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), the diabetes brand (Ozempic), and the oral tablet (Rybelsus).
Last updated 2026-08-24
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.
Wegovy (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) |
Maximum: 2.4 mg once weekly (the recommended maintenance dose for adults).
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.
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, the label schedule reaches the 2.4 mg maintenance dose at week 17, after four monthly steps. For Ozempic, reaching the 2 mg maximum takes at least 16 weeks. 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 steps 0.25 to 2.4 mg for weight management, while Ozempic steps 0.25 to 2 mg for diabetes. Do not apply one brand's schedule to the other.
Sources
- [1]WEGOVY (semaglutide) injection - DailyMed label, Novo Nordisk (Revised 4/2024)Adult 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]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
- [3]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)
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.