The maximum dose of semaglutide: what the licensed schedule reaches and why

You've been on 1.7 mg for a month and you're wondering what comes next

The Wegovy injection follows a stepped schedule: 0.25 mg for four weeks, then 0.5 mg, then 1.0 mg, then 1.7 mg, and finally 2.4 mg as the standard maintenance dose. That 2.4 mg weekly figure is the ceiling the clinical trials were built around. The STEP 1 trial, published in the New England Journal of Medicine, found an average body-weight reduction of around 15% over 68 weeks at this dose alongside lifestyle changes, a meaningful figure, but one that reflects an average across thousands of people, not a promise.

Then there's the 7.2 mg development. In January 2026 the MHRA authorised a 7.2 mg maintenance dose (initially supplied as three 2.4 mg pens per week), and in April 2026 a dedicated single-dose 7.2 mg pen was approved, one pre-set weekly injection for adults with a BMI of 30 or above. Early trial data at this dose reported average weight loss of around 20.7% over 72 weeks, which narrows the gap with tirzepatide results considerably. Whether that pen format is available to you is confirmed at consultation; the titration still starts at 0.25 mg.

The practical point: if you've reached 2.4 mg and your prescriber hasn't raised 7.2 mg, it's worth having that conversation explicitly. The higher dose is not automatic. A named clinician reviews your case (not a system running rules in the background) and that review happens before any dose change is processed.

The oral route has a different maximum altogether

If needles genuinely put you off, the Wegovy tablet has its own licensed schedule in the UK. It starts at 1.5 mg daily and steps up through 4 mg, then 9 mg, to a maximum of 25 mg once daily. The MHRA approved this formulation on 11 June 2026, making the UK the first country in Europe to license an oral GLP-1 medicine for weight management.

The 25 mg tablet ceiling matters because people occasionally arrive having read about Rybelsus, also oral semaglutide, but licensed only for type 2 diabetes at 3 mg, 7 mg and 14 mg. Those strengths are not interchangeable with the Wegovy tablet schedule. You can read more about how the semaglutide dose schedule differs by formulation if that distinction matters for your situation.

Trial data from the OASIS 4 study showed roughly 13.6% average weight loss at 25 mg over 64 weeks. Among participants who adhered fully to the daily tablet, that figure reached around 17%, though that figure only applies to the fully adherent subgroup, not the trial average. Gastrointestinal side effects were more common with the tablet than with placebo (around 74% vs 42%), generally mild to moderate and settling with time.

What stops someone reaching the maximum semaglutide dose

Two things, mainly. The first is tolerability: nausea, vomiting, constipation and other GI symptoms are most pronounced after a dose increase and can be significant enough that a prescriber holds the current dose, reduces it temporarily, or decides the next step isn't appropriate right now. Moving more slowly through the schedule is common and sensible, not a failure.

The second is response. NICE guidance on semaglutide (Wegovy) (NICE technology appraisal TA875) states that if a patient hasn't achieved at least 5% weight loss after six months at the highest tolerated dose, the prescriber should review whether continuing is worthwhile. That's a clinical checkpoint, not a cliff edge, and the conversation happens in context of everything else going on for that person.

Holidays, unusually busy months and (frankly) a dose increase landing the week before payday can all affect how smoothly someone moves through the schedule. None of those things disqualifies you from the maximum semaglutide dose, which our guidance covers in full, eventually; they're just reasons the real-world journey rarely looks exactly like the trial protocol. If you want to understand what the full Wegovy dose range looks like across the schedule, that detail is covered separately.

When the maximum dose still isn't the highest dose available

There is a specific group for whom the 7.2 mg semaglutide pen licence applies: adults with obesity (BMI 30 or above) who have stepped through the standard schedule and for whom the higher dose is clinically appropriate. The 7.2 mg approval is for weight management only at that BMI threshold, it doesn't carry across to the cardiovascular risk indication or the MASH (fatty liver disease) approval that semaglutide also holds in the UK.

Semaglutide also holds licences beyond weight management: one for reducing major cardiovascular event risk in eligible adults, and a conditional approval from July 2026 for a specific form of fatty liver disease. Those indications have their own dosing and clinical criteria, quite separate from the weight-management maximum. If your interest in the max semaglutide dose relates to weight specifically, the relevant ceilings are 2.4 mg or 7.2 mg weekly by injection, with the semaglutide 2 mg dose marking the point just before the standard maintenance level is reached, or 25 mg daily by tablet.

For a sense of where Wegovy sits in the broader private weight-loss treatment landscape, including cost context, the Wegovy cost overview runs through what private prescriptions typically include. And if you'd like to understand how you might access treatment through a GPhC-registered pharmacy, our weight-loss treatment overview is the place to start.

If this is the point where you want to move from reading to doing, our prescribers can review your eligibility through a free consultation, same-day clinical review, no waiting list. For context on the research behind higher-strength options, you can also explore what 5 mg of semaglutide looks like in the dose development data.