Wegovy (Semaglutide) Dosing and Administration for Weight Management
For weight management in adults, Wegovy (semaglutide) should be administered as a once-weekly subcutaneous injection with a gradual dose titration schedule starting at 0.25 mg and increasing to the maintenance dose of 2.4 mg over 16-20 weeks. 1, 2
Dosing Schedule for Wegovy
- Initial dose: 0.25 mg subcutaneously once weekly for 4 weeks 1, 3
- Week 5-8: 0.5 mg subcutaneously once weekly 1, 3
- Week 9-12: 1.0 mg subcutaneously once weekly 1, 3
- Week 13-16: 1.7 mg subcutaneously once weekly 1, 3
- Week 17 and beyond: 2.4 mg subcutaneously once weekly (maintenance dose) 1, 3
Administration Guidelines
- Administer as a subcutaneous injection in the abdomen, thigh, or upper arm 4
- Inject on the same day each week, but the time of day can be changed if needed 4
- If a dose is missed and it has been less than 5 days since the missed dose, administer as soon as possible; if more than 5 days have passed, skip the missed dose and administer the next dose on the regularly scheduled day 4
Efficacy and Treatment Duration
- Wegovy produces significant weight loss, with clinical trials showing 15-20% total body weight reduction at maintenance dose 2, 5
- Real-world data shows mean weight loss of 17.6% at 12 months and 20.4% at 24 months 5
- Treatment should be continued beyond reaching weight loss goals to maintain health benefits 1
- Discontinuation often results in weight regain and worsening of cardiometabolic risk factors 1
Monitoring and Evaluation
- If a patient has not lost at least 5% of baseline body weight after 12 weeks on the maintenance dose (2.4 mg), discontinue treatment as further therapy is unlikely to be effective 1
- Monitor for common side effects, particularly gastrointestinal symptoms such as nausea, vomiting, and diarrhea 1, 2
- Screen patients who have lost significant weight for malnutrition 1
Special Populations
- No dosage adjustment is required for patients with renal impairment, including those with end-stage renal disease 3, 4
- Use with caution in patients with severe hepatic impairment due to limited clinical experience 3
- No specific dose adjustment is needed based on age for elderly patients 3
- Approved for adolescents ≥12 years with obesity 6
Contraindications and Precautions
- Contraindicated during pregnancy and breastfeeding 1
- Use with caution in patients with personal or family history of medullary thyroid cancer or Multiple Endocrine Neoplasia syndrome type 2 1
- Monitor for pancreatitis, acute gallbladder disease, and suicidal ideation 1
Common Side Effects
- Nausea (most common), vomiting, diarrhea, constipation, and abdominal pain 1, 2
- Gastrointestinal side effects are typically transient, mild-to-moderate in severity, and diminish over time 2
- Gradual dose titration helps minimize gastrointestinal adverse effects 3
Wegovy represents a significant advancement in pharmacological weight management, offering substantial and sustained weight loss when used as prescribed in conjunction with lifestyle modifications 7, 8.