Semaglutide dosage chart: weekly shot and daily pill schedules, step by step

Safety info: Compounded semaglutide is not FDA-approved, and FDA has not evaluated it for safety, effectiveness or quality. It may cause serious side effects, including possible thyroid tumors and pancreatitis. Do not use if you or your family have a history of MTC or MEN 2. Full safety information

Semaglutide starts at a low dose and goes up in steps. The slow start gives your stomach time to adjust, because nausea and other digestive side effects are most common right after a dose increase.

Below are the schedules from the FDA-approved labels for the weekly injection and the daily pill, followed by the rules for missed doses and a plain explanation of how mg, mL and syringe units work if you use compounded semaglutide from a vial. Your own schedule is set by your clinician and can be slower than the chart.

Weekly injection: the standard schedule

This is the dose escalation on the FDA label for semaglutide injection for weight management (Wegovy, label revised March 2026). Each step lasts four weeks.

Weeks	Weekly dose	What’s going on
1 to 4	0.25 mg	Starting dose. It’s mainly there to let your body adjust.
5 to 8	0.5 mg	First increase. Digestive side effects often show up around dose changes.
9 to 12	1 mg	Second increase.
13 to 16	1.7 mg	Third increase. 1.7 mg can also be a long-term dose.
17 onward	2.4 mg (or 1.7 mg)	Maintenance dose. The label lists 2.4 mg as recommended and 1.7 mg as an option.

If a dose isn’t tolerated during escalation, the label says your clinician can consider delaying the next increase by four weeks. Staying on a step longer is common and isn’t a setback.

The 7.2 mg dose

In March 2026, FDA approved a higher 7.2 mg weekly dose for adults with obesity, or overweight plus at least one weight-related condition. Per the label, it’s an option only after you’ve tolerated 2.4 mg for at least four weeks and your clinician decides more weight reduction is clinically indicated. It isn’t a step everyone takes.

Daily pill: the standard schedule

FDA has also approved semaglutide as a once-daily tablet for weight management (Wegovy tablets). Each step lasts about a month.

Days	Daily dose
1 to 30	1.5 mg
31 to 60	4 mg
61 to 90	9 mg
91 onward	25 mg (maintenance)

How you take the pill matters, because food and drink get in the way of absorption. The label says to take it in the morning on an empty stomach with up to 4 ounces of plain water, swallow it whole, and wait at least 30 minutes before eating, drinking anything else or taking other pills.

Semaglutide for type 2 diabetes

Ozempic, the weekly semaglutide injection for type 2 diabetes, uses a shorter schedule on its label (revised May 2026): 0.25 mg for four weeks, then 0.5 mg. If more blood sugar control is needed, the dose can go to 1 mg after at least four weeks, then to 2 mg after at least four more. It’s a different product with a different purpose, so don’t use one chart for the other.

Missed doses

Product	What the label says
Weekly injection for weight management	If your next dose is more than 2 days away, take the missed dose as soon as you can. If it’s less than 2 days away, skip it and take your next dose on your usual day. If you miss 2 or more doses in a row, your clinician may restart you at a lower dose.
Daily pill for weight management	Skip the missed dose and take your next one the following day.
Weekly injection for type 2 diabetes	Take the missed dose within 5 days. After that, skip it.

Never take two doses to catch up. If you’ve been off semaglutide for a couple of weeks or more, check with your clinician before your next dose, because going straight back to a high dose can bring the side effects back hard.

Compounded semaglutide: mg, mL and units

Compounded semaglutide usually comes in a multi-dose vial, and you draw each dose with a syringe. Your prescription gives the dose in milligrams (mg). The syringe is marked in units. How many units equal your dose depends on the vial’s concentration, which is printed on the label in mg per mL and can differ from one pharmacy to another.

Here’s why that matters. The table shows the same 0.25 mg dose drawn from two vials with different concentrations, using a standard U-100 syringe, where 100 units equals 1 mL.

