Wegovy Starting Dose
The starting dose of Wegovy (semaglutide) is 0.25 mg subcutaneously once weekly for 4 weeks. 1
Dose Escalation Schedule
After the initial 4-week period at 0.25 mg, Wegovy requires gradual dose titration with increases every 4 weeks until reaching the target maintenance dose 1:
- Weeks 1-4: 0.25 mg once weekly 1
- Weeks 5-8: 0.5 mg once weekly 1
- Weeks 9-12: 1.0 mg once weekly 1
- Weeks 13-16: 1.7 mg once weekly 1
- Week 17 onward: 2.4 mg once weekly (maintenance dose) 1
The full titration to the 2.4 mg maintenance dose takes 16 weeks to complete 1.
Rationale for Gradual Titration
The slow dose escalation is essential to minimize gastrointestinal adverse effects (nausea, vomiting, diarrhea, constipation), which are the most common side effects of semaglutide. 1 These GI symptoms are typically transient and mild-to-moderate in severity, and the gradual titration allows tolerance to develop 1.
Administration Details
- Wegovy is administered as a subcutaneous injection once weekly 1
- It can be given at any time of day, with or without meals 1
- The injection should be given on the same day each week 1
Missed Dose Management
If doses are missed, specific protocols apply 1:
- Less than 5 days since missed dose: Administer as soon as possible 1
- More than 5 days since missed dose: Skip the missed dose and resume at next scheduled time 1
- 2 consecutive doses missed: Use clinical judgment—consider resuming at same dose if previously well-tolerated, or lower the dose 1
- 3 or more consecutive doses missed: Consider restarting the entire titration schedule 1
Flexibility in Dosing
Some patients achieve significant weight loss at submaximal doses (below 2.4 mg) and can continue at that lower dose long-term rather than escalating further. 1 This individualized approach is appropriate when patients reach their weight loss goals or experience intolerable side effects at higher doses.
Important Contraindications
- Do not use Wegovy with other GLP-1 receptor agonists or DPP-4 inhibitors 1
- Use caution when combining with insulin or sulfonylureas due to hypoglycemia risk; dose adjustments of these medications may be needed 1
Note on Formulation
Wegovy is not available as a tablet—it is only available as a subcutaneous injection. The question asks about "Wegovy tablet," but this formulation does not exist. Semaglutide is available in oral tablet form under the brand name Rybelsus, but that is approved only for type 2 diabetes at different doses (not for weight management).