From the Guidelines
For patients on Wegovy (semaglutide) 2 mg who have missed 3 weeks of doses, the recommended restart protocol is to restart the titration schedule. This approach is based on the expert opinion from the 2022 clinical practice guideline on pharmacological interventions for adults with obesity 1. The guideline suggests that if 3 or more consecutive doses are missed, restarting the titration schedule should be considered. This means that the patient should start again from the initial dose of 0.25 mg weekly for the first 4 weeks, followed by doses of 0.5 mg, 1.0 mg, and 1.7 mg weekly every 4 weeks at each dose, until the maintenance dose of 2.4 mg is reached after 16 weeks. Key considerations for this restart protocol include:
- Minimizing the risk of gastrointestinal adverse effects through gradual dose titration
- Clinical judgment for adjusting the titration schedule as needed for an individual patient’s response, tolerance, and adverse effects
- The importance of maintaining dietary and exercise routines during the restart period
- Advising patients to contact their healthcare provider if they experience severe gastrointestinal symptoms. Given the potential for diminished effects on slowing gastric emptying and reducing appetite during treatment gaps, and the risk of renewed nausea, vomiting, or diarrhea when restarting at the full dose, a gradual reintroduction is crucial 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Restarting Wegovy 2 mg After Missing Doses
If a patient on Wegovy (semaglutide) 2 mg misses 3 weeks of doses, the recommended restart protocol is not explicitly stated in the provided studies. However, here are some general considerations:
- The studies provided do not offer specific guidance on restarting Wegovy after missing doses 2, 3, 4, 5, 6.
- It is essential to consult the prescribing information or contact the healthcare provider for personalized advice on restarting the medication.
- The healthcare provider may consider the patient's individual circumstances, such as the length of time since the last dose and any changes in their medical condition, when determining the best course of action.
General Guidance on Missed Doses
Some general points to consider when missing doses of Wegovy:
- If a dose is missed, it should be taken as soon as possible within 5 days of the missed dose 2.
- If it has been more than 5 days since the missed dose, the patient should wait until the next scheduled dose 2.
- Patients should not take two doses at the same time to make up for a missed dose 2.
Importance of Consulting Healthcare Provider
It is crucial to consult the healthcare provider for specific guidance on restarting Wegovy after missing doses, as they can:
- Assess the patient's individual situation and provide personalized advice.
- Consider any potential interactions with other medications or changes in the patient's medical condition.
- Help the patient get back on track with their treatment plan.