Semaglutide Dosage Chart
Table of Contents
What is Semaglutide?
Semaglutide is a GLP-1 receptor agonist approved for chronic weight management (Wegovy® 2.4 mg weekly) and type 2 diabetes (Ozempic® up to 2.0 mg weekly). It works by activating GLP-1 receptors to reduce appetite, slow gastric emptying, and improve metabolic parameters.
Proper dose titration is essential to minimize gastrointestinal side effects, which are the primary reason for treatment discontinuation. The following charts detail the precise weekly schedule used in the STEP clinical trial program.
Semaglutide Titration Schedule (Wegovy® Protocol)
The standard FDA-approved titration schedule for weight management:
| Week | Weekly Dose | Phase | Pen Strength |
|---|---|---|---|
| Week 1–4 | 0.25 mg | Titration 1 | 0.25 mg pen |
| Week 5–8 | 0.50 mg | Titration 2 | 0.5 mg pen |
| Week 9–12 | 1.00 mg | Titration 3 | 1.0 mg pen |
| Week 13–16 | 1.70 mg | Titration 4 | 1.7 mg pen |
| Week 17+ | 2.40 mg | Maintenance | 2.4 mg pen |
Compounded Semaglutide Volume Chart
For compounded semaglutide vials, injection volumes depend on the reconstitution concentration. The following chart shows volumes for common concentrations:
| Target Dose | 2 mg/mL Vial | 2.5 mg/mL Vial | 5 mg/mL Vial |
|---|---|---|---|
| 0.25 mg | 0.125 mL (12.5 units) | 0.10 mL (10 units) | 0.05 mL (5 units) |
| 0.50 mg | 0.25 mL (25 units) | 0.20 mL (20 units) | 0.10 mL (10 units) |
| 1.00 mg | 0.50 mL (50 units) | 0.40 mL (40 units) | 0.20 mL (20 units) |
| 1.70 mg | 0.85 mL (85 units) | 0.68 mL (68 units) | 0.34 mL (34 units) |
| 2.40 mg | 1.20 mL (120 units) | 0.96 mL (96 units) | 0.48 mL (48 units) |
Note: 1 mL = 100 units on a standard insulin syringe. Always double-check concentration before drawing your dose.
Extended Titration for Sensitive Subjects
Some subjects experience significant GI side effects at standard escalation speed. An extended titration option doubles each step:
| Week | Weekly Dose | Notes |
|---|---|---|
| Week 1–8 | 0.25 mg | Extended initial phase |
| Week 9–16 | 0.50 mg | Extended step 2 |
| Week 17–24 | 1.00 mg | Extended step 3 |
| Week 25–32 | 1.70 mg | Extended step 4 |
| Week 33+ | 2.40 mg | Maintenance |
This 32-week titration is not the standard protocol but is used in clinical practice when GI tolerance is a limiting factor. Some subjects achieve adequate weight loss at 1.0 or 1.7 mg without needing to reach 2.4 mg.
Ozempic® vs Wegovy® Dosing Comparison
| Parameter | Ozempic® (Diabetes) | Wegovy® (Weight Loss) |
|---|---|---|
| Starting Dose | 0.25 mg weekly | 0.25 mg weekly |
| Maintenance Dose | 0.5–1.0 mg (max 2.0 mg) | 2.4 mg |
| Titration Duration | 8 weeks to 1.0 mg | 16 weeks to 2.4 mg |
| Indication | Type 2 Diabetes | Chronic Weight Management |
| Available Pens | 0.25/0.5, 1.0, 2.0 mg | 0.25, 0.5, 1.0, 1.7, 2.4 mg |
Important Safety Notes
Always follow the prescribed titration schedule. Do not skip dose levels. Rapid escalation significantly increases the risk of nausea, vomiting, and treatment discontinuation.
Semaglutide carries a boxed warning for thyroid C-cell tumors (rodent studies). Contraindicated in individuals with MTC or MEN 2 history. Monitor for signs of pancreatitis and gallbladder disease. Use only under medical supervision.
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Frequently Asked Questions
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