How many mg of Wegovy should you take — and how does the schedule work?

Step 1: why every course opens at 0.25 mg

A common belief is that a higher starting dose will produce faster results. It won't, and it raises the risk of nausea, vomiting and other gastrointestinal side effects that cause people to stop treatment early. The 0.25 mg starting dose is a tolerability step: its job is to let your gut adapt to semaglutide, not to drive significant weight loss. You stay on it for four weeks before your prescriber considers moving up.

This opening phase is also when most of the injection-site adjustment happens. Rotating between the abdomen, thigh and upper arm helps keep reactions minor. If 0.25 mg still causes significant discomfort, a prescriber may extend the period at this level rather than escalating, there is no fixed rule that says you must step up after exactly four weeks. Your comfort and tolerability guide the pace. For a closer look at the early days of treatment, the guidance on taking your first Wegovy dose covers the practical side in more detail.

One thing worth knowing early: missed doses, illness and recent dose increases can all affect how the medicine feels. The Patient Information Leaflet is the right reference for what to do in those situations, not a general article.

Step 2: the four middle steps and what drives the decision to increase

After the initial 0.25 mg period, the standard schedule moves through 0.5 mg, then 1.0 mg, then 1.7 mg, each held for approximately four weeks before your prescriber reviews whether to progress. That four-week window gives a realistic read on how you are tolerating each level. Jumping rungs to get to a higher dose faster is not recommended and is not something a responsible prescriber will support.

The decision to increase is based on two things: tolerability (are side effects manageable?) and, at later steps, clinical progress. Semaglutide was studied in the STEP 1 trial at 2.4 mg for 68 weeks, producing an average body-weight reduction of around 15%, but that figure reflects sustained treatment at maintenance dose, not early weeks at lower levels. Pushing dose increases before the body is ready does not bring that outcome closer; it usually delays it by triggering side effects that force a step back down.

If you are weighing up how quickly to progress or what prompts an increase, the page on how often Wegovy dose increases happen goes into the clinical reasoning in more depth. The signs that a dose increase might be due are also worth reading before your next review.

Step 3: reaching 2.4 mg, and the 7.2 mg option approved in 2026

For most people, 2.4 mg once weekly is the maintenance dose. You reach it after roughly 16–20 weeks on the full titration schedule. NICE's recommendation for semaglutide (Wegovy) specifies a maximum treatment duration of two years within a specialist weight management service, with a review if less than 5% weight loss has occurred after six months at the maintenance dose. That review threshold applies at whichever maintenance dose you are on.

On 14 April 2026, the MHRA approved a dedicated single-dose 7.2 mg pen, the first of its kind. It is licensed for adults with a BMI of 30 or above, and titration still begins at 0.25 mg; 7.2 mg is the ceiling, not the starting point. Trials reported around 20.7% average weight loss over 72 weeks at this dose, narrowing the gap with tirzepatide at its highest strength. Whether the 7.2 mg pen is clinically appropriate for a given patient is a prescriber's decision made at consultation, and if you are unsure where you fit within the schedule, the page on what dosage of Wegovy you should take sets out how those decisions are made. The full overview of available Wegovy dose options covers both pen formats.

Treatment cost is part of the picture for many people considering private prescribing; the weight-loss treatment overview includes context on what private treatment typically involves.

Step 4: what your prescriber is looking at before every repeat

Unlike a standard repeat prescription, clinical review before each supply matters here. A prescriber checks that your current dose is still appropriate: that you are tolerating it, that your weight trajectory is in the expected range, and that no new health information changes the picture. This is the same process whether you are on your second pen or your tenth.

At nume, our pharmacy operates under GPhC registration 9012878, and every repeat goes to a real prescriber for review, the same day for orders placed before noon Monday to Friday. Evidence of your current dose and progress is part of what makes that review meaningful rather than administrative. If you have questions about the process or about your current stage in the titration schedule, the FAQs cover the most common ones, including guidance on what dose of Wegovy to start with if you are at the beginning of treatment, and the team is reachable through the contact page seven days a week.

If you are ready to discuss which dose stage is right for your situation, check your eligibility with a free consultation.