Semaglutide dosage: Ozempic and Wegovy step by step

Medically reviewed by Dr. Jaramillo, a doctor at Goodweigh. Last updated on 8 October 2026

Short answer from Dr. Jaramillo

With semaglutide, you start at a low dose of 0.25 mg per week and increase the dose by one step every four weeks or longer. With Wegovy, the titration period lasts sixteen weeks. This allows your body to get used to the medicine and reduces the likelihood of gastrointestinal side effects.

Dr. Jaramillo, doctor at Goodweigh

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Semaglutide is found in Ozempic, Wegovy and Rybelsus, and with all three you gradually increase the dose. You don’t start with the dose that works best, but with a low dose that allows your body to adjust gradually. In this blog, you can compare the dosing schedules for Ozempic and Wegovy side by side. You’ll also find out how the dose is increased at Goodweigh and what to do if you miss a dose. We’ll also cover the side effects that may occur during the dose-escalation phase, as well as briefly discussing the tablet versions.

What is the Ozempic dosage and the Wegovy dose-escalation schedule?

You start on 0.25 mg per week for both medicines. After that, the regimen differs: Wegovy follows fixed increments, while with Ozempic the doctor decides how far you go. With Wegovy, you increase the dose every four weeks, in steps, until you reach the maintenance dose from week 17. This is the dose you will continue to take. The gradual increase is intended to reduce the risk of gastrointestinal side effects.

Ozempic is authorised in the Netherlands for type 2 diabetes, not for weight loss. The dosage schedule therefore has fewer fixed steps. After four weeks, you move up to 0.5 mg, as the starting dose is not a maintenance dose. Further increases are determined by your doctor on an individual basis, only if necessary and each time after at least four weeks on the previous dose.

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Do not count the number of clicks on the Ozempic pen. You can read how the pen works in how to administer Ozempic.

What is the maximum dose of semaglutide?

For Ozempic, the maximum dose is 2 mg per week. For Wegovy, 2.4 mg per week is the standard maintenance dose.

At that dose, participants in the STEP 1 study lost an average of around 15 per cent of their body weight over 68 weeks, in combination with a lifestyle programme. This is an average, not a guarantee. Not everyone reaches that dose: the increase is adjusted to how you feel.

Since early 2026, a higher dose of 7.2 mg per week has also been approved in the EU.

It is intended for adults with obesity who tolerate 2.4 mg well and need extra support with weight loss.

How does Goodweigh gradually increase your dose?

At Goodweigh, the build-up phase lasts 16 to 20 weeks, depending on the medication and how you respond to it. The schedule in the table is therefore a guideline: the doctor will assess on a case-by-case basis whether it is advisable to move on to the next step. Every four weeks, you’ll fill in an evaluation form for this purpose. If you have any questions in the meantime, you can ask them via the chat.

Your doctor will also monitor the pace of your weight loss. Our doctors use this gradual approach to prevent anyone from losing weight too quickly. As well as your doctor, a lifestyle coach will support you. Wegovy and Ozempic are available from Goodweigh. The current price is listed on each medicine’s product page. You’ll discuss whether Ozempic or Wegovy is right for you during the intake. You can find out how this works under weight loss with Goodweigh and who is eligible.

What should you do if you miss a dose?

If you miss a dose, take it as soon as possible, provided this is within five days. If more than five days have passed, skip the dose and take the next one on your usual day. This is stated in the product information for Wegovy and Ozempic. Never take a double dose to make up for a missed one.

If you have missed several doses of Wegovy, please speak to your doctor. They may suggest starting again at a lower dose. If you wish to change your regular injection day for Ozempic, you can do so provided there are at least three days between doses.

What side effects are associated with the build-up?

Nausea, vomiting and diarrhoea are common during the titration phase, and you usually notice them most after increasing the dose. A detailed overview can be found under the side effects of semaglutide and the side effects of Wegovy. If you are experiencing significant discomfort, your doctor may delay the next dose increase or revert to the previous dose. This is a standard approach when severe gastrointestinal symptoms occur.

If you are vomiting or have diarrhoea, make sure you drink plenty of fluids, as you can become dehydrated. This is particularly important if you have kidney problems. If you have severe and persistent pain in your stomach area, call a doctor straight away. It could be pancreatitis. If you have type 2 diabetes and are also taking insulin or a medicine that stimulates the pancreas to produce insulin, you may need a lower dose of these medicines.

How long will you continue on the maintenance dose?

The maintenance dose is intended for long-term use. Follow-up research after discontinuation showed that many participants regained a significant proportion of the weight they had lost. Those who continued on the maintenance dose in the STEP 4 study maintained their weight loss. If you wish to stop or taper off the treatment, please discuss this with your doctor. At Goodweigh, tapering off usually involves reducing the dose by one step every four weeks. You can read more about the effects of stopping Ozempic.

What about Rybelsus and the Wegovy tablet?

Semaglutide is also available in tablet form. Rybelsus is a tablet for type 2 diabetes. You start with 1.5 mg a day, and after a month you increase the dose to 4 mg a day. If necessary, the dose can be increased further. You should take it on an empty stomach.

For weight loss, there’s the Wegovy tablet. You take it once a day on an empty stomach, rather than having a weekly injection. You can find more information on the product page for the Wegovy tablet. Further information can be found under Wegovy tablet and oral semaglutide.

You should choose the correct dose in consultation with a doctor

A good treatment plan is gentle, tailored to your symptoms and adjusted as necessary. Skipping a dose or increasing the dose on your own is not a good idea. Lifestyle remains the foundation: according to the NHG Obesity Standard, a healthy lifestyle is the basis of any treatment, including medication. At Goodweigh, a doctor will work with you to decide on the next step, with a lifestyle coach by your side. If you’d like to find out whether this is right for you, start the intake process.

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