Titration schedule
Semaglutide titration schedule
Semaglutide is started low and stepped up on a fixed schedule to ease stomach side effects. Here are the escalation schedules exactly as the FDA labels write them, for the weight-management brand (Wegovy, injection and tablet), the diabetes brand (Ozempic), and the diabetes oral tablet (Rybelsus).
By An NayalLast reviewed 5 sources
These are the manufacturer's labeled schedules, not a plan for anyone in particular. Your prescriber may move faster or slower based on how you tolerate each step. Brands are not interchangeable: Wegovy and Ozempic are the same molecule but carry different escalation schedules and maximum doses, and Wegovy now comes in both an injectable and an oral tablet form with their own separate schedules.
Wegovy injection (chronic weight management)
FDA-approved labelOnce weekly subcutaneous injection, adults
| Step | Dose | Notes |
|---|---|---|
| Weeks 1-4 | 0.25 mg | Starting dose; not a maintenance dose |
| Weeks 5-8 | 0.5 mg | |
| Weeks 9-12 | 1 mg | |
| Weeks 13-16 | 1.7 mg | |
| Week 17 onward | 2.4 mg | Recommended maintenance (1.7 mg is an alternative) |
| After at least 4 weeks at 2.4 mg | 7.2 mg | Optional 'Wegovy HD' step, FDA-approved March 19, 2026 - only for patients who have tolerated 2.4 mg and whose prescriber confirms more weight reduction is needed; not a step everyone on 2.4 mg takes |
Maximum: 2.4 mg once weekly is the standard maintenance dose. A 7.2 mg 'Wegovy HD' maintenance dose was FDA-approved in March 2026 for patients who have tolerated 2.4 mg and need additional weight reduction.
The label says that if a patient does not tolerate a dose during escalation, the prescriber may delay the increase by 4 weeks.
Ozempic (type 2 diabetes)
FDA-approved labelOnce weekly subcutaneous injection, adults
| Step | Dose | Notes |
|---|---|---|
| Weeks 1-4 | 0.25 mg | Starting dose for the first 4 weeks; not a maintenance dose |
| After 4 weeks | 0.5 mg | |
| After at least 4 more weeks | 1 mg | If additional glycemic control is needed |
| After at least 4 more weeks | 2 mg | If additional glycemic control is needed (maximum) |
Maximum: 2 mg once weekly.
The Ozempic label frames each increase around whether more glycemic control is needed, after at least 4 weeks at the prior dose.
Rybelsus (type 2 diabetes, oral tablet)
FDA-approved labelOnce daily oral tablet, empty stomach
| Step | Dose | Notes |
|---|---|---|
| Days 1-30 | 3 mg daily | Initiation dose; not effective for glycemic control |
| Days 31-60 | 7 mg daily | |
| Day 61 onward | 14 mg daily | If additional glycemic control is needed (maximum) |
Maximum: 14 mg once daily.
Rybelsus is taken on an empty stomach with a sip of water, at least 30 minutes before the first food, drink, or other medicines of the day.
Wegovy tablets (oral, weight management and CV risk reduction)
FDA-approved labelOnce daily oral tablet, empty stomach
| Step | Dose | Notes |
|---|---|---|
| Days 1-30 | 1.5 mg daily | Starting dose; not a maintenance dose |
| Days 31-60 | 4 mg daily | |
| Days 61-90 | 9 mg daily | |
| Day 91 onward | 25 mg daily | Recommended maintenance dose |
Maximum: 25 mg once daily.
FDA-approved December 22, 2025 as the first oral GLP-1 for weight management, and distinct from Rybelsus, which is a different oral semaglutide product approved only for type 2 diabetes and tops out at 14 mg. Like Rybelsus, taken on an empty stomach with a sip of water at least 30 minutes before food, drink, or other medicines.
Get reminded when it's time to step up
Step-up reminders are part of the Pepteca tracker, which is on the way. Leave your email and we will tell you when it opens. Email only, unsubscribe anytime.
Using this as a tracker template
- Print or copy the schedule for your specific brand, then write the calendar date next to each step so you can see when the next increase is due.
- Log the date and dose each week. A step is meant to hold for its full window before the next increase.
