Semaglutide Dosing Chart: Complete Week-by-Week Schedule
Medically Reviewed
Dr. Sarah Chen, MD
Board Certified Endocrinologist
Last reviewed: December 15, 2025
Semaglutide's dosing schedule spans four months and five dose levels. This comprehensive chart walks you through each phase, helping you understand when increases happen, what to expect at each dose, and how to determine your ideal maintenance level.
Understanding Semaglutide's Titration Logic
The semaglutide dosing chart isn't arbitrary—it represents years of clinical research determining the safest path to effective weight loss. Think of it as a carefully mapped journey where each stop allows your body to adapt before advancing. Rushing this process doesn't accelerate results; it typically triggers intense side effects that derail treatment.
Here's the science: your GLP-1 receptors need time to adjust to semaglutide's presence. When introduced gradually, these receptors adapt smoothly, leading to sustainable appetite suppression and steady weight loss. Jump too quickly, and those receptors become overwhelmed, triggering the severe nausea and digestive distress that causes many patients to abandon treatment entirely.
The STEP clinical trials—which established semaglutide's efficacy for weight loss—tested multiple titration protocols before settling on this specific schedule. Patients who followed the gradual approach had significantly better adherence rates, meaning they actually completed treatment long enough to see transformative results. Those who tried accelerating the schedule? Most discontinued within the first two months due to intolerable side effects.
Understanding this logic helps frame your expectations correctly: the slow ramp-up isn't delaying your success—it's ensuring it. Every week at a lower dose prepares your body for the therapeutic levels that will drive meaningful, sustainable weight loss.
Complete Semaglutide Dosing Timeline
Standard 16-Week Titration Schedule
Weeks 1-4
Foundation Phase
Starting dose for body acclimation. Minimal therapeutic effect expected. Focus: establishing injection routine and monitoring tolerance. Average weight loss: 2-4 lbs total.
Weeks 5-8
Early Therapeutic Phase
First therapeutic increase. Noticeable appetite suppression begins for most patients. Weekly weight loss: 1-2 lbs typical. Side effects most common 2-3 days post-injection.
Weeks 9-12
Primary Therapeutic Phase
Strong appetite control established. Weight loss often accelerates to 2-3 lbs weekly. About 30% of patients find their optimal maintenance dose here. Significant changes in food preferences common.
Weeks 13-16
Higher Therapeutic Dose
Enhanced therapeutic effect for patients needing additional support. Consistent 2-3 lb weekly weight loss. Many patients establish long-term maintenance here rather than advancing to 2.4mg.
Week 17+
Maximum Maintenance Dose
Maximum approved dose. Clinical trials demonstrated average 15-17% total body weight reduction over 68 weeks. Represents peak therapeutic effect for chronic weight management.
Critical Schedule Reminders
- • Each dose level requires minimum 4 weeks before advancing (no shortcuts)
- • Reaching maximum 2.4mg dose is not mandatory—find your optimal level
- • You can pause progression at any dose that delivers good results with minimal side effects
- • Provider approval required for any schedule modifications
- • Side effects typically peak 48-72 hours after dose increases
Month-by-Month: What Really Happens
Month 1: Getting Started (0.25mg)
Your first month on semaglutide centers on adaptation rather than dramatic weight loss. At 0.25mg, you're essentially teaching your GLP-1 receptors to recognize the medication. This dose is intentionally subtherapeutic—designed to prime your system while minimizing side effects.
What to expect realistically: Most patients notice very little at first, and that's completely normal. Some experience subtle fullness after meals, perhaps eating slightly less without conscious effort. Others feel virtually no difference this first month. Don't let that discourage you—the adaptation happening internally is setting the stage for everything that follows.
Common experiences: Mild nausea affecting about 15-20% of patients (usually resolves within 48-72 hours after each injection). Slight decrease in appetite beginning week 2-3. Minimal to no side effects for roughly 70-80% of patients. Weight loss averaging 2-4 pounds total for the month—modest but meaningful.
Focus this month: Establish your weekly injection routine. Choose a consistent day and time. Master proper injection technique and site rotation. Begin tracking weight, side effects, and appetite changes to establish your personal baseline for comparison later.
Month 2: Entering Therapeutic Territory (0.5mg)
The jump to 0.5mg represents your first significant dose increase—and this is when most patients truly feel the medication working. Your GLP-1 receptors have had 4 weeks to adapt, and now they're receiving a therapeutic signal strong enough to produce noticeable effects.
