Wegovy doses: the full UK titration schedule explained

You've just been prescribed Wegovy, and 0.25 mg feels like nothing

A lot of people look at that first dose and feel quietly disappointed. 0.25 mg sounds tiny. You've read about 2.4 mg or even 7.2 mg online, and the gap seems enormous. Here's the thing: the starter dose is not meant to produce weight loss. Its job is to introduce semaglutide to your system slowly enough that nausea, indigestion and stomach cramping stay manageable. Think of it as a settling-in period, not a therapeutic plateau.

After roughly four weeks at 0.25 mg, your prescriber will typically move you to 0.5 mg, then 1.0 mg, then 1.7 mg, and finally 2.4 mg, the standard maintenance dose that was the focus of the STEP 1 trial, published in the New England Journal of Medicine, which reported an average body-weight reduction of around 15% over 68 weeks. Each step takes at least a month. The pace is deliberate: the gastrointestinal side effects that put people off Wegovy early on are much easier to tolerate when the dose climbs gradually. The practical rules around taking Wegovy matter here too, what you eat during each dose stage can make the difference between a smooth transition and a difficult one.

If at any point side effects become unmanageable, your prescriber may hold you at a lower dose for longer. That's normal clinical practice, not a failure.

What happens once you reach 2.4 mg, and when 7.2 mg enters the picture

For most people on Wegovy, 2.4 mg is where treatment settles. It's the dose that has the longest evidence base and is the foundation of NICE guidance on semaglutide for weight management. You stay at 2.4 mg for as long as treatment continues and remains clinically appropriate, NICE's appraisal of semaglutide (TA875) recommends use within a specialist weight management context, with a review if less than 5% weight loss has occurred after six months on the maintenance dose.

The 7.2 mg dose changes that picture somewhat. On 12 January 2026 the MHRA approved 7.2 mg as a higher maintenance option, initially supplied as three 2.4 mg pens per week. Then, on 14 April 2026, the MHRA approved a dedicated single-dose 7.2 mg pen, one pre-set weekly injection, with a built-in covered needle that locks after use. Trial data at 7.2 mg reported approximately 20.7% average weight loss over 72 weeks, narrowing the gap with tirzepatide 15 mg results considerably. For anyone wanting to understand how semaglutide sits alongside other licensed treatments, the semaglutide overview sets out the broader context clearly.

One important detail: the 7.2 mg pen is licensed for adults with a BMI of 30 or above only. It is not approved for the cardiovascular risk indication, and eligibility is confirmed through clinical assessment, not self-selection. Specific dose availability is always confirmed at consultation, no prescriber should commit to a particular pen format before reviewing your case.

The dose your prescriber chooses depends on more than your BMI

People sometimes assume they can work out their ideal Wegovy dose from a chart. In reality, the clinical picture is more layered. Prescribers weigh up tolerability at each stage, any weight-related conditions you have, how your body has responded so far, and whether you're on other medicines that interact with semaglutide. If you prefer to read guidance in Spanish, our page covering la dosis de Wegovy explains the schedule in full, while how Wegovy dosing works covers the same ground in English with additional clinical detail. How Wegovy dosing is approached for weight loss specifically goes into that detail if you want to read further.

There's also a practical side. Women taking oral contraceptives alongside tirzepatide are advised to add a barrier method during the first four weeks of treatment and after each dose increase, because absorption may be affected. The equivalent guidance for semaglutide is less restrictive (NHS evidence does not flag the same level of concern for the pill) but it remains worth raising at consultation if it applies to you. The school-run moment here is real: people sometimes collect their repeat pen on the way out the door without reading the updated patient information leaflet. That leaflet changes when new dose formats are approved, and it's worth a read each time.

For anyone wondering about cost alongside the dosing question, the treatment page gives a clear picture of what's included in a private prescription through a GPhC-registered pharmacy. The broader range of weight-loss treatments we offer is there too, if you're still deciding which medicine suits your situation.

How a clinical review at nume sets each dose, safely

At nume, every dose decision sits with a GPhC-registered Independent Prescriber. Not a form that auto-approves. A named clinician reads your consultation the same day, checks your health history, reviews any evidence required for a transfer or dose increase, and determines whether the next step is clinically appropriate. Our clinical team takes that review seriously, and takes it personally.

If you're not yet on Wegovy and want to understand whether you'd be eligible, or if you're already on treatment elsewhere and considering a transfer, the process for accessing Wegovy through a registered online pharmacy walks through what to expect. The FAQ page covers some of the questions that come up most often once treatment has started. And if you'd like to speak to someone directly, our support team is available seven days a week. When you're ready, check your eligibility through a free consultation, there's no obligation, and the clinical review costs nothing upfront.