Wegovy comes in five dose strengths: 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, and 2.4 mg. Every patient starts at the lowest dose and works up over about 16 weeks, reaching the full maintenance dose of 2.4 mg once weekly by week 17. This gradual increase, called titration, exists to reduce the gastrointestinal side effects that are common with the medication.
The Five-Dose Titration Schedule
Wegovy is injected once a week, on the same day each week. The schedule moves through each dose level in four-week blocks:
- Weeks 1 through 4: 0.25 mg once weekly
- Weeks 5 through 8: 0.5 mg once weekly
- Weeks 9 through 12: 1 mg once weekly
- Weeks 13 through 16: 1.7 mg once weekly
- Week 17 onward: 2.4 mg once weekly (maintenance dose)
Each dose comes in its own pre-filled pen, so you’ll get a new pen strength from your pharmacy roughly every month as you move through the schedule. You don’t adjust the dose yourself within a pen.
Why Doses Increase Gradually
The step-up schedule isn’t optional. It’s designed to let your body adjust to the medication and lower the risk of nausea, vomiting, and other stomach-related side effects. In clinical trials, 73% of people taking Wegovy reported some form of gastrointestinal discomfort, and these reactions were most frequent during the escalation period rather than at the maintenance dose.
If you’re struggling with side effects at any step, your prescriber may keep you at the current dose for an extra four weeks before moving up. That pause can make a meaningful difference in tolerability without restarting the whole process.
The Maintenance Dose
The target for all patients is 2.4 mg once weekly. This is the dose studied in the large clinical trials that demonstrated significant weight loss, and it’s the dose you’ll stay on long term.
If you can’t tolerate 2.4 mg even after a slower escalation, the FDA allows a reduced maintenance dose of 1.7 mg once weekly. However, if 1.7 mg still causes problems, the guidance is to discontinue the medication entirely. There is no approved protocol for staying on a lower dose like 0.5 mg or 1 mg as a long-term maintenance strategy.
Dosing for Adolescents
Wegovy is approved for patients aged 12 and older. The dosing schedule for adolescents is identical to the adult schedule: the same five dose levels, the same four-week intervals, and the same 2.4 mg maintenance target starting at week 17. The 1.7 mg fallback option also applies if the full dose isn’t tolerated.
Where and How to Inject
You inject Wegovy just under the skin in one of three areas: the stomach (at least two inches from your belly button), the front of your upper thighs, or the upper arms. Rotating between these sites helps prevent irritation. If you find injecting uncomfortable at one spot, switching to a firmer area like the thigh or upper arm can help. Some people also find it easier to stand while injecting into the stomach.
The pens should be stored in the refrigerator. If needed, a pen can be kept at room temperature (up to 86°F) for up to 28 days in its original carton. After 28 days outside the fridge, it should be discarded even if it still contains medication.
What to Do if You Miss a Dose
For the injectable pen, the rules depend on timing. If your next scheduled dose is more than two days (48 hours) away, take the missed dose as soon as you remember. If it’s less than two days until your next dose, skip the missed one and resume on your regular day. Never double up to make up for a missed injection.
If you’ve missed two or more weeks of doses, you can either take the next dose on your regular day or contact your prescriber about whether you need to restart at a lower dose. Going without the medication for an extended period may mean your body has lost some of its adjustment, and jumping back to a higher dose could bring back the stomach side effects you already worked through during titration.
Wegovy also comes in a pill form, which follows slightly different rules. If you miss a day of the oral version, you simply skip that dose and take the next one the following day at your usual time. No doubling up applies here either.