Vial concentration	0.25 mg dose in mL	On a U-100 syringe
2.5 mg per mL	0.1 mL	10 units
5 mg per mL	0.05 mL	5 units

This example only shows the math. Follow the label on your vial and your prescriber’s directions.

Mix-ups between these numbers are behind many of the errors FDA has reported with compounded semaglutide. In a July 2024 alert it described patients who injected 5 to 20 times their intended dose, and some of them needed hospital care. Before your first dose, and every time your dose or your vial changes, confirm three things with your clinician or pharmacist:

1. Your dose in mg.
2. The concentration on your vial, in mg per mL.
3. How many units on your syringe that equals.

Use the syringes that come with your prescription, and don’t switch vials or pharmacies without a new set of instructions. Our guide to compounded semaglutide covers what else to ask before you start, including which form of semaglutide the pharmacy uses.

When to contact your clinician

Mild nausea, a smaller appetite and changes in your bowel habits are common, especially in the first days after an increase. Contact your care team promptly, or get urgent care, if you have:

• Severe stomach pain that doesn’t go away, with or without vomiting, which can be a sign of pancreatitis
• Vomiting or diarrhea that keeps you from holding down fluids, or signs of dehydration such as dizziness or very little urine
• Pain in your upper right belly, fever, yellowing skin or eyes, or clay-colored stools, which can point to a gallbladder problem
• A lump or swelling in your neck, trouble swallowing or a hoarse voice that doesn’t go away
• Swelling of your face, lips or throat, or trouble breathing
• New or worsening depression or thoughts of self-harm

Our GLP-1 side effects guide goes through the common ones and what helps.

How dosing works at Elara

If you’re prescribed medication through Elara, your clinician sets your starting dose and decides when, or whether, to increase it, based on how you’re doing. You can message your care team between check-ins during business hours, and your certified health coach helps with eating and habits around each change. Quarterly metabolic labs at Quest or Labcorp, timed by your clinician, give them more to go on.

Your price doesn’t change when your dose does. Compounded semaglutide injection is $249 every 4 weeks, or $179 every 4 weeks on the 52-week plan. See the pricing page for every plan, or start a free assessment to have a clinician review your history.

Frequently asked questions

How long does it take to reach the full dose?

On the label schedule for the weekly injection, you reach the 2.4 mg maintenance dose at week 17. On the pill schedule, you reach 25 mg on day 91. Many people take longer because their clinician pauses an increase.

Can I stay on a lower dose?

Yes, if you and your clinician decide it’s right for you. For weight management, the injection label lists 1.7 mg as a maintenance option alongside 2.4 mg.

What’s the highest dose of semaglutide?

For the weight-management injection, 7.2 mg weekly, and only after at least four weeks at 2.4 mg. For the weight-management pill, 25 mg daily. For the diabetes injection, 2 mg weekly.

Is a compounded semaglutide dose the same as a brand-name dose?

The dose is written in mg either way, but compounded semaglutide is not FDA-approved and isn’t the same product. Concentration and inactive ingredients can differ, so the volume you inject can differ too. Always go by your own label and instructions.

Sources

• FDA: Wegovy prescribing information (revised March 2026)
• FDA: Ozempic prescribing information (revised May 2026)
• FDA: Dosing errors associated with compounded injectable semaglutide (July 26, 2024)
• FDA: Concerns with unapproved GLP-1 drugs used for weight loss

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Important safety information

Compounded semaglutide and tirzepatide are not FDA-approved, and FDA has not evaluated them for safety, effectiveness or quality. They are not the same as FDA-approved brand-name products. GLP-1 medicines may cause serious side effects, including possible thyroid tumors and pancreatitis. Do not use if you or your family have a history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2). Full safety information: elarahealthandwellness.com/trust.

This is general education. Your clinician sets your dose and schedule. Last updated October 9, 2026.