The lowest dose of Wegovy is 0.25 mg, taken as a once-weekly injection. This is the starting dose for every patient, and you stay on it for the first four weeks of treatment before moving up. It’s one-tenth the strength of the standard 2.4 mg maintenance dose, and it exists specifically to help your body adjust to the medication gradually.
Why Everyone Starts at 0.25 mg
Wegovy works by mimicking a gut hormone that regulates appetite and blood sugar. Introducing it at full strength would overwhelm your digestive system. The 0.25 mg starting dose lets your body get used to the drug while minimizing nausea, vomiting, and diarrhea, which are the most common side effects. These stomach-related symptoms tend to flare up at the beginning of treatment and whenever a dose increases too quickly.
At 0.25 mg, you likely won’t see significant weight loss. That’s not the point of this dose. It’s a tolerability phase, not a treatment phase. For most people, side effects at this level are mild and temporary, fading within a few weeks.
The Full Dose Escalation Schedule
Wegovy uses a 16-week step-up schedule. Your dose increases every four weeks until you reach the maintenance level:
- 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)
A higher-dose version, Wegovy HD at 7.2 mg, is also available for patients who need additional effect beyond the standard maintenance dose. But regardless of your eventual target, the journey always begins at 0.25 mg.
What the 0.25 mg Pen Looks Like
Each dose strength comes in its own color-coded prefilled pen, so there’s no risk of confusing them. The Wegovy pen line includes six strengths: 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, 2.4 mg, and 7.2 mg. Each pen delivers a single fixed dose, meaning you don’t need to measure or dial anything. You inject it under the skin of your abdomen, thigh, or upper arm once a week on the same day each week.
Staying on a Lower Dose Longer
Some people don’t tolerate dose increases well. If moving from 0.25 mg to 0.5 mg triggers persistent nausea or other side effects, your prescriber may keep you at the lower dose for an additional four weeks before trying again. The four-week intervals in the standard schedule are minimums, not deadlines. Slowing down the escalation is a common adjustment.
That said, staying at 0.25 mg indefinitely isn’t the intended use of the medication. The dose is too low to produce meaningful weight loss on its own. The clinical benefits that Wegovy is approved for, including significant weight reduction and cardiovascular risk lowering, are tied to reaching and maintaining the higher doses.
Tablet Form Has a Different Starting Dose
Wegovy recently became available as a daily oral tablet in addition to the weekly injection. The tablet version has its own dosing schedule, and the lowest tablet dose is 1.5 mg taken once a day. The numbers aren’t directly comparable to the injection because oral semaglutide is absorbed differently through the stomach lining, requiring a higher milligram amount to achieve similar blood levels. If you’re considering the tablet form, the escalation schedule and dose strengths are separate from the injection pens.