The reality check: Week 5 (your first 0.5mg injection) often brings temporary side effect resurgence. Expect possible nausea for 2-3 days—uncomfortable but manageable for most patients. By week 6, these effects typically diminish significantly as your receptors adapt to the higher dose level.
Weight loss acceleration: Most patients begin losing 1-2 pounds weekly at this dose. That translates to 4-8 pounds for the month—often enough that clothes start fitting differently. Your appetite suppression becomes more obvious: portions that satisfied you before now seem too large, and the constant background hunger that characterized your pre-treatment life fades noticeably.
Metabolic shifts: Beyond appetite changes, many patients report altered food preferences. Rich, heavy foods lose their appeal. High-fat meals that once sounded delicious now cause mild queasiness or simply don't interest you. These changes aren't forced—they happen naturally as semaglutide modulates your brain's reward pathways related to food.
Month 3: The Sweet Spot (1.0mg)
Welcome to what many consider semaglutide's primary therapeutic dose. By month three, your body has had 8 weeks adapting to the medication. The increase to 1.0mg typically triggers less dramatic side effects than the 0.5mg jump because your GLP-1 receptors have developed tolerance.
Peak weight loss velocity: Many patients experience their fastest weight loss during this phase—2-3 pounds weekly is common. That's 8-12 pounds for the month. You're now 12 weeks into treatment with potentially 15-20 pounds lost total. Physical changes become undeniable: face slimming, waistline shrinking, overall body composition visibly shifting.
Appetite control mastery: At 1.0mg, most patients describe feeling completely in control around food for the first time in years. The medication doesn't eliminate hunger entirely—you still experience physical hunger signals when your body needs nutrition—but the obsessive food thoughts, constant cravings, and emotional eating impulses diminish dramatically.
Critical decision point: About 30% of patients in clinical trials found their optimal maintenance dose right here at 1.0mg. If you're losing weight steadily, tolerating the medication well, and approaching your goals, staying at 1.0mg makes perfect sense. There's no requirement to advance further—success is about finding what works for your body.
Month 4: Higher Therapeutic Level (1.7mg)
For patients who advance to 1.7mg, this phase typically delivers enhanced appetite suppression and continued robust weight loss. Side effects at this level vary—some patients tolerate it as easily as 1.0mg, while others experience increased nausea or fatigue that requires management strategies.
Performance at this level: Patients who maintain 1.7mg long-term typically achieve 12-15% total body weight reduction over 9-12 months. For someone starting at 200 pounds, that represents 24-30 pounds lost—significant improvement in health markers and quality of life.
The decision point: After 4 weeks at 1.7mg (around week 16-17 of treatment), you and your provider will evaluate whether advancing to 2.4mg makes sense. Key considerations include: Are you still losing 1-2+ pounds weekly? How tolerable are any side effects? Have you reached or approached your goal weight? Is the current dose effectively controlling appetite?
Maintenance consideration: Many patients establish their long-term maintenance dose at 1.7mg rather than advancing to 2.4mg. If you're achieving goals, tolerating the medication well, and continuing to lose or maintain weight, remaining at 1.7mg makes perfect sense. The maximum dose isn't mandatory—it's simply available for those who need it.
Month 5+: Maximum Maintenance (2.4mg)
The 2.4mg dose represents semaglutide's maximum approved strength for weight management. Clinical trials at this level produced the headline results—average weight loss of 15-17% over 68 weeks, with some patients losing over 20% of their starting body weight.
Who benefits most: Patients with significant weight to lose (BMI 35+) who tolerated lower doses well and continue needing robust appetite suppression. Those with type 2 diabetes alongside obesity, as higher doses provide superior glycemic control. Individuals who plateaued at 1.7mg but haven't reached their health goals.
Long-term expectations: At 2.4mg maintenance, most patients transition from rapid weight loss to steady, sustainable reduction. Expect 1-2 pounds weekly if you have significant weight remaining to lose, or weight stabilization if you've approached your goal. The medication continues providing powerful appetite control—the benefit is sustained, not diminishing.
Staying power: Research indicates that patients who reach and maintain 2.4mg have excellent long-term adherence. The initial titration difficulties have long passed, side effects typically remain minimal at this stage, and the dramatic results serve as powerful motivation to continue treatment.
