What is the next dosage of Ozempic (semaglutide) after starting at 0.5 mg?

Ozempic Dosage Titration After 0.5 mg

After starting Ozempic at 0.5 mg weekly, the next dosage is 1.0 mg once weekly, which should be initiated after at least 4 weeks on the 0.5 mg dose if additional glycemic control is needed. 1

Dosing Schedule for Ozempic (Semaglutide)

The FDA-approved dosing regimen for Ozempic follows a specific titration schedule:

1. Initial dose: 0.25 mg subcutaneously once weekly for 4 weeks

   • This starting dose is intended for treatment initiation and is not effective for glycemic control

2. First titration: Increase to 0.5 mg once weekly after the initial 4 weeks

3. Second titration: If additional glycemic control is needed after at least 4 weeks on the 0.5 mg dose, increase to 1.0 mg once weekly 1

4. Maximum recommended dose: 1.0 mg once weekly 1

Administration Guidelines

• Administer Ozempic on the same day each week, at any time of day, with or without meals 1
• Injection sites include abdomen, thigh, or upper arm; rotate injection sites within the same body region each week 1
• If a dose is missed, administer as soon as possible within 5 days; if more than 5 days have passed, skip the missed dose and resume the regular schedule 1

Clinical Considerations

• The gradual dose escalation is designed to minimize gastrointestinal adverse effects, which are the most common side effects 2
• Nausea is the most frequently reported adverse event with semaglutide, affecting approximately 21-22% of patients 3
• Patients should be monitored for glycemic control, gastrointestinal symptoms, body weight, and blood pressure during titration 2

Special Populations

• No dose adjustment is required for patients with eGFR > 30 mL/min/1.73m² 2
• For patients with eGFR < 30 mL/min/1.73m², use with caution and consider slower titration 2

Common Pitfalls to Avoid

• Premature dose escalation: Ensure patients complete at least 4 weeks on each dose before titrating up 1
• Inadequate management of side effects: If significant gastrointestinal symptoms occur, patients may need to maintain the current dose longer than recommended before attempting further titration 2
• Mixing with insulin: When using Ozempic with insulin, administer as separate injections and never mix the products 1

By following this structured titration approach, patients are more likely to achieve optimal glycemic control while minimizing adverse effects.