Directions for Wegovy: what the guidance actually says

What does the dose schedule for Wegovy actually look like?

The Wegovy injection schedule is designed with tolerance in mind. You start at 0.25 mg once weekly for four weeks. That first period is not about weight loss; its purpose is to let your digestive system adjust to semaglutide before the dose climbs. From there, the prescriber steps the dose up through 0.5 mg, then 1.0 mg, then 1.7 mg, arriving at the 2.4 mg maintenance dose after roughly 16 weeks of titration.

If side effects are difficult at any step, your prescriber may extend a dose level rather than push forward. That flexibility matters: the titration is a guide, not a rigid timetable. The MHRA has also approved a higher 7.2 mg maintenance dose, available as a single-dose pen, for adults with a BMI of 30 or above. Whether that is appropriate for you is a clinical decision made after assessment. Trial data published in the STEP 1 study in the New England Journal of Medicine recorded an average weight reduction of around 15% over 68 weeks at 2.4 mg alongside lifestyle changes.

For the precise step-up timings and what to do if you miss a dose, the full injection instructions for Wegovy cover the practical detail your prescriber will walk you through.

How do you actually give the injection?

Wegovy comes as a pre-filled pen. You choose an injection site (the fatty layer of the abdomen, the outer thigh, or the upper arm) and rotate between sites each week to avoid soreness building up in one spot. The pen is designed so that you do not need to see a needle to use it: press the pen against the skin, hold it still, and the mechanism does the rest.

Before injecting, check the liquid in the pen window. It should be clear and colourless. If it looks cloudy or contains particles, do not use it. Storage matters: Wegovy is kept refrigerated between 2°C and 8°C. Once taken out of the fridge, there is a limited period during which it remains usable at room temperature, the exact window is stated in your Patient Information Leaflet, and that is the figure to follow, not a general estimate you might find online.

Picking a consistent day helps. Some people tie it to a routine, a Monday-morning ritual, the same moment each week before the rest of the day starts. That kind of anchor tends to improve adherence more than a reminder app alone. The NHS semaglutide medicines page has a clear summary of how to use the pen and what to do if a dose is delayed.

Who do these directions apply to, and are there cases where they change?

Wegovy is licensed in the UK for adults with a BMI of 30 or above, or a BMI of 27 or above alongside at least one weight-related condition such as high blood pressure, type 2 diabetes or obstructive sleep apnoea. The directions in the Patient Information Leaflet are written for that licensed population. There are groups for whom use is not recommended: Wegovy is not licensed for use in under-18s, during pregnancy, while breastfeeding, or when actively trying to conceive. A full clinical picture is always assessed before a prescription is issued.

Some conditions affect how the directions are applied. If you are taking an oral contraceptive pill alongside tirzepatide, additional contraceptive precautions are recommended for the first weeks of treatment and after dose increases, because GI effects can reduce pill absorption, something worth discussing at consultation. For Wegovy specifically, the evidence of a similar effect on oral contraception is less clear, but it is worth raising with your prescriber. Conditions that affect Wegovy's suitability include a history of pancreatitis, medullary thyroid carcinoma or MEN2, and these require careful prescriber assessment before treatment begins.

Lower BMI thresholds can apply for some ethnic backgrounds under UK clinical guidance, which is explained in more detail on the eligibility criteria for Wegovy page.

What should you watch for once you have started?

The most common effects when starting or increasing the dose are gastrointestinal: nausea, diarrhoea, constipation, indigestion and burping are all reported. Most of these settle within a week or two of each dose step. Eating smaller meals, avoiding fatty or heavily spiced food in the early weeks, and staying hydrated can all help.

There are symptoms that warrant prompt medical attention. Severe, persistent stomach pain that radiates to the back (with or without vomiting) should be assessed urgently as it may indicate pancreatitis, an infrequent but serious risk that the MHRA highlighted in a Drug Safety Update in January 2026. Gallbladder-related pain, signs of dehydration if vomiting or diarrhoea is prolonged, and any symptoms of an allergic reaction also require same-day contact with a healthcare professional.

If you are thinking about how Wegovy compares to tirzepatide on both directions and outcomes, the Wegovy comparison overview sets out the evidence side by side. Questions about starting treatment can also be addressed through a consultation with the clinical team at nume. For anyone already considering their options, you can read what patients who have used Wegovy say about their experience before booking, and the free consultation is the practical next step, a GPhC-registered prescriber reviews your details the same day and can clarify exactly which directions would apply to you.