Does Wegovy Have a Fifth Dose? Understanding the Full Dose Schedule

What are the four doses in the standard Wegovy schedule?

Wegovy (semaglutide) follows a stepped titration designed to let your body adjust gradually. The schedule runs: 0.25mg for the first four weeks, 0.5mg for the next four, then 1.7mg, and finally 2.4mg as the standard maintenance dose. Each step is roughly one month apart, though the pace is set by your prescriber based on how you are tolerating the medicine. You can read more about how each stage works on the Wegovy dosing page.

The 0.25mg starting dose is there purely to let your system settle. It is not a therapeutic weight-loss dose; its job is to reduce the nausea and digestive discomfort that can come with starting a GLP-1 medicine. Most people find the side effects ease considerably once they have been on a dose for two or three weeks. The overview of all Wegovy strengths covers what each level is intended to achieve.

Throughout the titration, 2.4mg was (until recently) the ceiling. That changed with the MHRA's 2026 decision. NHS guidance on semaglutide outlines the medicine's standard use and side-effect profile, and remains a useful reference alongside anything your prescriber tells you.

Is the 7.2mg Wegovy dose what people mean by a 'fifth dose'?

Almost certainly, yes. On 14 April 2026 the MHRA approved a dedicated single-dose 7.2mg Wegovy pen, one pre-set weekly injection with an auto-dosing mechanism and a covered needle that locks after use. This sits above 2.4mg and is the highest authorised strength for Wegovy in the UK. If you add it to the four-step ladder, it becomes the fifth rung, which is likely where the phrase comes from.

It's worth being clear about who this dose is intended for. The 7.2mg pen is licensed for adults with a BMI of 30 or above only, not for people who fall under the 30 threshold, and not for the cardiovascular indication. The starting dose remains 0.25mg regardless; 7.2mg is reached through the same stepped titration, not by jumping straight to it. For a detailed look at this pen format, the Wegovy pen dose page explains the physical differences and what to expect.

Clinical trials at 7.2mg reported around 20.7% average weight loss over 72 weeks, a result that approaches tirzepatide 15mg territory. That said, trial figures describe group averages across specific study populations; individual results vary, and the page on the 7.2mg dose specifically covers the evidence in more depth.

Who decides when (or whether) a dose increase happens?

Your prescriber. This is the part of the process that matters most and is often underappreciated. Dose increases are not automatic milestones you tick through on a calendar. A prescriber looks at how much weight you have lost, how you are tolerating the current dose, and whether any side effects are still troublesome before recommending a change. Moving up is not always the right call, staying at 1.7mg for longer, for instance, can be the better option if 2.4mg caused significant nausea.

At nume, every repeat order goes back in front of a GPhC-registered prescriber for review. A real clinician reads your progress notes before any continuation or dose change is confirmed. If you are curious about whether the 7.2mg dose might be appropriate for your situation, or have questions about where you are in the schedule, the honest starting point is a proper clinical conversation, not a forum.

It is also worth knowing what the NICE recommendation for semaglutide (TA875) says about stopping: if you have not lost at least 5% of your starting weight after six months at the highest dose you can tolerate, continuing should be reviewed with your prescriber. This applies whether you are on 2.4mg or 7.2mg.

If you've been wondering whether to push for a higher dose

If you are reading this, there is a reasonable chance you have been on Wegovy for a while and feel like your progress has plateaued. That is genuinely frustrating, and it is one of the most common questions our prescribers field. The 7.2mg dose exists precisely because a meaningful proportion of patients respond better at a higher level, and the clinical evidence supports that.

The right path forward depends on your individual history: how long you have been on your current dose, what side effects you have experienced, your starting and current weight, and any other health factors your prescriber knows about. Information about the 2.4mg maintenance pen may be helpful if you are currently at that step and thinking about what comes next. If you would like a full picture of the treatment options available through a clinician-led service, the weight-loss treatments overview sets that out clearly.

Specific dose availability, including whether the 7.2mg single-dose pen is in stock, is confirmed at the point of consultation, never assumed in advance. For a broader look at how Wegovy fits into weight management overall, the Wegovy treatment page covers the medicine from eligibility through to aftercare. When you are ready to speak to a prescriber, you can check your eligibility with a free consultation.