The Wegovy Titration Schedule: 0.25 to 2.4 mg

Wegovy isn't a drug you start at full strength. It's titrated — stepped up slowly over months from a tiny starting dose to the maintenance dose that actually drives weight loss. That schedule isn't arbitrary, and it isn't a suggestion: it comes straight from the FDA label, and it exists to keep the gastrointestinal side effects tolerable while your gut adapts. Here's exactly how the escalation works, why each step matters, and what your options are if you can't comfortably reach the top.

The schedule, straight from the label

The FDA prescribing information for Wegovy lays out a five-step escalation. You initiate at 0.25 mg once weekly for 4 weeks, then follow the dosage-escalation schedule, titrating every 4 weeks to reach the maintenance dose¹. The standard injectable ladder is:

• •Weeks 1–4: 0.25 mg once weekly
• •Weeks 5–8: 0.5 mg once weekly
• •Weeks 9–12: 1 mg once weekly
• •Weeks 13–16: 1.7 mg once weekly
• •Week 17 onward: 2.4 mg once weekly (the recommended maintenance dose)

That's roughly four months of climbing before you reach the full 2.4 mg dose. The label is explicit that the usual recommended maintenance dosage of Wegovy injection is 2.4 mg once weekly¹.

Why the slow climb exists

The 0.25 mg starting dose is essentially a non-therapeutic "warm-up" — it produces little weight loss on its own. Its job is to let your body get used to the medication before the dose gets high enough to matter. Semaglutide works by slowing gastric emptying and acting on appetite centers in the brain², and those same actions are what cause its most common side effects: nausea, vomiting, diarrhea, and constipation. Those effects are dose-related and worst at increases, which is precisely why the dose is raised in small, spaced steps rather than all at once.

The pivotal STEP 1 trial that earned Wegovy its weight-management approval used exactly this gradual 16-week escalation to the 2.4 mg dose, and even with that careful ramp, gastrointestinal effects were the most common adverse events — typically mild to moderate and concentrated early³. A dose-ranging study of semaglutide for weight loss made the trade-off concrete: higher doses produced more weight loss but also more gastrointestinal side effects, which is the entire rationale for stepping up slowly to find the highest dose you tolerate⁴. We cover the day-to-day management of those symptoms in our guide to semaglutide dosing and side effects.

Don't rush it — and what to do if a step is rough

The single most common mistake is trying to race to 2.4 mg. Climbing faster doesn't speed up results in a way that's worth the misery, and it sharply raises the odds of nausea and vomiting bad enough to derail treatment. The label builds in flexibility for this: if you don't tolerate an escalation step, your prescriber can delay the increase — staying at the current dose for an extra few weeks before stepping up again. That's a normal, expected adjustment, not a failure.

The 1.7 mg fallback maintenance dose

Not everyone can comfortably sit at 2.4 mg, and the label accounts for that. For weight reduction in adults, the maintenance dosage of Wegovy is either 1.7 mg or 2.4 mg (2.4 mg recommended) once weekly¹. In plain terms: if you reach 1.7 mg and the jump to 2.4 mg brings side effects you can't live with, staying at 1.7 mg as your long-term maintenance dose is a legitimate, label-sanctioned option — not a consolation prize. You still get meaningful drug exposure; you simply prioritize tolerability. The label frames the choice as weighing treatment response against tolerability when selecting the maintenance dosage¹.

There's also now a higher rung beyond the standard maintenance dose: for adults who tolerate 2.4 mg for at least four weeks and need additional weight reduction, the label permits increasing to a maximum of 7.2 mg once weekly (marketed as Wegovy HD)¹. That's an option for a subset of patients, not part of the routine starting ladder.

How the schedule fits the rest of your routine

The escalation schedule is about dose, but the mechanics of the weekly injection are worth getting right from week one — the pen, the sites, and rotating them. Our step-by-step on how to inject Wegovy walks through it. It's also worth knowing how Wegovy compares to Ozempic, which uses the same drug but tops out lower at 2 mg and is approved for diabetes rather than weight loss; we lay that out in Ozempic vs Wegovy.

The bottom line

Wegovy's titration is a deliberate five-step climb — 0.25 → 0.5 → 1 → 1.7 → 2.4 mg, four weeks per step — set by the FDA label to keep side effects manageable while you reach an effective dose¹. Don't rush it: slowing a step when you're struggling is built into the label, and if 2.4 mg is genuinely intolerable, 1.7 mg is an approved maintenance dose rather than a failure. Reaching the dose you can actually live with, consistently, beats sprinting to the top and quitting. (Life happens, too — if you skip a week, the rule for catching up depends on your product, which we lay out in missed or late semaglutide dose.) For the full evidence picture — how well it works and the ongoing-use reality — start with our pillar, Semaglutide: how it works, results and side effects; and if you're choosing where to get treatment, our best semaglutide providers guide ranks legitimate options on price and oversight.