Wegovy injection dosage chart: what the UK titration schedule actually looks like

The myth that starting low means the medicine isn't working

A question our prescribers hear most weeks: "I'm only on 0.25 mg, is that really doing anything?" The answer is yes, but not in the way most people expect. The opening dose of 0.25 mg is there to let your digestive system get used to semaglutide, not to deliver maximum appetite suppression from week one. Jumping straight to 2.4 mg would, for most people, mean severe nausea and a far higher chance of stopping treatment early.

Semaglutide works by activating GLP-1 receptors that slow gastric emptying and signal fullness to the brain. Those effects are present at every dose level. At 0.25 mg they are mild, enough to acclimatise the gut, not enough to generate the weight-loss results the clinical trials reported. The NHS medicines page for semaglutide describes this stepped approach clearly: the early doses are a tolerability phase. Expecting the scales to move dramatically in the first four weeks sets people up for frustration. The therapeutic work begins in earnest as the dose climbs.

This matters practically because patients who don't understand the schedule sometimes try to self-escalate, moving up a step early, or asking a family member who is on a higher dose to share a pen. Both are unsafe and clinically counterproductive. Your schedule is set by your prescriber for your physiology. The chart below describes the licensed pathway; what applies to you is a clinical decision.

The five standard steps, and the newer 7.2 mg option

The standard UK titration pathway, as approved in the Wegovy SmPC, runs: 0.25 mg (weeks 1–4) → 0.5 mg (weeks 5–8) → 1.0 mg (weeks 9–12) → 1.7 mg (weeks 13–16) → 2.4 mg (week 17 onwards, maintenance). Each step is roughly four weeks, though prescribers may extend a step if the patient is experiencing significant side effects. You can find the full licensed dosing schedule in detail on the Wegovy Summary of Product Characteristics on the eMC.

In April 2026 the MHRA approved a dedicated 7.2 mg single-dose pen, a higher maintenance option for adults with a BMI of 30 or above. The pen uses an auto-dosing mechanism with a built-in covered needle that locks after use. Critically, starting dose remains 0.25 mg regardless: patients do not begin at 7.2 mg and work backwards. The 7.2 mg figure in trial data (around 20.7% average weight loss over 72 weeks) was achieved by participants who titrated up from the standard starting point. It is not a shortcut; it is an extended ceiling for people who tolerate the full schedule well.

If you are curious about what different steps involve in practice, the guide to Wegovy doses goes through each level in more depth. For context on how semaglutide compares with other weight-loss medicines, the Wegovy overview page covers the broader picture.

What the chart doesn't tell you: when to slow down, skip a step, or pause

A dosage chart is a starting-point schedule printed on paper. It does not know you had three days of nausea after moving to 1.0 mg, or that your GP flagged a kidney concern at your annual check. The clinical detail that actually governs your titration comes from your prescriber, not from any published table.

There are common situations where the standard four-week interval gets extended. Persistent vomiting, significant fatigue, or difficulty eating enough protein are all signals that the gut has not yet adapted. A prescriber may recommend staying at the current dose for eight weeks before stepping up, and that is not failure. It is the schedule working as intended. Similarly, if a patient needs surgery, the prescribing team needs to know, and timing around procedures is something to discuss directly with your anaesthetist and prescriber.

The titration schedule also interacts with contraception in a way that surprises some patients. There is no strong evidence that semaglutide reduces the effectiveness of the oral contraceptive pill in the same way tirzepatide does, but NHS England guidance still recommends discussing contraceptive choices with your prescriber before starting. That conversation belongs in the consultation, not in a comment thread. If you are considering treatment and want to understand the wider cost and access picture, the Wegovy access page explains the private prescription route in plain terms.

Practical notes for managing your injections week to week

Wegovy comes as a pre-filled injection pen, used once a week, into the abdomen, thigh or upper arm, rotating the site each time. The pen is stored in the fridge at 2–8 °C; once removed, there is a limited window at room temperature, the exact duration of which is stated in the Patient Information Leaflet that comes with your treatment. Read it.

Timing is flexible (you do not have to inject at the same time of day) but keeping to the same day of the week makes it easier to track. Some people pick a Sunday evening because it fits their routine; others choose a day they are at home in case a dose triggers brief nausea. The important thing is consistency, not which day you pick.

If you miss a dose and the next scheduled injection is five or more days away, take the missed dose as soon as you remember. If it is fewer than five days to your next injection, skip the missed dose and continue on your normal day. Never take two doses in the same week to make up for a missed one. For any uncertainty about your specific situation, the Patient Information Leaflet and your prescriber are the right sources, not online forums. The guide to semaglutide injection dosing covers the practical injection process in more detail, and if you are on or moving towards a higher strength, our page on the semaglutide 5 mg injection explains what that pen involves. Our page on how semaglutide injection doses work is also worth reading alongside your prescriber's guidance, and our FAQs address common questions that come up during treatment.