How often should you increase your Wegovy dose?

Why four weeks between each increase, and where that figure comes from

The Wegovy titration schedule is not an arbitrary calendar. It is grounded in the pharmacokinetics of semaglutide: at once-weekly dosing, the medicine takes roughly four to five weeks to reach a steady level in the body. Moving up before that steady state is established gives neither you nor your prescriber a reliable picture of how you are tolerating the current dose. The STEP 1 trial (published in the New England Journal of Medicine) used exactly this monthly step structure across the dose escalation period, and it is the schedule reflected in the UK-licensed Summary of Product Characteristics.

Practically, that means the journey from 0.25 mg to 2.4 mg takes around sixteen weeks if everything goes smoothly. Many people take longer. A prescriber who decides the 0.5 mg or 1.0 mg step needs another month, or two, before moving on is working precisely as the guidance intends. Rushing the steps does not accelerate weight loss; it mainly increases the likelihood of nausea and other gastrointestinal side effects, which can make continuing treatment harder.

The NHS medicines page for semaglutide summarises the standard pathway clearly and is worth bookmarking alongside your treatment plan.

What the titration ladder actually looks like

Starting dose is 0.25 mg weekly for the first four weeks. This is a tolerability step, its job is to let your system adjust, not to produce meaningful weight loss. After four weeks, a prescriber moves you to 0.5 mg, then 1.0 mg, then 1.7 mg, and finally 2.4 mg, with at least four weeks between each increase. The full breakdown of Wegovy dose strengths covers each stage in more detail.

There is now also a higher 7.2 mg maintenance dose, approved by the MHRA in early 2026, including a dedicated single-dose pen approved on 14 April 2026 for adults with a BMI of 30 or above. That option is discussed at the Wegovy injection strength page; whether it applies to you is something to raise with your prescriber at your regular review, not something to request ahead of the schedule.

One practical note: the pen you use in week one lives in the fridge, not on the shelf. Keeping it in the fridge door, somewhere visible, makes the weekly rhythm easier to build. Your prescriber or the Patient Information Leaflet will confirm the exact storage window, it is narrower than most people expect for room temperature use.

What happens if you can't tolerate a dose increase

Pausing the schedule is a legitimate clinical choice. If nausea, vomiting, or other gastrointestinal effects are still noticeable four weeks into a new dose, your prescriber may recommend staying at that level for an additional four weeks before trying to move up. This does not mean treatment has failed. The STEP 1 results (an average of around 15% body weight reduction over 68 weeks) came from a population where a meaningful proportion stayed at lower doses for extended periods.

There is also a question of what to do if tolerability becomes genuinely difficult. Dropping back to a previous dose temporarily is sometimes appropriate, but this is a decision for your prescriber, not one to make unilaterally. If you are managing side effects and wondering how to support weight loss on Wegovy at your current dose, there is good evidence that dietary adjustments and activity patterns make a real difference while the titration settles.

Thinking about the cost context as doses change

One thing people rarely think about at the start is that higher doses are typically priced differently from the starter pen. As your dose increases over those sixteen-plus weeks, the monthly cost of treatment can shift. It is worth understanding how Wegovy pricing works across the dose range before you start, so the escalation does not come as a surprise.

At nume, every dose increase is clinically reviewed, not processed automatically. A GPhC-registered prescriber looks at your progress and your notes before any change is agreed, which is why checking your eligibility through a free consultation is the natural starting point if you have not yet begun treatment or are considering switching provider. The same applies if you have transferred from another service and want your current dose confirmed: evidence of your existing treatment is reviewed before anything changes.

For everything else about how Wegovy works in practice, the Wegovy overview covers the full picture, and our FAQs answer the questions our prescribers hear most often.