Wegovy's highest strength: what the 7.2mg approval means for you

What the MHRA approval data actually showed at 7.2mg

The case for a higher-than-2.4mg semaglutide dose was built gradually. When Novo Nordisk submitted the data, the picture was striking: at 7.2mg weekly over 72 weeks, participants lost an average of around 20.7% of their body weight. That narrowed a gap that, on paper, had made tirzepatide look dominant — the STEP 1 trial, published in the New England Journal of Medicine, had placed 2.4mg semaglutide at roughly 15% average loss over 68 weeks, a meaningful difference from the SURMOUNT-1 tirzepatide figures.

The MHRA authorised the 7.2mg maintenance dose in January 2026. Initially, it was delivered as three separate 2.4mg pens in a single weekly session, which was workable but not elegant. The dedicated single-dose 7.2mg pen, approved on 14 April 2026, addressed that, one auto-dosing pen, covered needle, locks after use. If you want to understand how Wegovy's strengths are structured across the full range, from the starting dose right through to the newest additions, that gives useful context for where 7.2mg sits.

One caveat on the 7.2mg licence worth knowing: it applies only to adults with a BMI of 30 or above. The cardiovascular indication that Wegovy also holds does not extend to the 7.2mg pen. A prescriber will make clear which licence applies to your situation.

The titration path to the highest dose

Nobody starts at 7.2mg. The licensed schedule begins at 0.25mg, stepping up approximately every four weeks through 0.5mg, 1.0mg, 1.7mg and 2.4mg before the newer top rungs, and a full breakdown of the Wegovy dose schedule, including what each stage involves, is worth reading before you start. The principle behind slow escalation is straightforward: the GI side effects that most people experience (nausea, loose stools, that heavy-after-a-small-meal feeling) tend to be sharpest at step-up moments and softer once the body has had a few weeks to adjust.

For anyone already established on 2.4mg weekly injections, the path to 7.2mg is a clinical conversation, not automatic. Details on what reaching the highest Wegovy dose actually involves, and who it is most likely to suit, are worth reviewing before that conversation. A prescriber will look at how well the previous dose was tolerated, what weight progress has looked like, and whether 7.2mg is the right next step or whether staying at a lower maintenance dose makes more sense. Titration decisions sit firmly with the prescriber; the Patient Information Leaflet covers the schedule in full and should always be the reference for timing.

If you're switching from the weekly injection to the oral Wegovy tablet, the route is different again, patients already on 2.4mg injections may be able to move directly to the 25mg tablet, but that too requires clinical assessment.

Side effects at the highest strength and when to seek help

The higher the dose, the more pronounced the GI effects tend to be, at least initially. Nausea is the most commonly reported, followed by diarrhoea, constipation, vomiting and reflux. In most people these ease within days to a couple of weeks of each step up; at 7.2mg the adjustment period can feel more noticeable than at lower doses. Fatigue and headaches are reported less frequently but are part of the profile.

There are symptoms that need prompt medical attention regardless of which dose you're on. Severe stomach pain that radiates to the back, with or without vomiting, should be treated urgently, pancreatitis is a known, if uncommon, risk with this class of medicine. The MHRA's Yellow Card service allows patients to report any suspected side effects directly, which is worth bookmarking. Signs of a serious allergic reaction, significant dehydration after sustained vomiting or diarrhoea, and gallbladder symptoms all warrant a same-day call to a clinician or 111.

Women using oral contraceptives alongside tirzepatide face a separate consideration around pill absorption; for semaglutide, NHS guidance currently notes no equivalent evidence of reduced pill effectiveness, though your prescriber is the right person to review your full medicines list. If you have questions about what strength of Wegovy actually works for different people, and how to think about that decision, that page walks through the research in detail.

NHS access versus a private route at the highest dose

The NICE recommendation for Wegovy (semaglutide, TA875) specifies use for a maximum of two years, within a specialist weight management service, for adults with a BMI of 35 or above and at least one weight-related condition. Those thresholds are higher than the licence itself, and the specialist-service requirement means NHS access can involve long waits. Understanding how Wegovy strength options are defined and licensed helps clarify where the 7.2mg dose fits within those commissioning decisions, since formulary choices at individual services vary.

For people who don't meet the NHS criteria or don't want to wait, private treatment through a regulated online pharmacy is the legal alternative. Before booking with any online service, it takes about 30 seconds to check a pharmacy's registration on the GPhC register, something worth doing with any provider. Planning matters here too: if payday falls mid-month or you're away over a bank holiday weekend, timing your prescription request around the 12pm Monday-to-Friday cut-off for same-day dispatch is the kind of practical detail that makes a difference.

Our clinical team reviews every consultation personally, you can read more about our prescribers and the clinical oversight behind each decision. If you're ready to discuss whether the highest Wegovy strength is appropriate for you, the right starting point is a free consultation with our prescribers.