calculator converts any prescribed dose to units and mL for every common vial concentration, both directions — and the habit that actually protects you is simpler: recheck the mg/mL on the label every single refill, because pharmacies do change concentrations between batches.

Managing side effects during dose escalation

The label's numbers are honest about where the discomfort concentrates. In trials of semaglutide 2.4 mg, nausea affected 44% of participants (versus 16% on placebo), diarrhea 30%, vomiting 24%, constipation 24% — and the label notes these were reported most frequently during dose escalation. In other words: the weeks right after a step-up are the hard ones, and they usually ease at a steady dose. Mechanistically that tracks with how the molecule works — semaglutide slows gastric emptying and reduces appetite signaling, and your gut needs time to adjust each time the dose changes. Practical strategies for the rough patches — smaller meals, hydration, what actually helps semaglutide nausea — are worth having ready before week one, not after.

If a step-up is genuinely miserable, say so early. Holding a dose for an extra month is a normal, label-sanctioned move, and it beats white-knuckling toward a schedule that was never mandatory in the first place.

How dosing works in a telehealth program

Everything above describes the label schedule — the reference chart. Your actual schedule is set by your prescriber, and in a well-run telehealth program the dosing conversation doesn't end at the first prescription. At Nouri, a U.S.-licensed physician reviews your health intake and, when treatment is appropriate, prescribes compounded semaglutide with the titration plan built in; dose adjustments afterward happen by messaging your Care Team, and the price stays the same at any dose — so the decision to step up or hold is a purely clinical one, never a billing one. If you're still comparing options, our guide to getting semaglutide online walks the process step by step, and the checklist for vetting semaglutide providers shows what a legitimate operation discloses before you pay. Pricing across the market is its own maze — the semaglutide cost breakdown untangles it.

Frequently asked questions

Can you stay on a lower dose of semaglutide if it's working?

Yes. The label names 1.7 mg as an approved maintenance dose alongside 2.4 mg, and escalation beyond a dose that's working well is a clinical choice, not a requirement. Many people maintain below the maximum indefinitely.

What is the maximum dose of semaglutide?

For weight management, 7.2 mg once weekly as of March 2026 (Wegovy HD), reserved for adults who tolerated 2.4 mg for at least four weeks and need additional weight reduction. For type 2 diabetes (Ozempic), the maximum is 2 mg. Compounded programs typically cap around 2.4–2.5 mg.

Does the 0.25 mg starting dose of semaglutide cause weight loss?

It's not designed to. The label describes 0.25 mg as a treatment-initiation dose — its job is building GI tolerance over the first four weeks. Some people notice appetite changes early, but the therapeutic doses come later on the ladder.

What happens if I miss a dose of semaglutide?

If your next scheduled dose is more than 2 days away, take the missed dose as soon as possible. If it's less than 2 days away, skip it and resume your normal schedule. If you miss two or more consecutive doses, contact your prescriber — the label calls for restarting escalation at a lower dose.

How many units is 0.25 mg of compounded semaglutide?

It depends on the vial concentration: 10 units from a 2.5 mg/mL vial, 5 units from a 5 mg/mL vial, 25 units from a 1 mg/mL vial. Always convert from the mg/mL printed on your own pharmacy label — never from someone else's numbers.

Can I change my semaglutide injection day?

Yes — the day of the week can be changed as long as your two doses end up at least 2 days (48 hours) apart.

Sources

• Wegovy (semaglutide) Prescribing Information — DailyMed, revised June 2026. dailymed.nlm.nih.gov
• Ozempic (semaglutide) Prescribing Information — DailyMed. dailymed.nlm.nih.gov
• FDA press announcement — approval of higher-dose semaglutide (7.2 mg), March 2026. fda.gov
• Wilding JPH et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). NEJM 2021. nejm.org
• STEP UP trial — semaglutide 7.2 mg in obesity. Lancet Diabetes & Endocrinology 2025. thelancet.com
• Blundell J et al. Effects of once-weekly semaglutide on appetite and energy intake. Diabetes Obes Metab 2017. pubmed.ncbi.nlm.nih.gov
• FDA alert — dosing errors associated with compounded injectable semaglutide, July 2024. fda.gov
• FDA — Compounding and the FDA: Questions and Answers. fda.gov

Considering treatment? See if you qualify with Nouri — a five-minute health intake, reviewed by a U.S.-licensed physician. One all-inclusive price, the same at any dose.

Compounded semaglutide is not FDA-approved and has not been evaluated by the FDA for safety, effectiveness, or quality, and is not therapeutically equivalent to Wegovy or Ozempic. All dosing information above describes the FDA-approved product labels and published research; it is educational, not medical advice, and never a substitute for your prescriber's instructions. Nouri connects patients with licensed, independent physicians who make all prescribing decisions.