Semaglutide Dosage: Wegovy and Ozempic Schedules (2026)

Not dosing advice. This page reports doses that studies and approved labels used, with their sources. It does not recommend a dose, and we do not give mixing, injection or unit-conversion instructions. Gray-market vials often do not contain what their label says. How we report doses.

Every dose studied in people

Study	Who	People	Dose and route	What happened
SELECT (Lincoff 2023), randomized trial	Adults 45 or older with heart or blood-vessel disease and overweight or obesity, without diabetes	17,604	2.4 mg once a week Injection under the skin · Mean follow-up 39.8 months	Heart attack, stroke or cardiovascular death in 6.5% versus 8.0% on placebo; 16.6% versus 8.2% stopped because of side effects⁸.
evoke and evoke+ (Cummings 2026), two randomized trials	Adults aged 55 to 85 with early Alzheimer’s disease	3,808	Up to 14 mg once a day (flexible dose) Tablet by mouth · Up to 156 weeks; main result at week 104	No benefit: daily oral semaglutide did not slow decline on the main dementia rating scale over two years⁹.
FLOW (Perkovic 2024), randomized trial	Adults with type 2 diabetes and chronic kidney disease	3,533	1 mg once a week Injection under the skin · Median follow-up 3.4 years; stopped early after a planned interim analysis	The risk of kidney failure, kidney function falling by half or more, or death from kidney or heart causes was 24% lower than on placebo¹⁰.
STEP 1 (Wilding 2021), randomized trial	Adults with obesity, or overweight with a weight-related condition, without diabetes	1,961	2.4 mg once a week Injection under the skin · 68 weeks	Weight fell 14.9% versus 2.4% on placebo; digestive side effects led 4.5% versus 0.8% to stop¹¹.
STEP UP (Wharton 2025), randomized trial	Adults with obesity, without diabetes	1,407	7.2 mg or 2.4 mg once a week, versus placebo Injection under the skin · 72 weeks	Weight fell 18.7% on 7.2 mg and 15.6% on 2.4 mg, versus 3.9% on placebo; dysesthesia (unusual or unpleasant skin sensations) affected 22.9%, 6.0% and 0.5%¹².
STEP 2 (Davies 2021), randomized trial	Adults with overweight or obesity and type 2 diabetes	1,210	2.4 mg or 1 mg once a week, versus placebo Injection under the skin · 68 weeks	Weight fell 9.6% on 2.4 mg versus 3.4% on placebo; digestive side effects affected 63.5% on 2.4 mg, 57.5% on 1 mg and 34.3% on placebo³.
SUSTAIN FORTE (Frías 2021), randomized trial	Adults with type 2 diabetes not controlled on metformin, with or without a sulfonylurea	961	2 mg or 1 mg once a week Injection under the skin · 40 weeks	On treatment, HbA1c (a measure of average blood sugar) fell 2.2 percentage points on 2 mg versus 1.9 on 1 mg, and weight fell 6.9 kg versus 6.0 kg².
STEP 4 (Rubino 2021), randomized withdrawal trial	Adults with overweight or obesity, without diabetes, after a 20-week run-in on semaglutide	803	2.4 mg once a week, or a switch to placebo Injection under the skin · 20-week run-in, then 48 weeks	Weight fell a further 7.9% on semaglutide and rose 6.9% after the switch to placebo¹.
ESSENCE (Sanyal 2025), randomized trial, first analysis	Adults with MASH (fatty liver disease with inflammation) and moderate to advanced liver scarring	800	2.4 mg once a week Injection under the skin · 72 weeks (first analysis of a 240-week trial)	MASH resolved without worse scarring in 62.9% versus 34.3% on placebo, and scarring improved without worse MASH in 36.8% versus 22.4%¹³.
SURMOUNT-5 (Aronne 2025), open-label randomized trial	Adults with obesity, without type 2 diabetes	751	Highest tolerated dose, 1.7 or 2.4 mg once a week, versus tirzepatide 10 or 15 mg Injection under the skin · 72 weeks	Weight fell 13.7% on semaglutide versus 20.2% on tirzepatide¹⁴.
OASIS 4 (Wharton 2025), randomized trial	Adults with obesity, or overweight with a weight-related condition, without diabetes	307	25 mg once a day Tablet by mouth · 71 weeks; main result at week 64	Weight fell 13.6% versus 2.2% on placebo at week 64; digestive side effects affected 74.0% versus 42.2%¹⁵.

