What are the dose forms and administration guidelines for Wegovy (semaglutide)?

Wegovy (Semaglutide) Dose Forms and Administration Guidelines

Wegovy (semaglutide) is available as a subcutaneous injection in a prefilled, single-patient-use, dial-a-dose pen that requires a specific dose escalation schedule to minimize gastrointestinal side effects.

Dose Forms and Strengths

Wegovy is administered as a once-weekly subcutaneous injection with the following dose progression:

Week	Dose
1-4	0.25 mg
5-8	0.5 mg
9-12	1.0 mg
13-16	1.7 mg
17 onward	2.4 mg (maintenance dose)

1

Administration Guidelines

Dose Titration

• Start with 0.25 mg weekly for the first 4 weeks
• Increase to 0.5 mg weekly for weeks 5-8
• Increase to 1.0 mg weekly for weeks 9-12
• Increase to 1.7 mg weekly for weeks 13-16
• Reach maintenance dose of 2.4 mg weekly from week 17 onward 1, 2

Injection Procedure

1. Wash hands with soap and water
2. Check that the medication is clear and colorless
3. Attach a new needle to the pen immediately before injection
4. For first-time use of a new pen, check the flow by turning the dose selector to the flow check symbol
5. Select the appropriate dose
6. Insert the needle and press the dose button until the counter shows 0
7. Hold the needle under the skin for at least 6 seconds
8. Remove and dispose of the needle after each injection 3

Storage Requirements

• Unused pens: Refrigerate between 36°F to 46°F (2°C to 8°C)
• Pen in use: Can be stored at room temperature between 59°F to 86°F (15°C to 30°C) or refrigerated between 36°F to 46°F (2°C to 8°C) for up to 56 days
• Do not freeze Wegovy
• Keep away from heat and light
• Always keep the pen cap on when not in use 3

Clinical Considerations

Missed Doses

• If a dose is missed and the next scheduled dose is more than 2 days away (48 hours), take the missed dose as soon as possible
• If more than 2 consecutive doses are missed, clinical judgment is required:
  • For patients who tolerated the medication well, resuming at the same dose may be considered
  • Otherwise, consider lowering the next dose
  • If 3 or more consecutive doses are missed, consider restarting the titration schedule 1, 2

Gastrointestinal Side Effects Management

• Gradual dose titration is essential to minimize GI adverse effects
• Most common side effects include nausea, vomiting, and diarrhea, which are typically transient and mild-to-moderate in severity
• These side effects generally subside with time as the body adjusts to the medication 1, 4

Special Precautions

• Do not use with other GLP-1 receptor agonists or DPP-4 inhibitors
• Use caution when combining with insulin or insulin secretagogues (e.g., sulfonylureas) due to hypoglycemia risk
• May delay gastric emptying, potentially affecting absorption of oral medications requiring rapid onset of action
• Contraindicated during pregnancy and breastfeeding
• Contraindicated in patients with personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 1, 2

Efficacy and Outcomes

Clinical trials have demonstrated that semaglutide 2.4 mg once weekly is associated with significant weight reduction compared to placebo:

• Mean weight loss of 14.9% from baseline after 68 weeks (vs. 2.4% with placebo)
• 86.4% of participants achieved ≥5% weight reduction
• 69.1% achieved ≥10% weight reduction
• 50.5% achieved ≥15% weight reduction 4

Real-World Considerations

• Nearly half (46%) of patients discontinue treatment within the first 5 months
• Higher copayment amounts are strongly associated with discontinuation rates
• Lower household income and education levels are also associated with higher discontinuation rates 5

Remember that proper administration technique and adherence to the dose escalation schedule are critical for maximizing efficacy while minimizing adverse effects of Wegovy.