Wegovy Dosage

Starting dose and the first 4 weeks

Wegovy (semaglutide) is always started on a low dose of 0.25 mg per week. This is not the therapeutic dose for weight loss, but purely a run-in dose to keep side effects such as nausea, vomiting and diarrhoea to a minimum.

In these first 4 weeks you will probably experience little reduction in appetite. That is normal: the mechanism of action only builds up noticeably from around 0.5 mg. Some sensitivity in the digestive system may already occur, however.

The injection is given once a week, preferably on the same day and at the same time. You may shift the injection day by up to 3 days if that suits you better.

Titration schedule week by week

The official Wegovy titration schedule proceeds in 5 steps of 4 weeks. In total, titration takes around 16 to 20 weeks before you are on the maintenance dose.

If you suffer too much from side effects at a particular step, the doctor may decide to stay on that dose for longer (for example 8 instead of 4 weeks) before the next step follows.

The titration matters: starting directly at 2.4 mg is not well tolerated and carries a considerably higher risk of nausea, vomiting, dehydration and gallstones.

Maintenance dose 2.4 mg

The standard maintenance dose for weight loss is 2.4 mg per week. You continue on this dose for as long as you benefit from the treatment and there is no reason to stop. In clinical studies, the maintenance phase lasted at least 68 weeks.

If you do not tolerate 2.4 mg well, the doctor can set the maintenance dose at 1.7 mg. Weight loss is then slightly lower (on average 12 to 14 percent versus 15 percent on 2.4 mg), but still clinically relevant.

Resuming after a break always requires a new titration from 0.25 mg. So you cannot simply restart at 2.4 mg after an interruption of more than two weeks.

Missed injection: what now?

Have you forgotten an injection and is it less than 5 days ago? Take the dose as soon as you remember, and give your next injection on the normal day.

Are you already more than 5 days past the scheduled day? Skip the dose and wait for the next regular weekly day. Never take two injections close together.

Have you missed more than 2 weeks in a row (for example because of a holiday or illness)? Consult your doctor: you usually need to restart on a lower dose and titrate up again to prevent side effects.

Injection technique

Wegovy is administered subcutaneously via a pre-filled disposable pen. You can inject into the abdomen (at least 5 cm from the navel), thigh or upper arm. Rotate the site each week to prevent skin reactions.

Before injecting: let the pen come to room temperature for 15 to 30 minutes for less pain. Disinfect the skin, place the pen perpendicular to the skin and press until you hear clicks. Keep holding for 5 seconds before removing the pen.

Store unopened pens in the fridge between 2 and 8 degrees. A pen in use may be kept at room temperature (up to 30 degrees) for 6 weeks, but it may also go back in the fridge.

Monitoring and dose adjustment

During treatment, weight, blood pressure, HbA1c (blood sugar), kidney function and liver values are checked regularly. At Go Leaner you have blood tests at the start and every six months thereafter, with interim consultations about progress.

If after 12 weeks on 2.4 mg you have achieved less than 5 percent weight loss, continuing is not worthwhile according to international guidelines. The doctor will then discuss alternatives such as tirzepatide (Mounjaro) or other interventions.

Tapering or stopping

Unlike many medicines, Wegovy does not require a strict tapering schedule. In principle you can stop without a gradual reduction. Research does show, however, that weight can return quickly after stopping (in studies up to two-thirds within one year), so stopping is a joint decision.

At Go Leaner, after successful weight loss we always discuss a maintenance strategy: continuing on a lower dose, a temporary pause with intensive coaching, or careful tapering with close follow-up. The choice depends on your personal situation.