The approved schedule (Wegovy injection (FDA label))

The Wegovy label (version 19, effective 18 June 2026) uses one starting schedule for all its uses: lowering the risk of heart attack, stroke and cardiovascular death in adults with heart disease and obesity or overweight; weight reduction in adults and in children 12 and older; and MASH (fatty liver disease with inflammation) with moderate to advanced scarring in adults⁴. It raises the dose this way to reduce the risk of digestive side effects, and if a dose is not tolerated it says to consider delaying the next increase by 4 weeks⁴. FDA approved the 7.2 mg dose on 19 March 2026⁴⁵.

When	Dose on the label	Note
Weeks 1 to 4	0.25 mg once a week	Starting dose
Weeks 5 to 8	0.5 mg once a week
Weeks 9 to 12	1 mg once a week
Weeks 13 to 16	1.7 mg once a week
Week 17 onward	2.4 mg (recommended) or 1.7 mg once a week	Maintenance, chosen by response and tolerability; for MASH, 2.4 mg, lowered to 1.7 mg only if 2.4 mg is not tolerated
After at least 4 weeks on 2.4 mg	Up to 7.2 mg once a week (Wegovy HD)	Adults, weight reduction only, if 2.4 mg is tolerated and more weight loss is clinically indicated

Studies, animals and users: kept apart

Doses below are what studies used or what a label says. They are not advice, and gray-market products may not contain what their label says.

In human studies

Approved labels: Wegovy injection starts at 0.25 mg once weekly and rises every 4 weeks (0.5, 1, 1.7 mg) to a maintenance dose of 2.4 mg (recommended) or 1.7 mg. Adults who tolerate 2.4 mg for at least 4 weeks may go up to 7.2 mg weekly if more weight loss is needed. Wegovy tablets start at 1.5 mg daily and rise every 30 days (4 mg, 9 mg) to 25 mg daily⁴. Ozempic starts at 0.25 mg weekly for 4 weeks, then 0.5 mg, up to a maximum of 2 mg weekly¹⁷. Rybelsus starts at 3 mg daily for 30 days, then 7 mg, then 14 mg if needed¹⁸. Trial doses: 2.4 mg weekly in STEP 1, SELECT and ESSENCE; 7.2 mg weekly in STEP UP; 1 mg weekly in FLOW; 25 mg daily by mouth in OASIS 4; up to 14 mg daily by mouth in evoke and evoke+^891011121315.

In animal studies

Two-year cancer studies on the US label: mice received 0.3, 1 or 3 mg/kg/day (males) and 0.1, 0.3 or 1 mg/kg/day (females) under the skin; rats received 0.0025, 0.01, 0.025 or 0.1 mg/kg/day. Thyroid C-cell adenomas increased at every dose in both species, and C-cell carcinomas increased in male rats at 0.01 mg/kg/day and above⁴. In mini-pigs, plasma half-life after an intravenous dose was 46.1 hours¹⁹. These are animal doses, not human doses.

What users report Anecdotal · not validated · not a recommendation

“Microdosing” is described as 25% to 50% of the manufacturer’s recommended starting dose, or doses spaced further apart than the labeled schedule. A 2026 commentary says the practice gained traction during recent shortages through patient communities, telemedicine weight-loss programs and clinician anecdotes, and that high-quality evidence is essentially absent¹⁶.

