Wegovy Dosing After 0.5 mg
After completing 4 weeks on Wegovy 0.5 mg, increase to 1.0 mg once weekly for the next 4 weeks, then continue escalating every 4 weeks through 1.7 mg to reach the maintenance dose of 2.4 mg once weekly. 1
Standard Titration Schedule
The FDA-approved escalation protocol for Wegovy follows a specific monthly progression 1:
- Week 0-4: 0.25 mg once weekly (starting dose)
- Week 5-8: 0.5 mg once weekly (your current dose)
- Week 9-12: 1.0 mg once weekly (your next dose)
- Week 13-16: 1.7 mg once weekly
- Week 17 onward: 2.4 mg once weekly (maintenance dose)
Each dose level should be maintained for at least 4 weeks before advancing to allow gastrointestinal tolerance and to minimize nausea and vomiting, which occur in 44% and 25% of patients respectively at maximum doses. 1
Administration Details
- Administer subcutaneously once weekly at any time of day, without regard to meals, in the abdomen, thigh, or upper arm 1, 2
- If you miss a dose, take it within 5 days of the missed dose; if more than 5 days have passed, skip that dose and resume your regular schedule 2
- If you miss 3 or more consecutive doses, consider restarting the entire titration schedule from 0.25 mg to minimize gastrointestinal side effects 3
Managing Side Effects During Escalation
The gradual titration is specifically designed to reduce gastrointestinal adverse events 1:
- Monitor for nausea (44%), diarrhea (32%), vomiting (25%), and constipation (23%) at each dose level 1
- If gastrointestinal symptoms are severe, maintain your current dose for an additional 4 weeks before advancing rather than pushing through to the next level 1
- Most GI side effects are mild-to-moderate and transient, typically resolving with continued treatment 3
Required Lifestyle Modifications
Wegovy must be combined with specific lifestyle interventions for optimal efficacy 1:
- Implement a caloric deficit of at least 500 kcal/day below your total energy requirements 1
- Engage in minimum 150 minutes weekly of structured physical activity 1
- Participate in ongoing behavioral counseling for dietary changes 1
Monitoring During Titration
- Evaluate body weight every 4 weeks during dose escalation 1
- If you have concomitant type 2 diabetes, monitor blood glucose more closely during each dose adjustment due to increased hypoglycemia risk 1
- Assess gastrointestinal symptoms at each visit to guide titration pace 1
Expected Weight Loss Outcomes
At the 2.4 mg maintenance dose, expect mean weight loss of 14.9% from baseline at 68 weeks, with 69% of patients achieving ≥10% weight loss and 51% achieving ≥15% weight loss. 4, 5