Dosing & Usage

Wegovy Dosing Guide

Learn the Wegovy dosing schedule in the UK, including the starting dose, weekly increases, and how dose escalation works over time.

Whether you are about to start Wegovy or trying to plan dose changes, this guide explains the licensed 16-week dose-escalation schedule, why doses are stepped up gradually, and what to expect at each stage. LetsLoseWeight is an independent comparison site; we do not prescribe medication, and the right dose for you is a decision for your prescriber based on your individual circumstances.

The Wegovy dose ladder

Wegovy (semaglutide 2.4mg) is given as a once-weekly subcutaneous injection. UK pre-filled pens are available at five dose strengths:

  • 0.25mg — starter dose
  • 0.5mg — second titration step
  • 1mg — third titration step
  • 1.7mg — fourth titration step
  • 2.4mg — maintenance dose

The licensed approach is a 16-week dose escalation to reach the 2.4mg maintenance dose, with each step lasting 4 weeks (Wegovy SmPC, EMC).

Why doses are stepped up gradually

The slow titration is to reduce the risk of gastrointestinal side effects — nausea, diarrhoea, vomiting, constipation, and reduced appetite — which are most common when starting or stepping up the dose. By increasing in small increments at 4-week intervals, the body has time to adjust before more medication is added.

Skipping ahead in the schedule, or starting above 0.25mg, significantly increases the risk of severe side effects. The regulated UK supply chain will not dispense doses outside the licensed schedule.

The standard 16-week Wegovy schedule

Week Dose Notes
1–4 0.25mg weekly Starter dose. Allows the body to acclimatise. Not a maintenance dose.
5–8 0.5mg weekly Second step. Most patients are still building tolerance here.
9–12 1mg weekly Third step.
13–16 1.7mg weekly Fourth step.
17+ 2.4mg weekly Licensed maintenance dose.

The decision to step up at each interval is taken by the prescriber based on tolerability and clinical response. The full 2.4mg dose is the licensed maintenance level — it is the dose at which Wegovy was studied for weight management in the STEP 1 trial (Wilding et al., NEJM 2021).

What if a step is not tolerated?

If side effects are too severe at any step, the licensed advice is:

  • Stay at the current dose for an additional 4 weeks before considering the next step-up.
  • Drop back to the previous step if symptoms remain severe.
  • If the maintenance dose of 2.4mg is not tolerated, the dose can be reduced to 1.7mg as a long-term maintenance dose, although weight-loss efficacy will be slightly lower than at 2.4mg.

This flexibility is built into the licence specifically because tolerance varies between patients. A slower-than-standard titration is normal and not a sign of failed treatment.

For practical strategies to reduce side effects, see our reduce side effects guide.

Missed doses

The handling of a missed Wegovy dose depends on how late it is:

  • Less than 48 hours late — take the missed dose as soon as you remember.
  • More than 48 hours late — skip the missed dose and take the next one on your normal schedule.
  • Two or more consecutive doses missed — contact your prescriber before the next injection. Depending on how long the gap has been, the prescriber may want to drop you back a dose level.

The Wegovy SmPC gives the formal guidance — different from Mounjaro's longer 96-hour window because semaglutide has a different pharmacokinetic profile.

For more detail, see our missed dose guide.

Switching from Wegovy to Mounjaro (or vice versa)

The two medicines act on different combinations of receptors and the doses do not equate. Standard advice is:

  • Wegovy → Mounjaro: stop Wegovy, wait around 5 weeks, start Mounjaro at 2.5mg.
  • Mounjaro → Wegovy: stop Mounjaro, wait several weeks, start Wegovy at 0.25mg.

In both directions, the new medicine begins at its standard starter dose regardless of the dose reached on the previous treatment. See our switching from Wegovy to Mounjaro guide.

How to take a Wegovy injection

Wegovy is given as a subcutaneous (just-under-the-skin) injection using a pre-filled pen. Key practical points:

  • Inject once a week, on the same day where possible. Time of day doesn't matter, and the injection can be given with or without food.
  • Rotate injection sites. The licensed sites are the abdomen, the front of the thigh, and the back of the upper arm. Rotate within and between these sites to reduce skin reactions.
  • Storage. Unused pens should be kept refrigerated at 2°C–8°C. Once first used, the pen can be kept at room temperature (below 30°C) for up to 28 days. Do not freeze.
  • Disposal. Used pens go into a sharps bin, which most UK pharmacies will provide.

For step-by-step injection technique, see our how to inject guide and the manufacturer's instructions inside each pen pack.

NHS dosing — TA875 and the 2-year cap

For patients prescribed Wegovy under NICE TA875, the dosing schedule is the same as private. The key NHS-specific point is that NHS treatment is capped at two years, after which the patient may need to discuss continuing privately or stopping treatment.

NICE's earlier 2-year cap on semaglutide reflected the available efficacy and cost-effectiveness data at the time. The cap does not apply to Mounjaro, which has a more recent and broader NICE recommendation under TA1026.

Frequently asked questions

Why is the maintenance dose 2.4mg and not higher?
2.4mg is the licensed maintenance dose because it is the dose studied in the pivotal weight-management trials. Higher doses have not been licensed for weight management, and a regulated UK pharmacy will not dispense above 2.4mg for this indication.

Can I stay at 1.7mg long-term?
Yes — the SmPC permits 1.7mg as a long-term maintenance dose for patients who do not tolerate 2.4mg. Weight-loss efficacy is slightly lower than at 2.4mg.

Why does Wegovy take 16 weeks to titrate when Mounjaro takes longer?
The full Mounjaro titration to maximum dose can take 20+ weeks — both follow a similar gradual approach. Wegovy reaches its single licensed maintenance dose (2.4mg) at week 17. Mounjaro's titration to its highest dose (15mg) is longer because there are more steps.

What happens if I want to slow down the titration?
Slower titration — staying 6 or 8 weeks at each step instead of 4 — is acceptable and often reduces side effects. Speeding up the schedule below 4 weeks is not licensed.

Will I need to stay on Wegovy forever?
Privately, treatment can continue long-term as long as it remains clinically appropriate. On the NHS, treatment is capped at two years. Weight regain is common after stopping, so any decision to discontinue should be planned with your prescriber.

Next steps

Sources

This guide is for general information only and is not a substitute for prescriber advice. The right dose for you is a clinical decision based on your individual circumstances.

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Wegovy Dosing Guide UK: 16-Week Schedule Explained | LetsLoseWeight