Half-life and how it is taken

Half-life: About 1 week⁴Elimination half-life in adults with overweight or obesity (Wegovy label). Semaglutide stays in the blood for about 5 to 7 weeks after the last dose. Bioavailability is 89% by injection under the skin and about 1% to 2% by tablet.
Routes: Subcutaneous injection once weekly (approved as Ozempic and Wegovy; human trial data)
Oral tablet once daily (approved as Rybelsus, Ozempic tablets and Wegovy tablets; human trial data)
Unapproved “research” vials sold for injection (no quality control; no trials of these products found)

Wegovy tablets: the daily schedule

Wegovy tablets are approved for adults only, for weight reduction and for lowering heart risk⁴. The label starts at 1.5 mg once a day for 30 days, then 4 mg on days 31 to 60 and 9 mg on days 61 to 90, and sets a maintenance dose of 25 mg once a day from day 91⁴. As with the injection, the slow start is meant to reduce digestive side effects⁴.

The label says to take the tablet in the morning on an empty stomach with up to 4 ounces (about 120 mL) of water, and to wait at least 30 minutes before eating, drinking or taking other pills⁴. In studies, more semaglutide was absorbed with less water and a longer wait before eating⁴. At 25 mg a day, average steady blood levels (about 77 nmol/L) were close to those on the 2.4 mg weekly injection (about 75 nmol/L)⁴.

The label also sets how to switch: 25 mg tablets start 1 week after the last 2.4 mg injection, and the 2.4 mg injection starts the day after the last 25 mg tablet⁴. If 25 mg tablets are not tolerated, it says to consider the 1.7 mg weekly injection instead⁴.

Why the dose goes up slowly

The label says the dose goes up in steps to reduce the risk of digestive side effects⁴. In the adult weight-loss trials, 73% of people on Wegovy injection reported digestive side effects versus 47% on placebo, and 4.3% versus 0.7% stopped treatment because of them⁴.

Not everyone reaches the top dose⁴. In SELECT, people who could not tolerate the increases could stay on a lower dose; of those still on treatment after 1 year, 76% were on 2.4 mg, 8% on 1.7 mg and 16% on lower doses⁴.

Side effects also rise with the dose¹². In STEP UP, digestive side effects affected 70.8% of people on 7.2 mg, 61.2% on 2.4 mg and 42.8% on placebo¹².

What happens if you miss a dose (per the label)

For the weekly injection, the Wegovy label says to take a missed dose as soon as possible if the next dose is more than 2 days (48 hours) away, and to skip it if the next dose is less than 2 days away⁴. If 2 or more doses in a row are missed, it says to restart the dose increases at a lower dose, to reduce the risk of digestive side effects⁴. A missed tablet is skipped, and the next one is taken the following day⁴.

The Ozempic label differs: a missed dose can be taken within 5 days, and after that it is skipped¹⁷. The weekly dose day can be changed as long as doses are at least 2 days (48 hours) apart¹⁷.

The Ozempic schedule for type 2 diabetes

Ozempic is semaglutide approved for type 2 diabetes in adults¹⁷. In those with heart disease, it is also approved to lower the risk of heart attack, stroke and cardiovascular death; in those with chronic kidney disease, the risk of lasting kidney decline, kidney failure and cardiovascular death¹⁷. Its label (version 20, effective 1 June 2026) starts at 0.25 mg once a week for 4 weeks, then 0.5 mg¹⁷. If more blood-sugar control is needed, the dose can go to 1 mg and then 2 mg, each after at least 4 weeks on the previous dose; 2 mg is the maximum¹⁷.

For chronic kidney disease, the label sets 1 mg once a week after at least 4 weeks on 0.5 mg, the dose used in FLOW¹⁰¹⁷. In SUSTAIN FORTE, 2 mg lowered HbA1c 0.23 percentage points more than 1 mg over 40 weeks, assuming everyone stayed on treatment without rescue medication². Counting everyone, including those who stopped or needed rescue medication, the difference was 0.18 points².

