Raw semaglutide dosage: what the titration schedule actually means

Step 1: the starting dose and why 0.25 mg is not a therapeutic level

The injection schedule begins at 0.25 mg once weekly for four weeks. This is purely a tolerability dose. At this level, most people experience minimal weight-loss effect, that's by design. The first four weeks give your gut's hormone-receptor system time to adjust to semaglutide's mechanism (GLP-1 receptor agonism slows gastric emptying and reduces appetite signalling), which is also what drives the nausea and digestive discomfort that can accompany the early weeks. Jumping straight to a higher dose doesn't accelerate results; it increases the likelihood of side effects that force you to step back down anyway.

Your prescriber reviews your response before authorising the step to 0.5 mg. At nume, that review is carried out by a named GPhC-registered prescriber, not automated software. If 0.25 mg is producing symptoms that feel unmanageable, that conversation happens before anything changes.

The NHS patient information for semaglutide covers the injection technique and what to do if a dose is missed, and understanding how semaglutide dosage works is worth reading alongside any clinical advice you receive. The short answer on missed doses: follow the Patient Information Leaflet, and ask your prescriber rather than doubling up.

Step 2: climbing from 0.5 mg to 1.7 mg (what each four-week interval is actually doing

Each subsequent rung on the ladder) 0.5 mg, 1.0 mg, 1.7 mg, is held for approximately four weeks before the next increase is considered. For most people, meaningful appetite suppression becomes noticeable somewhere in the 0.5–1.0 mg range. Weight loss tends to accelerate as the dose climbs, though the rate varies considerably between individuals depending on diet, activity, starting weight and how well the drug is absorbed.

Side effects are typically most pronounced after a dose increase and settle within one to two weeks. The GI profile (nausea, loose stools, constipation, reflux) is common across the ladder but generally mild to moderate and transient. Staying well hydrated and keeping fat-heavy meals smaller helps most people manage the adjustment period without needing to pause the titration.

Understanding how the increases are timed in detail is covered on the semaglutide dose escalation page, including what happens if a step needs to be held longer. The short version: slower is fine; faster is not.

Step 3: reaching 2.4 mg and the case for the newer 7.2 mg option

The 2.4 mg weekly injection has been the standard maintenance dose since Wegovy's UK approval, supported by the STEP 1 trial's finding of roughly 15% average body-weight reduction over 68 weeks. Not everyone reaches 2.4 mg, some people achieve good results at a lower maintenance level and stay there with their prescriber's agreement.

The MHRA approved a 7.2 mg maintenance dose for semaglutide in January 2026, initially supplied as three 2.4 mg pens administered in a single weekly session. On 14 April 2026 a dedicated single-dose 7.2 mg pen was approved, one pre-set injection per week, with a built-in covered needle that locks after use. Trial data showed approximately 20.7% average weight loss over 72 weeks at this dose, narrowing the gap with tirzepatide's 15 mg results. The 7.2 mg dose is licensed for adults with a BMI of 30 or above only; it is not approved for lower-BMI weight-related conditions. You can read more about the maximum licensed dose of semaglutide and what the evidence says about who benefits most.

Cost context is worth factoring in: the Wegovy cost page sets out how private treatment is priced across the dose range, and what a transparent all-inclusive price should cover.

Oral semaglutide: a completely different dose schedule

The Wegovy tablet (approved by the MHRA on 11 June 2026 as the first oral GLP-1 medicine licensed for weight management in the UK) uses a separate schedule that has no overlap with the injection figures. The tablet steps are 1.5 mg, 4 mg and 9 mg, building to a 25 mg daily maintenance dose, with at least one month at each level.

These tablet strengths are easy to confuse with Rybelsus, which is also oral semaglutide but licensed for type 2 diabetes at 3 mg, 7 mg and 14 mg. Those are entirely different products for a different indication. The weight-loss tablet ladder is 1.5 → 4 → 9 → 25 mg and nothing else. Taken first thing in the morning on an empty stomach with up to 120 ml of plain water, with a minimum 30-minute gap before any food, drink or other medicine, the tablet is a practical option for people who prefer not to inject. No refrigeration is required, which is a genuine convenience if you travel regularly or just find the fridge logistics awkward.

The OASIS 4 trial reported roughly 13.6% average weight loss over 64 weeks versus placebo, rising to around 17% among participants who adhered fully to treatment. The Wegovy treatment page covers both the injection and tablet in more detail. For a side-by-side look at all licensed dose options, the semaglutide dosage chart is the clearest reference. And if you want to understand where semaglutide sits relative to other weight-loss treatments available in the UK, the weight-loss treatments overview is a good starting point.