What are the doses of Wegovy (semaglutide) for weight management?

From the Guidelines

Wegovy (semaglutide) for weight management should be initiated at a dose of 0.25 mg injected subcutaneously once weekly for the first 4 weeks, followed by gradual dose escalation to 0.5 mg, 1.0 mg, and 1.7 mg weekly every 4 weeks, until the maintenance dose of 2.4 mg is reached after 16 weeks. This dosing regimen is designed to minimize gastrointestinal side effects, which are the most common adverse effects associated with semaglutide, particularly during the dose escalation phase 1. The medication works by mimicking the hormone GLP-1, which helps regulate appetite and food intake by acting on receptors in the brain, leading to increased feelings of fullness, reduced hunger, and slower gastric emptying.

Key considerations for the dosing schedule include:

• Starting with a low dose of 0.25 mg weekly for the first 4 weeks to allow the body to adjust to the medication
• Gradually increasing the dose every 4 weeks to 0.5 mg, 1.0 mg, and 1.7 mg weekly, as tolerated
• Reaching the maintenance dose of 2.4 mg weekly after 16 weeks
• Administering the medication on the same day each week, with flexibility to change the day if needed, as long as the last dose was given at least 2 days prior

It is essential to note that the dose escalation schedule may need to be adjusted based on individual patient response, tolerance, and adverse effects, and clinical judgment should be used to determine the best approach for each patient 1. Additionally, if more than 2 consecutive doses are missed, clinical judgment is required to decide on subsequent dosing, and restarting the titration schedule may be necessary if 3 or more consecutive doses are missed 1. The use of semaglutide for weight management has been supported by recent guidelines, which suggest its effectiveness in reducing weight and improving cardiovascular risk factors, such as lipids and blood pressure 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Doses of Wegovy (Semaglutide) for Weight Management

The doses of Wegovy (semaglutide) for weight management are as follows:

• The FDA-approved dose of semaglutide for chronic weight management is 2.4 mg once weekly, administered via subcutaneous injection 2, 3, 4, 5, 6.
• This dose has been shown to achieve significant and sustained weight loss, as well as improvements in cardiometabolic risk factors, in adults with overweight or obesity 2, 4, 5, 6.

Efficacy of Semaglutide 2.4 mg

The efficacy of semaglutide 2.4 mg for weight management has been demonstrated in several clinical trials, including:

• The STEP 1 trial, which showed a mean weight loss of -14.9% with semaglutide 2.4 mg versus -2.4% with placebo from baseline to week 68 4.
• The STEP 2 trial, which showed a mean weight loss of -9.6% with semaglutide 2.4 mg versus -3.4% with placebo from baseline to week 68 6.
• The STEP 3 and 4 trials, which showed mean weight losses of -14.9% to -16.0% with semaglutide 2.4 mg versus 4.0% to 10.9% with other approved anti-obesity medications 5.

Safety and Tolerability

The safety and tolerability of semaglutide 2.4 mg for weight management have been evaluated in several clinical trials, with the most common adverse events being gastrointestinal events, such as nausea and diarrhea 2, 4, 5, 6. These events are typically transient, mild-to-moderate in severity, and resolve without permanent treatment discontinuation.