Wegovy (semaglutide) is taken once weekly, but you do not start at the full dose. Most people follow a step‑up schedule (titration) that slowly increases the dose over several months. The point of titration is simple: reduce side effects while your body adjusts. This guide explains the standard dose schedule, what the maintenance dose means, what happens if you miss a dose, and how clinicians usually handle strong side effects during dose increases.

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Table of Contents

Quick answer: the standard Wegovy titration schedule

The standard Wegovy schedule increases the dose about every 4 weeks: 0.25 mg → 0.5 mg → 1.0 mg → 1.7 mg → 2.4 mg. Your clinician may slow this down if side effects are difficult.

Wegovy dose escalation table (once weekly)

Phase	Dose (mg)	Typical duration	Purpose
Start	0.25 mg weekly	4 weeks	Body adjustment; side‑effect minimisation
Step 2	0.5 mg weekly	4 weeks	Continue adjustment; appetite effect often strengthens
Step 3	1.0 mg weekly	4 weeks	Further clinical effect; monitor GI tolerance
Step 4	1.7 mg weekly	4 weeks	Approach maintenance; side effects can flare again
Maintenance	2.4 mg weekly	Ongoing (if tolerated)	Target maintenance dose for many patients

Why Wegovy titration exists (the logic behind the schedule)

Wegovy often causes gastrointestinal side effects especially nausea, constipation, diarrhoea, reflux, and sometimes vomiting. These are most common when you first start or when the dose increases. Titration gives your body time to adapt while still moving you toward an effective maintenance dose.

What is the ‘maintenance dose’ on Wegovy?

A maintenance dose is the ongoing dose used after the step‑up phases. For many people, the target maintenance dose is 2.4 mg once weekly. However, not everyone reaches (or stays on) 2.4 mg. Some people remain on a lower dose because it still works for them or because side effects limit escalation. Your prescriber decides the safest effective dose for you.

How fast does the dose increase?

The usual pattern is a dose increase every 4 weeks. That doesn’t mean you must increase exactly on schedule. Clinicians often adapt the timeline if you have strong nausea, repeated vomiting, dehydration, or other problems.

If side effects are strong: what clinicians typically do

If side effects are difficult, prescribers generally consider a few safe options rather than forcing escalation. Exact decisions depend on your health history, how severe symptoms are, and how you are responding.

Common clinician-led options

Option 1: Stay on the current dose longer

Many people improve after an extra couple of weeks on the same dose. Extending the phase can improve tolerability.

Option 2: Delay the next increase until symptoms settle

If symptoms flare after an increase, clinicians may delay the next increase rather than stepping up again.

Option 3: Reduce to the previously tolerated dose (clinician decision)

If symptoms are severe, a clinician may temporarily step back to a lower dose.

Option 4: Treat side effects with targeted strategies

Diet changes, hydration routines, and symptom-focused tips can reduce nausea and constipation.

If you have persistent vomiting or can’t keep fluids down, treat that as urgent and contact a clinician. Dehydration can become serious.

Missed dose rules (simple and practical)

Because Wegovy is weekly, missed doses are common. The key questions are: how many days have passed, and how many doses have you missed in a row? Product information includes rules for missed doses, but your prescriber may tailor advice if you are in the middle of titration.

Missed one dose: the common rule pattern

If you miss a dose, the usual advice is to take it as soon as possible within a limited time window, then continue with your next dose on your normal day. If too much time has passed, you skip the missed dose and take the next dose on the regularly scheduled day. Always confirm the exact missed-dose rule in your patient leaflet and follow your prescriber’s advice especially during titration.

Missed multiple doses: why it matters

If you miss several weeks, your tolerance may decrease. Some people need to restart at a lower dose to reduce side effects. This is especially important if you previously had strong nausea or vomiting at higher doses.

Dose day tips (what actually prevents mistakes)

Practical habits that reduce missed doses and side effects:

Keep the same injection day each week.
Choose a day you can rest if you tend to feel nauseous after dosing.
Plan meals around the injection day: smaller portions, slower eating, and hydration.
Use a reminder on your phone or calendar.

Do you lose weight at the lower doses?

Some people notice appetite reduction and weight loss even on 0.25 mg or 0.5 mg, but results vary. Lower doses are primarily for tolerability and adaptation. Weight loss often becomes more noticeable as doses increase, but the best dose is the highest dose you can tolerate safely under clinician guidance.

FAQs

What is the starting dose of Wegovy?

The standard starting dose is 0.25 mg once weekly, usually for 4 weeks, before stepping up.

What is the maximum dose of Wegovy?

The commonly used target maintenance dose is 2.4 mg once weekly, if tolerated. Some people remain on lower doses based on clinician guidance.

How long do you stay on each dose?

Typically about 4 weeks per step, but clinicians may extend phases if side effects are difficult.

What if I can’t tolerate the dose increase?

Clinicians may keep you on the same dose longer, delay the increase, or adjust the plan. Do not change doses without medical advice.

Can I change my injection day?

Many people can, but there are spacing rules to keep weekly dosing safe and consistent. Check your patient leaflet and follow clinician advice.

Does everyone reach 2.4mg or 7.2 mg?

No. Some people stop earlier due to side effects or remain on a lower dose if it is effective and better tolerated.