Does Wegovy have a fifth dose — and what changed in 2026?

You've finished titrating to 2.4mg and you're wondering what comes next

A question our prescribers hear most weeks goes something like this: 'I've been on 2.4mg for a few months, the weight loss has slowed, is there anything higher?' Until early 2026, the honest answer was no. The 2.4mg weekly injection was the ceiling for Wegovy in the UK, and patients who plateaued there had limited options beyond optimising lifestyle and waiting.

That changed on 12 January 2026, when the MHRA granted approval for a 7.2mg maintenance dose of semaglutide (Wegovy). Initially, this meant three 2.4mg pens administered weekly, a practical arrangement but not exactly convenient. Then, on 14 April 2026, the MHRA approved a dedicated single-dose 7.2mg pen: one injection per week, with an auto-dosing mechanism, a built-in covered needle, and a lock-after-use design. The starting dose remains 0.25mg regardless; 7.2mg is the new maximum. You can read the MHRA's announcement on GOV.UK's news page for the 7.2mg Wegovy pen approval.

The licence for the 7.2mg dose applies to adults with a BMI of 30 or above, not for BMI below that threshold, and not for the separate cardiovascular indication. If you're curious whether this higher dose could be relevant to your situation, our page on the 7.2mg and higher-dose question goes into more depth on who the evidence applies to.

What the trial data actually shows at 7.2mg

The 7.2mg approval wasn't made on a hunch. Clinical trial data reported average weight loss of around 20.7% over 72 weeks at this dose, meaningfully higher than the approximately 15% average seen with 2.4mg in the STEP 1 trial, which enrolled over 1,900 adults and was published in the New England Journal of Medicine. The 7.2mg results bring semaglutide closer to tirzepatide 15mg territory, which is significant because the head-to-head SURMOUNT-5 trial (NEJM, 2025) had previously shown tirzepatide producing greater average loss than semaglutide 2.4mg over 72 weeks.

None of that makes 7.2mg the automatic next step for every Wegovy patient. Trials measure averages across populations; individual response varies considerably. Tolerability matters too, gastrointestinal effects are the most common reason patients pause or step back during titration, and a higher ceiling means more time in that adjustment window. The question of whether you have to keep increasing your dose is one worth discussing with your prescriber, not resolving alone.

For context on how Wegovy compares with the broader landscape of licensed weight-management medicines, the treatment overview page covers the options available through a regulated UK service.

The 'golden dose' idea and what it means for Wegovy

Alongside the 7.2mg news, you may have come across the phrase 'golden dose', the idea that some people find an intermediate dose that delivers good results with fewer side effects, and that this might actually be their personal maintenance level rather than a stop on the way to something higher. It's a concept worth understanding before you assume more is always better. The golden dose question explained runs through the evidence and what it means in practice.

The clinical picture here is nuanced. NICE's guidance on semaglutide (TA875) recommends reviewing whether to continue treatment if less than 5% weight loss has occurred after six months at the maintenance dose, which means the ceiling isn't purely about what's licensed, but about what's working for a specific person. NICE Technology Appraisal 875 sets out the full recommendation, including the two-year maximum and specialist-service context for NHS prescribing.

If you're at 2.4mg and wondering whether a dose question is worth raising with a clinician, or if you're earlier in the journey and planning ahead, the right starting point is a proper clinical consultation. At nume, every prescription decision is reviewed by a GPhC-registered Independent Prescriber, a real clinician reading your case, not a form being processed automatically. Our clinical team oversees every stage of treatment.

Practical things worth knowing about dose changes

Dose increases with Wegovy happen on a schedule set by your prescriber, typically in four-weekly steps, and they're not automatic. Each increase is a clinical decision that weighs your response, your tolerability, and your overall health picture. Jumping ahead, or sourcing a higher dose outside that process, carries real risks, not least because the supply of genuine Wegovy in the UK runs through GPhC-registered pharmacies, and pens sold informally may not be what they claim to be. The MHRA has flagged counterfeit weight-loss pens as a live public safety concern, and fake pens have caused serious harm. If you want to understand how the fifth dose fits into the titration schedule before discussing it with your prescriber, our page covering the Wegovy fifth dose explains what to expect at that stage.

If you're considering starting Wegovy, or you're already on it and want to understand your options, how to access Wegovy safely covers the legitimate UK route. The one transparent price at nume includes your consultation, prescription, and free tracked next-working-day delivery, no subscription, no hidden fees. You can see what's included on the treatment page, and if you'd like a prescriber to review your eligibility, checking your eligibility takes a few minutes and costs nothing.