Wegovy dosing guide: how much semaglutide should you take?

Prescription weight loss drugs like Wegovy have been making a lot of headlines recently. If you’re considering starting this medication, you may have questions, including what the Wegovy dosing schedule is like, how much weight you can lose, and what side effects to expect. This article discusses everything you need to know about taking Wegovy safely.

Wegovy is a GLP-1 medication prescribed for weight loss. Wegovy is intended to be used in addition to lifestyle changes, including a low-calorie diet and regular exercise, to aid in weight loss for people with obesity or medical problems related to being overweight.

The Food and Drug Administration (FDA) first approved Wegovy for weight loss in adults in June 2021. Specifically, the drug is indicated for weight management in adults who meet one of the following criteria:

• Body mass index (BMI) of 30 or greater, which is generally considered obesity 

• BMI of 27 or greater with at least one health condition that is related to being overweight. Weight-related health conditions include type 2 diabetes, high blood pressure, or high cholesterol. 

In December 2022, the FDA approved Wegovy for certain children. The drug is approved for kids ages 12 years and older with a BMI in the 95^th percentile or greater based on their age and biological gender.

Wegovy belongs to a class of drugs known as GLP-1 agonists. GLP-1 stands for glucagon-like peptide-1, a hormone in your body that helps you feel full, among other things. Wegovy mimics these natural GLP-1 hormones, helping you feel full more quickly so you don’t feel like eating as much. GLP-1 also helps your body release more insulin, a hormone responsible for regulating blood sugar. Insulin helps to move the sugar in your blood into your body’s cells where it can be used as a source of energy. 

The active ingredient in Wegovy is semaglutide. Wegovy comes as an injection pen that is fitted with a hidden needle. The prefilled pen contains a single dose of semaglutide in a liquid solution. You’ll use the Wegovy pen to inject yourself once a week. Wegovy comes in a pack of four pens. Each pen is used only one time and then discarded.

Wegovy contains the same active ingredient as Ozempic, another popular GLP-1 agonist medication. Unlike Wegovy, Ozempic has a different dosage and is FDA-approved to improve blood sugar levels in adults with type 2 diabetes. It helps lower blood sugar levels and also aids in weight loss, but it is not approved for weight loss. However, healthcare providers can choose to prescribe Ozempic off-label to lose weight.

When you first start Wegovy, you’ll begin with the lowest dose of 0.25 milligrams (mg) injected once weekly for the first four weeks. Then your healthcare provider will titrate (gradually increase) your dosing over the course of several months until you reach the target recommended dosage of 2.4 mg injected once weekly. This can vary according to how well your body responds to the treatment, so your provider will work with you to find the dose and titration schedule that suits you best.

Wegovy is available in multiple strengths. With Wegovy, it’s easy to administer the right amount because each pen contains only one dose. You do not need to “dial” your dose or measure anything. The available strengths of Wegovy are as follows:

• 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 

You’ll inject Wegovy on the same day each week, at any time of day. The timing of meals doesn’t affect Wegovy. Choose the day and time that works best for your schedule. For example, you might take a dose of Wegovy every Sunday afternoon.

In most people, Wegovy requires dose increases to reach its full effectiveness for weight loss. See the chart below to see the starting dose of Wegovy and the typical timeline for dose increases. The dosing escalation schedule outlined below is the typical recommended dosage of Wegovy for adults and children ages 12 and older. However, follow the directions and dosing schedule from your healthcare provider.

*The target maintenance dose for adults is 2.4 mg once weekly. For children ages 12 and older that cannot tolerate this dosage, a maintenance dose of 1.7 mg once weekly may be used.

The dosing is designed with your treatment success in mind—so don’t be tempted to up your dosage too quickly. Starting at a low dose and slowly increasing it over time helps to minimize side effects of Wegovy, such as nausea, and allows your body to adjust to tolerating the medication.

A healthcare professional will show you how to self-administer Wegovy. Step-by-step instructions are also included in the drug packaging, and a demo video is available on the Novo Nordisk website. 

Here are the basic steps to know:

Prepare injection site. Choose where you’ll inject Wegovy. It’s given subcutaneously (just under the skin) of the front of your thigh, upper arm, or lower abdomen (at least two inches away from your belly button). You should avoid skin areas with any scars, stretch marks, bruising, or sores. Be sure to rotate your injection site—in other words, don’t inject Wegovy into the same exact spot every time. Doing so can irritate or toughen your skin. Wash your hands, then clean the injection site with an alcohol swab or soap and water and allow the skin to dry.

Inject Wegovy. After removing the cap, firmly push the Wegovy pen against your skin. You may feel a small pinch and hear two clicks, but you won’t see the needle. Do not remove the Wegovy pen from your skin until you see the yellow bar on the pen stop moving. Once the yellow bar on the pen stops, the full dose has been delivered, and you can remove the pen from your skin and discard it in a needle-safe collection container.

Note: the needle cover on the pen will immediately lock once you remove the pen from your skin. This means you cannot administer part of the dose, stop the injection, and continue later; the dose must be administered in one go.

Where to store Wegovy

Store Wegovy in the refrigerator until you are ready to use it for the first time—but don’t freeze it. Once you take it out of the fridge, Wegovy is good at room temperature for 28 days. Store Wegovy in its original packaging to protect it from light.

