What is the recommended dosage and administration of Wegovy (semaglutide) for weight loss?

Recommended Dosage and Administration of Wegovy (Semaglutide) for Weight Loss

For weight loss management, Wegovy (semaglutide) requires a specific dose titration schedule starting at 0.25 mg subcutaneously once weekly and gradually increasing to the maintenance dose of 2.4 mg once weekly over 16 weeks. 1

Dose Titration Schedule

• Start with 0.25 mg subcutaneously once weekly for 4 weeks 1
• Increase to 0.5 mg once weekly for 4 weeks 1
• Increase to 1.0 mg once weekly for 4 weeks 1
• Increase to 1.7 mg once weekly for 4 weeks 1
• Maintain at 2.4 mg once weekly for ongoing treatment 1

Clinical Considerations for Dose Adjustment

• Gradual dose titration is essential to minimize gastrointestinal adverse effects, which are the most common side effects 2, 1
• If a patient misses 2 consecutive doses, clinical judgment is needed for subsequent dosing - consider resuming at the same dose if well-tolerated previously, or lowering the dose 2
• If 3 or more consecutive doses are missed, consider restarting the titration schedule from the beginning 2
• Some patients may achieve significant weight loss response at submaximal doses and could continue at that dose long-term 2

Administration Guidelines

• Wegovy can be administered at any time of day, with or without meals 1
• If a dose is missed and it has been less than 5 days, administer as soon as possible; if more than 5 days have passed, skip the missed dose 1
• Store in refrigerator (36°F to 46°F/2°C to 8°C); may be kept at room temperature for up to 28 days 1

Efficacy in Weight Management

• In clinical trials, semaglutide 2.4 mg once weekly resulted in significant weight loss compared to placebo (mean weight change of -14.9% vs -2.4%) 3
• Real-world data shows mean weight loss of approximately 17.6% at 12 months and 20.4% at 24 months with continued use 4
• Approximately 50% of patients achieve ≥20% weight loss with long-term treatment (24 months) 4

Safety Considerations

• Gastrointestinal adverse effects (nausea, vomiting, diarrhea, constipation) are common but typically transient and mild-to-moderate in severity 3
• Discontinuation rates due to gastrointestinal events are relatively low (4.5% in clinical trials) 3
• Wegovy should not be used concurrently with other GLP-1 receptor agonists or dipeptidyl peptidase-4 inhibitors 2
• Use caution when combining with insulin or insulin secretagogues due to potential hypoglycemia risk; dose adjustments of these medications may be needed 2
• No dosage adjustment is required for patients with renal impairment 1

Special Populations

• Wegovy has not been studied in pediatric patients 5
• Women of childbearing potential should use effective contraception when taking Wegovy due to potential risks 2
• Semaglutide has been associated with thyroid C-cell tumors in animal studies; the human relevance is unknown 5

Maintenance of Weight Loss

• Continued treatment with semaglutide is necessary for maintenance of weight loss; discontinuation results in weight regain (mean weight change +6.9% after switching to placebo) 6
• Long-term treatment shows sustained weight loss benefits up to 24 months in real-world settings 4