Wegovy Maintenance Dose for a 36-Year-Old Female
The maintenance dose of Wegovy (semaglutide) for a 36-year-old female is 2.4 mg administered subcutaneously once weekly, reached after a 16-week dose escalation protocol. 1
Standard Dose Escalation Schedule
The FDA-approved titration schedule follows a specific pathway to minimize gastrointestinal side effects 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
Each dose level must be maintained for at least 4 weeks before advancing to minimize gastrointestinal adverse effects 1.
Alternative Maintenance Strategy
Some patients achieve adequate weight loss at submaximal doses (0.5 mg, 1.0 mg, or 1.7 mg) and can remain at that lower dose long-term rather than escalating to the full 2.4 mg 2, 1. This approach may reduce costs and side effects while maintaining therapeutic benefit 3.
Expected Weight Loss Outcomes
At the 2.4 mg maintenance dose, patients can expect 4, 5:
- Mean weight loss: 14.9-17.4% from baseline at 68 weeks 4, 5
- ≥10% weight loss: Achieved by 69-79% of patients 5
- ≥15% weight loss: Achieved by 51-64% of patients 5
- Long-term results: Mean weight loss of 20.4% at 24 months in real-world settings 6
Critical Requirements for Maintenance Therapy
Wegovy must be combined with lifestyle modifications 1:
- Caloric deficit of at least 500 kcal/day 1
- Minimum 150 minutes weekly of structured exercise 1
- Lifelong treatment is typically necessary, as discontinuation results in regain of one-half to two-thirds of lost weight within 1 year 3
Managing Missed Doses at Maintenance
- If 2 or fewer consecutive doses are missed: Resume at the same maintenance dose if previously well-tolerated 1
- If 3 or more consecutive doses are missed: Restart the entire titration schedule from 0.25 mg to minimize gastrointestinal adverse effects 1
Safety Considerations
Do not combine Wegovy with 1:
When using with insulin or sulfonylureas: Monitor closely for hypoglycemia and reduce doses of these medications as clinically indicated 1
Special Population Considerations
For this 36-year-old female patient 1, 7:
- No dosage adjustment required for renal impairment, including end-stage renal disease 1, 7
- No age-based adjustment needed 2
- The patient population in clinical trials was predominantly middle-aged females with Class II obesity, making this an appropriate demographic 8
Common Pitfalls to Avoid
- Do not advance doses faster than every 4 weeks, as this increases gastrointestinal side effects 1
- Do not discontinue treatment after achieving weight loss goals without understanding the high risk of weight regain 3
- Do not ignore the need for concurrent lifestyle modifications, as medication alone provides suboptimal results 1