Wegovy comes as 1 pen with 4 doses — here's what that means for your treatment

The myth worth correcting first: 'four doses' does not mean four different strengths

Search for Wegovy and you will quickly find people writing about "dose 1, dose 2, dose 3, dose 4" as if each injection inside a pen is a different step up. It is not. Every injection from a single pen delivers exactly the same amount of semaglutide. If you are on the 0.5 mg pen, all four shots are 0.5 mg. The pen does not automatically escalate. Titration (the gradual increase from a lower to a higher strength) happens when you move from one pen to the next, and only when your prescriber decides you are ready.

This matters because assuming you are "on dose 3" of a single pen is medically meaningless. What matters is which strength pen you are currently using and when your prescriber plans to review your progress. If you are mid-way through a 1 mg pen, you have had two or three injections at 1 mg, you have not crossed any titration threshold. The full Wegovy dose schedule sets this out clearly. Per the NHS patient information for semaglutide, the standard maintenance target for most adults is 2.4 mg weekly.

The practical upshot: track which pen strength you are on and how many injections you have taken from it, not which "dose number" within the pen.

How the four injections inside each pen are meant to work

You inject once a week, on the same day each week if you can manage it. Four injections use the pen up completely. At that point, if your prescriber has cleared you to step up, you open a pen of the next strength and continue. If you are staying at the same dose (because 4 or 12 weeks at a given level is still early, or because side effects need settling) you simply open another pen of the same strength.

The pen itself clicks to confirm delivery and will not refire once all four doses are used, and if you want a closer look at how a single Wegovy pen with its four doses works in practice, we cover that in detail. There is no manual measuring and no cartridge to change. A used pen should go into a sharps bin rather than a household bin; our FAQs cover disposal. Storage is straightforward between uses: the pen stays in the fridge at 2–8°C. For the exact out-of-fridge window before a dose, check the Patient Information Leaflet inside the box rather than relying on any third-party source, that window matters more than most people realise.

One timing note worth planning for: orders placed after 12 pm, or over a bank holiday, ship the next working day. If payday falls mid-week and you plan to order then, a Monday morning order will land Tuesday. Build that into your calendar so your injection day does not slip.

Which pen strength you are on, and who decides when to move up

The licensed titration path runs 0.25 mg → 0.5 mg → 1.0 mg → 1.7 mg → 2.4 mg, spending roughly four weeks at each level, and you can find a full breakdown of Wegovy pen doses and what each strength involves if you want to read into the specifics. The 2.4 mg pen is the standard maintenance dose for most adults. As of April 2026, the MHRA has also approved a 7.2 mg pen for adults with a BMI of 30 or above who need a higher maintenance dose, confirmed by the gov.uk announcement on 14 April 2026. Whether that higher dose is appropriate for you is a clinical question, not one the pen format answers on its own.

Your prescriber (not the pens arriving through the post) decides the pace. Moving up because a new pen of a higher strength has arrived is not a clinical basis for a dose increase. At nume, every repeat order receives a fresh clinical review before dispatch; for each new four-dose pen, a prescriber looks at your progress before confirming the right strength. That review is what separates a legitimate supply from an unmonitored one.

Eligibility for Wegovy broadly requires a BMI of 30 or above, or 27 or above alongside a weight-related health condition such as high blood pressure or type 2 diabetes. Lower BMI thresholds apply for some ethnic backgrounds under UK guidance. Those criteria are a starting point; the prescriber's full assessment is what matters. You can read more about how the dose delivered by each Wegovy pen is determined if you want more detail on specific strengths.

Practical side-effect awareness by pen stage

Gastrointestinal effects (nausea, loose stools, reflux, low appetite) are most common when starting treatment or stepping up to a new strength. Because each pen stays at a fixed dose for four weeks, your system usually has time to adjust before the next increase. That adjustment window is one reason the titration is spread out the way it is.

If side effects are significant, the answer is usually to stay at the current pen strength for longer rather than push ahead. Severe, persistent abdominal pain that radiates to the back needs prompt medical attention regardless of which pen you are on, this can be a sign of pancreatitis, which the MHRA highlighted as a known risk in a 2026 Drug Safety Update. Any side effect you want to flag can also be reported directly through the Yellow Card scheme at the same link.

If questions about a specific dose come up mid-treatment, the right place to take them is your prescriber rather than a forum. For broader reading on the treatment, the weight-loss treatment overview covers how Wegovy sits alongside diet and activity support.