Why gray-market vials make doses unreliable

Every dose on this page comes from approved products and their trials⁴¹⁷. FDA calls unapproved semaglutide sold online products of unknown quality, and warns that counterfeit Ozempic may contain the wrong ingredients, or too little, too much or none of the active ingredient²⁰. As of 30 September 2026, 74 of Finnrick’s latest 196 completed semaglutide tests failed (37.8%)⁷.

Dosing mistakes are documented with compounded semaglutide and with GLP-1 drugs in general²⁰²¹. FDA has received reports of adverse events, some needing hospital care, that may be linked to dosing errors with compounded semaglutide, by patients measuring their own doses or by clinicians miscalculating them²⁰. A UT San Antonio study found that US poison-center calls about GLP-1 drugs rose from about 1,000 to 1,500 a year before 2021 to more than 8,000 in 2023, mostly from unintentional dosing or therapeutic errors²¹.

Some products hold a different drug²². Two people described in a Dutch medical journal fell into a coma with severe low blood sugar after injecting “semaglutide” bought without a prescription that contained insulin²². In a 2024 study, all 3 vials bought online held bacterial toxin, one at a raised level²³²⁴.

Questions people ask

How much semaglutide should I take?

For the approved medicine, the Wegovy label starts injections at 0.25 mg once a week and reaches a maintenance dose of 2.4 mg (recommended) or 1.7 mg from week 17⁴. For type 2 diabetes, the Ozempic label sets 0.5, 1 or 2 mg once a week¹⁷. Ask your prescriber which dose, if any, fits you.

What is the highest approved dose of semaglutide?

For injections, 7.2 mg once a week (Wegovy HD), for adults who have tolerated 2.4 mg for at least 4 weeks and need more weight loss; FDA approved it on 19 March 2026⁴⁵. The Ozempic maximum for type 2 diabetes is 2 mg once a week¹⁷. Wegovy tablets go up to 25 mg a day, a larger number because little of a tablet is absorbed: 25 mg a day gives blood levels close to those of the 2.4 mg weekly injection⁴.

Is there a semaglutide pill for weight loss?

Yes: FDA approved Wegovy tablets on 22 December 2025 for weight reduction and for lowering heart risk in adults⁴⁵⁶. The dose rises from 1.5 mg once a day to 25 mg once a day from day 91⁴. In OASIS 4, 25 mg a day cut weight by 13.6% at 64 weeks, versus 2.2% on placebo¹⁵.

How long does it take to reach the full dose of semaglutide?

On the Wegovy injection schedule, 16 weeks: the dose rises every 4 weeks and reaches the maintenance dose in week 17⁴. It can take longer, because the label allows a step to be delayed by 4 weeks if a dose is not tolerated, and 7.2 mg needs at least 4 more weeks on 2.4 mg⁴. Wegovy tablets reach 25 mg on day 91⁴.

What happens when you stop taking semaglutide?

In STEP 4, people switched to placebo after 20 weeks on semaglutide saw their weight rise 6.9% over the next 48 weeks, while those who stayed on it lost a further 7.9%¹. Semaglutide stays in the blood for about 5 to 7 weeks after the last dose⁴.