Customizing Your Dosing Schedule
The standard 4-weeks-per-dose schedule works well for most patients, but individualization matters. Here's when and how to modify your progression:
When Slower Titration Makes Sense
Persistent Side Effects
If nausea, vomiting, or GI issues continue beyond the first week after a dose increase, extending that phase to 6-8 weeks allows more adaptation time. No point advancing if you're struggling to maintain adequate nutrition.
Implementation: Simply stay at your current dose for the additional weeks. Your next injection continues at the same level until side effects resolve. Then wait 4 more weeks at that dose before considering advancement.
Older Adults (65+)
Older patients often benefit from extending each dose phase to 6 weeks. Age-related changes in metabolism, kidney function, and medication sensitivity mean a more conservative approach often produces better outcomes with fewer complications.
History of GI Sensitivity
Patients with pre-existing conditions like IBS, gastritis, or GERD sometimes require longer acclimation periods. If you've always had a sensitive stomach, discuss a modified schedule with your provider from the start.
Excellent Results at Current Dose
Losing 1-2+ pounds weekly with minimal side effects at your current dose? There's no rush to increase. Many patients achieve their goals without reaching maximum dosing. The medication isn't more effective just because you're on a higher dose—it's about finding your optimal therapeutic level.
When Faster Progression Might Work
Faster titration is rare but occasionally appropriate:
- Exceptional tolerance: If you experience absolutely zero side effects through multiple dose increases, your provider might consider 3-week phases instead of 4-week. This remains uncommon—most patients do better with standard timing even when tolerating the medication well.
- Previous GLP-1 experience: Patients transitioning from other GLP-1 medications (liraglutide, tirzepatide) sometimes accelerate through early semaglutide doses since their GLP-1 receptors are already adapted.
- Medical urgency: In cases where rapid weight loss is medically necessary (pre-surgical requirements, severe diabetes complications), providers may adjust the schedule. This requires careful medical supervision.
The Golden Rule of Dose Advancement
Only advance when you're confident the current dose is fully tolerated. If you're still experiencing bothersome side effects, adding more medication only makes them worse. Patience during titration translates to better long-term adherence—and adherence is what drives results. A slower schedule that keeps you on the medication beats a faster one that leads to discontinuation.
Tracking Your Dose Response
Monitoring your journey through the dosing schedule helps you and your provider make informed decisions. Here's what to track at each stage:
Essential Metrics by Phase
Daily During Dose Increases
- • Side effect intensity (1-10 scale): Helps identify patterns and when effects resolve
- • Food intake quality: Ensure you're eating enough despite reduced appetite
- • Hydration status: Especially important with any nausea or vomiting
Weekly Measurements
- • Weight: Same day, same time, same conditions (morning, after bathroom, before eating)
- • Current dose and injection date: Track which dose you're on and when you took it
- • Appetite rating (1-10): How hungry do you feel between meals?
- • Energy levels: Note any patterns related to dose changes
Monthly Check-ins
- • Body measurements: Waist, hips, chest—changes often appear here before the scale moves
- • Progress photos: Front, side, and back views in similar lighting
- • Overall wellbeing: Sleep quality, mood, physical stamina
- • Side effect trends: Are they improving, stable, or worsening?
Dose Increase Checklist
Before each dose increase, ask yourself:
- □ Have I completed at least 4 weeks at current dose?
- □ Are side effects minimal or resolved?
- □ Am I maintaining adequate nutrition and hydration?
- □ Is my weight loss steady (at least 1 lb per week)?
- □ Have I discussed the increase with my provider?
What Your Tracking Reveals
Consistent tracking helps identify your optimal dose level. Signs you've found it include:
- • Steady weight loss of 1-2 pounds weekly
- • Minimal or no persistent side effects
- • Good appetite control without feeling deprived
- • Stable energy and mood
- • Ability to maintain adequate nutrition and hydration
If you're hitting all these markers, you've likely found your therapeutic sweet spot—whether that's 1.0mg, 1.7mg, or 2.4mg.
Finding Your Maintenance Dose
Not everyone needs to reach 2.4mg. Understanding when you've found your optimal dose prevents unnecessary increases and potential side effects.
