Can you start Wegovy at 2.4 mg?

Wegovy (semaglutide) is a once-weekly injectable prescription medication for weight loss. It comes in five dosage strengths, ranging from 0.25 milligrams (mg) to 2.4 mg. If you’ve been prescribed Wegovy for weight loss, you may be wondering, “Can I start Wegovy at 2.4 mg?” 

The short answer is: no. While it may be enticing to skip ahead and start at the highest dose, you should always follow the dosing schedule as prescribed by your doctor. 

For the longer answer, read on.

Wegovy is a prescription medication for weight loss. It’s also FDA-approved to lower cardiovascular risk in people with obesity or overweight and heart disease. Wegovy belongs to a group of medications known as GLP-1s. These drugs mimic a gut hormone called glucagon-like peptide-1, or GLP-1. GLP-1s like Wegovy help with weight loss by slowing down digestion, so you feel full sooner. GLP-1s also regulate your appetite, so you develop more control over how much you eat and have fewer cravings for fatty, calorie-dense foods. 

In one study, people taking 2.4 mg of Wegovy ate 35% fewer calories after 20 weeks on Wegovy 2.4 mg, compared to people taking a placebo. In another study, people taking 2.4 mg Wegovy lost nearly 15% of their body weight at 68 weeks.

In short, no. It’s not a good idea to start Wegovy at 2.4 mg. It’s much more likely that your healthcare provider will have you start at the lowest dose of Wegovy, which is 0.25 mg once weekly. Then, every four weeks, they’ll increase your dosage to the next dosage strength, until you reach the recommended Wegovy maintenance dosage of 2.4 mg. All in all, it can take up to 17 weeks, or a little over four months, to reach the 2.4 mg dosage strength of Wegovy.

Healthcare providers call this titrating — gradually increasing the dosage until you reach the maximum effective strength — and it’s done for good reason. By slowly increasing your dosage of Wegovy, you give your body time to get used to the medication, which helps keep side effects manageable.

If you’re feeling impatient about Wegovy’s gradual dosing schedule, let us reassure you: the medication typically starts working soon after you start taking it. You may start noticing changes in your appetite, cravings, and body weight well before you reach the 2.4 mg dosage. In one study, people with obesity lost an average of nearly 15 pounds — or 6% of their body weight — by three months. In the same study, people with type 2 diabetes lost nearly 4% of their body weight in the same time frame. (People with type 2 diabetes tend to lose less weight on medications like Wegovy, which could be due to a number of factors. For example, they may be taking other medications, like insulin, which can cause weight gain.)

Gradually increasing your dose can help prevent or lessen unpleasant side effects. Even so, in clinical trials, the side effects of Wegovy 2.4 mg included:

The digestive side effects of Wegovy tend to be most intense when you first start Wegovy and after each dose increase. During the titration process, it’s a good idea to stay in touch with your healthcare provider and let them know how your body is responding to the medication. If the side effects feel too intense or unmanageable when you start the 2.4 mg dosage, your healthcare provider may recommend you go back to the 1.7 mg dosage. After a few weeks on the 1.7 mg dosage, they may have you try the 2.4 mg dosage one more time.

It’s important not to increase the dose too quickly. A rapid increase can lead to side effects that are too intense to handle, which could require stopping the treatment in some cases. 

Wegovy is taken on the same day each week. You can take it at any time of day, regardless of when you last ate, but it’s important to be consistent about taking it the same day each week. Wegovy is injected subcutaneously, or under the skin, of your thigh, abdomen, or upper arm. You can rotate through the injection sites each week, to give each area a bit of time to heal. Each pen of Wegovy comes pre-filled with a full dose of the medication, and you’ll inject the entire dose at once. 

In between doses, you can store Wegovy at room temperature (46°F to 86°F, or 8°C to 30°C ) for up to 28 days, or in the fridge (36°F to 46°F, or 2°C to 8°C) in its original carton.

To get a prescription for Wegovy, you’ll need to meet with a licensed healthcare provider, either in-person or online. Then, you can fill your prescription at your local pharmacy or through an online pharmacy. Without insurance, the cost of Wegovy is around $1,350 for a one-month supply, which includes four doses of Wegovy. Depending on whether your insurance covers Wegovy, you may be eligible for the Wegovy coupon. You can also find pharmacy discount cards online at websites like GoodRx, Optum Perks, and SingleCare. 

Each pen of Wegovy contains a single dose of semaglutide (the active ingredient) in a liquid solution. There are five dosage strengths of Wegovy:

• 0.25 milligrams of semaglutide per 0.5 milliliters of solution (0.25 mg/0.5 mL)

• 0.5 mg/0.5 mL 

• 1 mg/0.5 mL

• 1.7 mg/0.75 mL 

• 2.4 mg/0.75 mL 

The highest 2.4 mg strength is the recommended maintenance dosage of Wegovy, although for some people the 1.7 mg dosage may be enough. Typically, healthcare providers prescribe a starting dosage of 0.25 mg. Then, every four weeks, you’ll increase to the next dosage strength following a schedule that looks something like this:

If at any point the side effects become intolerable, tell your healthcare provider. They may have you stay at your current dose for another four weeks before you increase to the next one.

What affects Wegovy dosing?

The main factor affecting Wegovy dosing is sensitivity to side effects. Some people are more sensitive to Wegovy’s side effects than others, so their health provider may titrate their dosage up on a slower schedule, or they may stick with the 1.7 mg dosage strength as their maintenance dosage instead of increasing all the way up to 2.4 mg. Staying on the “lowest therapeutic dose” usually requires an appeal to the insurance company to continue a specific dose, so your dose may also be affected by your insurance company’s final decision, too.

If you find Wegovy’s side effects difficult to tolerate at 2.4 mg or 1.7 mg, your healthcare provider may recommend alternative medications to Wegovy, such as Saxenda (liraglutide) or Zepbound (tirzepatide). 

How much weight you lose on Wegovy can depend on a number of factors, from the lifestyle changes you make to other health conditions you have. Having said that, people taking higher doses of Wegovy generally tend to lose more weight than those taking lower doses. For example, in one 68-week study, people taking the 2.4 mg dosage of Wegovy lost 13.2% of their body weight, while those taking the 1.7 mg maintenance dosage lost 9.6%.

It’s understandable to want to ramp up to the 2.4 mg dosage of Wegovy as soon as possible. However, it’s important to follow the dosing schedule your healthcare provider prescribes. Slowly increasing your dosage of Wegovy keeps side effects manageable as you get used to the medication. Don’t change up your dosage of Wegovy without talking to your healthcare provider first.

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

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Current version

August 20, 2024

Written by

Amelia Willson

Fact checked by

Patricia Weiser, PharmD and Beverly Tchang, MD

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About the medical reviewers

Patricia Weiser, PharmD

Patricia Weiser, PharmD, is a licensed pharmacist, health content writer, and medical reviewer with more than a decade of clinical experience in community and hospital pharmacy.

Beverly Tchang, MD

Beverly Tchang, MD, is an Obesity Medicine Advisor for Ro. She is also an assistant professor of Clinical Medicine at Weill Cornell Medicine in New York and triple board-certified in Internal Medicine, Endocrinology, and Obesity Medicine.