If you accidentally freeze Wegovy, forget it in a hot place (like in your parked car on a hot sunny day) or leave it sitting at room temperature for more than 28 days, do not use it. Instead, dispose of it in a sharps container and contact your pharmacy for a new supply. As with all medications, keep Wegovy out of reach of pets and kids.

It’s normal to have a lot of questions when you’re trying or considering a new medicine. Here are some common Q & A’s about Wegovy.  

Does Wegovy cause thyroid cancer?

While Wegovy hasn’t been known to cause thyroid cancer in humans, the drug carries a serious warning from the FDA called a boxed warning about the risk of thyroid tumors. The warning exists because rodent studies found semaglutide (the active ingredient in Wegovy and Ozempic) to cause thyroid C-cell tumors, including medullary thyroid carcinoma (MTC). As a precaution, healthcare providers typically do not recommend this medication for individuals with a personal or family history of thyroid cancer or a condition called multiple endocrine neoplasia syndrome type 2 (MEN2). 

What are the common side effects of Wegovy?

In clinical trials of Wegovy, the most commonly reported adverse reactions or side effects were:

• Nausea

• Diarrhea

• Vomiting

• Constipation

• Abdominal pain

• Headache

• Fatigue

• Dyspepsia or reflux

• Bloating and gas

• Hypoglycemia (low blood sugar) in people with type 2 diabetes

This is not a complete list of side effects; others may occur. If you’re experiencing bothersome side effects, such as nausea, talk to your healthcare provider. They may suggest tips for managing nausea, as this side effect usually goes away as your body adjusts to taking Wegovy. They may temporarily lower your dosage to see if it helps. If you’re having side effects that feel severe, call 911 or go to the nearest emergency room.

What foods should I avoid while using Wegovy?

Wegovy is just one part of a comprehensive approach you can use to reach and maintain a healthy weight. Like any weight loss drug, Wegovy is meant to be used along with diet changes and increased physical activity. These lifestyle changes are key to seeing the best results with Wegovy. A good place to start is limiting or eliminating sugary drinks, fried foods, and processed snack foods from your diet. Instead, fill your plate with nutritious whole foods, such as vegetables, fruits, and lean meats. 

When taking Wegovy, avoid processed foods and fast food as well. Limit added sugars, sodium, saturated fats, trans fats, and high-cholesterol foods for best results.

How does Wegovy compare to Ozempic?

Wegovy is similar to Ozempic in that both medications have the same active ingredient (semaglutide) and are given as once-weekly injections, though Wegovy has a higher maximum dose than Ozempic. Wegovy and Ozempic have similar common side effects, like nausea, vomiting, abdominal pain, headache, fatigue, diarrhea, or constipation.

Unlike Wegovy, Ozempic is FDA-approved for controlling blood sugar levels in people with type 2 diabetes and reducing the risk of heart problems, like heart attack and stroke. Wegovy is FDA-approved for weight loss management in certain adults and children, and not explicitly for those with type 2 diabetes.

Is there a shortage of Wegovy?

Yes, due to very high demand, there is a shortage of Wegovy in the United States (as of early May 2023). Novo Nordisk, the drug’s manufacturer, is working on increasing production to meet the demand. The company recently stated that the 0.25-mg, 0.5-mg, and 1-mg strengths would remain in limited supply until September 2023. Talk to your healthcare provider or pharmacist for medical advice if you’re having trouble filling your Wegovy prescription due to shortage or backorder issues.

If you miss a dose of Wegovy, don’t fret. Take the missed dose as soon as possible, as long as your next scheduled dose is more than two days away. But if your next dose is coming up in less than two days, just skip the missed dose and continue with your next regular dose. 

If you miss your Wegovy dose for more than two weeks, you have two options: take your next dose on the next regularly scheduled day, or call your healthcare provider to discuss if you need to restart treatment at a lower dose.

If you want to change the day of the week you take Wegovy, you can choose a new day so long as the last dose of Wegovy you received was given at least two days prior. 

As always, talk to a healthcare provider if you aren’t sure what to do after missing a dose of Wegovy or have questions about changing your dosing schedule.

Some prescription drugs come with a different set of dosing guidelines for older people or those with kidney or liver problems. But, Wegovy isn’t one of them. Doctors generally prescribe the same starting dose of Wegovy for everyone. Then they’ll recommend increasing the dose over time until you reach the target maintenance dose of 2.4mg per week.

Some people may be more sensitive to Wegovy’s side effects, such as nausea, and they may have to take a low dose for a longer period of time before they can tolerate a higher dose. If you don’t tolerate the maintenance 2.4 mg once-weekly dosage, your healthcare provider can lower it to 1.7 mg once weekly for a month. After that, if you still don’t tolerate 2.4mg once weekly, your healthcare provider can talk to you about other weight management strategies or medications to try instead.

Many people have lost substantial weight with the help of Wegovy. As a once-weekly injection, Wegovy offers a convenient dosing schedule that can help people trying to improve their health through weight loss. Talk with a healthcare provider to learn more about trying Wegovy.

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Current version

May 30, 2023

Written by

Patricia Weiser, PharmD

Fact checked by

Felix Gussone, MD

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About the medical reviewer

Felix Gussone, MD, Ro

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.