Wegovy injection strengths: how the dose ladder works in the UK

What strengths does Wegovy come in, and why so many?

A question our prescribers hear most weeks: "do I have to start at the lowest dose, even if I want to lose weight quickly?" The short answer is yes, and there is a good reason for it.

Wegovy (semaglutide) is injected once a week. The UK-approved strengths run in a stepped sequence: 0.25 mg, 0.5 mg, 1.0 mg, 1.7 mg, and 2.4 mg, with 7.2 mg now sitting at the top following MHRA approval in 2026. Each step is designed to be held for roughly four weeks before moving to the next, giving your digestive system time to adapt. Semaglutide slows gastric emptying and reduces appetite through GLP-1 receptor activation; doing that abruptly at a high dose tends to cause pronounced nausea, vomiting and other gastrointestinal side effects. The gradual climb is not bureaucratic caution, it is how the medicine works best in practice.

The 0.25 mg strength is a tolerability phase. Your body is learning to work with the drug; meaningful appetite reduction typically comes later in the schedule. The Wegovy dosing overview covers what to expect at each stage. For a visual reference, the Wegovy dosage chart maps the schedule month by month.

How does the 7.2 mg strength differ from standard maintenance?

The 2.4 mg weekly injection was Wegovy's maintenance dose from launch. On 14 April 2026, the MHRA approved a dedicated single-dose 7.2 mg pen, a pre-set, once-weekly injection with an auto-dosing mechanism and a built-in covered needle that locks after use. This approval applies to adults with a BMI of 30 or above; it is not licensed for lower BMI thresholds or for Wegovy's cardiovascular indication.

Trial data reported in connection with the 7.2 mg approval showed an average body-weight reduction of around 20.7% over 72 weeks, approaching the figures seen with tirzepatide 15 mg in the SURMOUNT programme. The starting dose remains 0.25 mg regardless of which maintenance strength you are ultimately aiming for; the same graduated escalation applies. The Wegovy highest strength page goes into more detail on what the 7.2 mg approval means practically.

It is worth being clear: getting to 7.2 mg is not the goal for every patient, and whether you ever reach it depends entirely on your prescriber's assessment of your progress and tolerance. The NHS medicines page for semaglutide on the NHS website provides patient-level information on the dose schedule and what to expect.

What happens if a strength is missed or a dose increase is delayed?

Dose increases are not a clock you set yourself. If side effects at a given strength are still noticeable after four weeks, it is entirely reasonable for a prescriber to hold you at that level for an additional month before moving up. Missing a scheduled dose, or taking a pen late, is covered in the Patient Information Leaflet supplied with your medication; prescribers and the leaflet are the right places to check, not a general website.

What is clear from the licensed schedule is that skipping steps or jumping strengths is not recommended. The escalation is cumulative, each rung prepares the body for the next. If you have been on treatment elsewhere and are transferring, a prescriber will want to see evidence of your current dose before continuing at the same level. That is standard clinical practice, not obstruction.

For a broader picture of how semaglutide's dose structure compares with tirzepatide's, the semaglutide injection dose guide and the Wegovy overview page both add useful context. If you are thinking about cost alongside dose, the weight-loss treatment overview explains how pricing works across different options without burying the details.

Does being on a lower Wegovy strength mean it is not working?

Not at all. The relationship between dose and outcome is real (higher maintenance doses tend to produce greater average weight loss in trial populations) but individual responses vary considerably. Some people see strong results at 1.7 mg and their prescriber decides that is the right stopping point. Others tolerate the full escalation without difficulty, including those who progress all the way to the semaglutide 5mg injection, which sits in the escalation sequence before the 7.2 mg maintenance pen. Neither pattern signals failure.

The NICE appraisal of semaglutide for weight management, NICE technology appraisal TA875, notes that continuing treatment should be reviewed if less than 5% weight loss has occurred after six months on the maintenance dose. That 6-month review is a safety net, not a judgment call you make on your own. Your prescriber is the right person to assess whether the current strength is working and what, if anything, should change.

If you are exploring whether Wegovy is the right fit for your situation, our clinical team reviews consultations the same day, a named prescriber reads your answers, checks your medical history and makes the call. Start with a free consultation to find out where you stand.