Go deeper

Sources

1Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial JAMA, 13 Apr 2021. pubmed.ncbi.nlm.nih.gov
2Efficacy and safety of once-weekly semaglutide 2·0 mg versus 1·0 mg in patients with type 2 diabetes (SUSTAIN FORTE): a double-blind, randomised, phase 3B trial The Lancet Diabetes & Endocrinology, Sep 2021. pubmed.ncbi.nlm.nih.gov
3Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial The Lancet, 13 Mar 2021. pubmed.ncbi.nlm.nih.gov
4WEGOVY (semaglutide) injection and tablets: prescribing information (SPL version 19) Novo Nordisk via DailyMed (U.S. National Library of Medicine), 30 Jun 2026. dailymed.nlm.nih.gov
5Drugs@FDA: applications containing semaglutide (NDA 209637, 213051, 213182, 215256, 218316; ANDA 220314) U.S. Food and Drug Administration (openFDA), 29 Sep 2026. api.fda.gov · data query
6FDA approves Novo Nordisk’s Wegovy pill, the first and only oral GLP-1 for weight loss in adults Novo Nordisk (PR Newswire), 22 Dec 2025. prnewswire.com
7Semaglutide: public lab test results (Finnrick product page) Finnrick, 29 Sep 2026. finnrick.com
8Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes New England Journal of Medicine, 2023. pubmed.ncbi.nlm.nih.gov
9Efficacy and safety of oral semaglutide 14 mg (flexible dose) in early-stage symptomatic Alzheimer’s disease (evoke and evoke+): two phase 3, randomised, placebo-controlled trials The Lancet, 2026. pubmed.ncbi.nlm.nih.gov
10Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes New England Journal of Medicine, 2024. pubmed.ncbi.nlm.nih.gov
11Once-Weekly Semaglutide in Adults with Overweight or Obesity New England Journal of Medicine, 2021. pubmed.ncbi.nlm.nih.gov
12Once-weekly semaglutide 7.2 mg in adults with obesity (STEP UP): a randomised, controlled, phase 3b trial The Lancet Diabetes & Endocrinology, Nov 2025. pubmed.ncbi.nlm.nih.gov
13Phase 3 Trial of Semaglutide in Metabolic Dysfunction-Associated Steatohepatitis New England Journal of Medicine, 2025. pubmed.ncbi.nlm.nih.gov
14Tirzepatide as Compared with Semaglutide for the Treatment of Obesity New England Journal of Medicine, 3 Jul 2025. pubmed.ncbi.nlm.nih.gov
15Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity New England Journal of Medicine, 2025. pubmed.ncbi.nlm.nih.gov
16Considerations and challenges in microdosing of GLP-1-based receptor agonists Expert Opinion on Pharmacotherapy, 5 Oct 2026. pubmed.ncbi.nlm.nih.gov
17OZEMPIC (semaglutide) injection: prescribing information (SPL version 20) Novo Nordisk via DailyMed (U.S. National Library of Medicine), 10 Jun 2026. dailymed.nlm.nih.gov
18RYBELSUS and OZEMPIC (semaglutide) tablets: prescribing information (SPL version 14) Novo Nordisk via DailyMed (U.S. National Library of Medicine), 19 Aug 2026. dailymed.nlm.nih.gov
19Discovery of the Once-Weekly Glucagon-Like Peptide-1 (GLP-1) Analogue Semaglutide Journal of Medicinal Chemistry, 2015. pubmed.ncbi.nlm.nih.gov
20FDA’s Concerns with Unapproved GLP-1 Drugs Used for Weight Loss U.S. Food and Drug Administration, 1 Oct 2026. fda.gov
21UT San Antonio study: As FDA approved semaglutide for weight management, calls to poison control centers skyrocketed in the U.S. UT San Antonio, 17 Jun 2026. news.utsa.edu
22[Insulin intoxications caused by falsified semaglutide] Nederlands Tijdschrift voor Geneeskunde, 29 Jun 2026. pubmed.ncbi.nlm.nih.gov
23Multifactor Quality and Safety Analysis of Semaglutide Products Sold by Online Sellers Without a Prescription: Market Surveillance, Content Analysis, and Product Purchase Evaluation Study Journal of Medical Internet Research, 2024. pubmed.ncbi.nlm.nih.gov
24Safety and Risk Assessment of No-Prescription Online Semaglutide Purchases JAMA Network Open, 1 Aug 2024. pubmed.ncbi.nlm.nih.gov

Not medical advice. Talk to a licensed clinician before using any drug. Report an error.