Optimal Dose Indicators
Stay at Current Dose If:
- • Losing 1-2+ pounds weekly consistently
- • Side effects are minimal or absent
- • Appetite control feels natural
- • Energy levels remain stable
- • Approaching or at goal weight
Consider Advancing If:
- • Weight loss has plateaued for 4+ weeks
- • Appetite suppression weakening
- • Still significant weight to lose
- • Tolerating current dose very well
- • Provider recommends advancement
Dose Distribution in Clinical Trials
Understanding where patients typically settle helps set realistic expectations:
More than half of successful patients found their optimal dose below the maximum. The goal isn't reaching 2.4mg—it's finding the dose that works for your body with acceptable side effects.
Special Dosing Scenarios
Restarting After a Break
Life happens, and sometimes semaglutide treatment gets interrupted. How you restart depends on how long you've been off:
Missed 1-2 weeks (up to 14 days)
Resume at your previous dose. Monitor for side effects—your tolerance may have decreased slightly. If nausea returns significantly, drop back one dose level for a week.
Missed 3-4 weeks (15-28 days)
Drop back one dose level (e.g., from 1.0mg to 0.5mg) for 1-2 weeks before returning to your previous dose. Your GLP-1 receptors have partially reset and need time to re-adapt.
Missed 5+ weeks (29+ days)
Full re-titration from 0.25mg recommended. However, you can progress through doses faster (2-3 weeks per level instead of 4) since your body has prior experience with the medication.
Switching from Tirzepatide
Patients transitioning from tirzepatide to semaglutide need careful dose mapping. Your starting dose depends on your tirzepatide level:
Note: Tirzepatide activates both GIP and GLP-1 receptors, while semaglutide only targets GLP-1. This means appetite suppression effects may feel different, and some patients require higher relative semaglutide doses to achieve similar results.
Compounded Semaglutide Dosing
Compounded semaglutide typically comes in vials requiring manual measurement rather than fixed-dose pens. Common concentrations and their corresponding volumes:
| Target Dose | 5mg/ml Solution | 10mg/ml Solution |
|---|---|---|
| 0.25mg | 0.05 ml | 0.025 ml |
| 0.5mg | 0.10 ml | 0.05 ml |
| 1.0mg | 0.20 ml | 0.10 ml |
| 1.7mg | 0.34 ml | 0.17 ml |
| 2.4mg | 0.48 ml | 0.24 ml |
Critical safety note: Always verify concentration and dosing calculations with your provider before administering compounded medication. Measurement errors with concentrated solutions can result in serious underdosing or overdosing.
Changing Your Injection Day
Need to change your weekly injection day? You can, with one important rule: maintain at least 48-72 hours (2-3 days) between doses.
Example: If you normally inject Mondays but want to switch to Fridays, you have two options: (1) Take your Monday injection, then wait until Friday (4 days) for the next one and continue Fridays; or (2) Wait a full week plus a few days, injecting on the new Friday directly. Both approaches work—just never take two doses within 48 hours of each other.
When to Contact Your Provider Immediately
- • Persistent vomiting preventing food/fluid intake for 24+ hours
- • Severe abdominal pain, especially if accompanied by fever
- • Signs of dehydration: dark urine, dizziness, rapid heartbeat
- • Vision changes or severe headaches
- • Suspected allergic reaction: rash, itching, difficulty breathing
- • Suicidal thoughts or severe mood changes
- • Any symptom that significantly interferes with daily function
Your Dosing Journey: Final Perspective
This dosing chart represents months of gradual progression, but those months pass whether you're on semaglutide or not. The difference is that following this schedule gives you a proven path to meaningful, sustainable weight loss backed by some of the strongest clinical evidence in obesity medicine.
Success with semaglutide isn't about speed—it's about finding the approach that works for your body, tolerating the medication well enough to stick with it long-term, and achieving results that meaningfully improve your health and quality of life. Some patients reach those goals at 1.0mg. Others need 2.4mg. Both outcomes represent success.
Keep this dosing chart as your reference guide, communicate openly with your healthcare team, track your progress honestly, and trust that the gradual process serves an important purpose. In four to six months, when you're looking back at where you started, you'll understand why patience through this titration schedule made all the difference.
More on Semaglutide
Semaglutide Dosage Guide: From Start to Maintenance
Complete dosing schedule for semaglutide including titration protocol and maintenance doses.
Semaglutide Injection Guide
Learn the proper technique for self-injecting semaglutide, including site selection and storage tips.
semaglutide injection site reactions
higher dose semaglutide options
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Written by Trimi Medical Team
Our team of healthcare professionals specializes in weight management and metabolic health, providing evidence-based information to help you make informed decisions about your health journey.