- If a step is hard on your stomach, that is the row to show your prescriber - the label allows staying longer at a dose rather than pushing ahead.
- When the Pepteca tracker arrives, it will import a schedule like this and remind you when each step is due.
Questions people ask
How long does it take to reach the full semaglutide dose?
For Wegovy injection, the label schedule reaches the 2.4 mg maintenance dose at week 17, after four monthly steps. For Ozempic, the earliest the label allows the 2 mg maximum is week 13, after at least 4 weeks each on 0.25, 0.5 and 1 mg. For the Wegovy tablet, reaching the 25 mg maintenance dose takes 90 days. These are minimums; prescribers often hold a dose longer if side effects need more time to settle.
Why does semaglutide start so low?
The low starting dose exists to reduce gastrointestinal side effects such as nausea. The labels treat it as an initiation step rather than a treatment dose - the oral Rybelsus label states plainly that its 3 mg starting dose is not effective for glycemic control, and the injectable 0.25 mg dose is a four-week starting step, not one of the maintenance doses. Stepping up slowly gives the gut time to adjust.
Are the Wegovy and Ozempic schedules the same?
No. They are the same molecule but different products with different escalation schedules and maximum doses: Wegovy injection steps 0.25 to 2.4 mg (with an optional 7.2 mg step added in 2026) for weight management, while Ozempic steps 0.25 to 2 mg for diabetes. Do not apply one brand's schedule to the other.
Is there a higher Wegovy dose than 2.4 mg?
Yes. The FDA approved a 7.2 mg 'Wegovy HD' maintenance dose on March 19, 2026, for patients who have tolerated 2.4 mg for at least 4 weeks and whose prescriber confirms they need additional weight reduction. It is an optional add-on step, not a change to the standard 2.4 mg maintenance schedule.
Is the Wegovy tablet the same as Rybelsus?
No, even though both are oral semaglutide. Rybelsus is approved for type 2 diabetes and tops out at 14 mg daily. The Wegovy tablet, FDA-approved December 22, 2025, is approved for weight management and cardiovascular risk reduction and titrates up to a 25 mg daily maintenance dose over 90 days. They are not interchangeable.
Sources
- [1]WEGOVY (semaglutide) injection - DailyMed label, Novo NordiskAdult weekly escalation: 0.25 mg (wk 1-4), 0.5 mg (wk 5-8), 1 mg (wk 9-12), 1.7 mg (wk 13-16), 2.4 mg maintenance (wk 17+); delay escalation 4 weeks if a dose is not tolerated
- [2]FDA Approves Fourth Product Under National Priority Voucher Program, Higher Dose Semaglutide (Wegovy HD, 7.2 mg) - FDA press announcement, March 19, 2026FDA approval of a 7.2 mg Wegovy maintenance dose for patients who have tolerated 2.4 mg and need additional weight reduction, based on the Phase 3 STEP UP trial program
- [3]OZEMPIC (semaglutide) injection - DailyMed label, Novo Nordisk (Revised 5/2026)Weekly escalation: 0.25 mg start (4 wk), 0.5 mg, then 1 mg after >=4 wk, then 2 mg maximum after >=4 wk if additional glycemic control is needed
- [4]RYBELSUS (semaglutide) oral tablets - DailyMed label, Novo Nordisk (Revised 1/2026)Oral daily escalation: 3 mg (days 1-30, not for glycemic control), 7 mg (days 31-60), 14 mg maximum (day 61+ if more control needed)
- [5]FDA Approves Novo Nordisk's Wegovy Pill, the First and Only Oral GLP-1 for Weight Loss in Adults - PR Newswire, December 22, 2025FDA approval and titration schedule (1.5 mg, 4 mg, 9 mg, 25 mg maintenance) for the oral Wegovy tablet, distinct from Rybelsus
Related
This page is educational information, not medical advice. GLP-1 medications are prescription drugs; dosing, escalation, and any combination with other compounds are decisions for you and a licensed prescriber, based on the actual product you hold and your own health. Figures here describe published FDA labels and clinical trials - they are not a recommendation to take any dose. Compounded and research-grade products can differ in concentration and purity from the approved versions these schedules were written for.