Wegovy mg doses: how the schedule works from first injection to maintenance

Step 1, 0.25 mg: settling in, not treating yet

Every Wegovy course starts here, at the 0.25 mg dose, for a minimum of four weeks. This is not a therapeutic dose in the sense that meaningful weight change is the goal at this point. The job of the first month is to introduce semaglutide to your system gradually, reducing the chance of pronounced nausea, vomiting or other gastrointestinal discomfort that can come with a higher opening dose. Think of it as giving your gut time to adjust before the medicine begins working in earnest. Many people find the first few weeks fairly unremarkable, which is exactly right.

Practically, what arrives is a pre-filled pen containing four weekly doses. It comes via DPD in plain, unbranded packaging, no logos, nothing to signal what's inside. Once you're four weeks in, your prescriber reviews how you're tolerating treatment before authorising the next pen.

The NHS patient information for semaglutide confirms this starter approach, and you can read it on the NHS semaglutide medicines page. Dose timing, what to do if you miss an injection, and storage requirements are all covered in the Patient Information Leaflet that comes with every pen, your prescriber will always refer you there for those specifics.

Step 2, 0.5 mg, 1.0 mg and 1.7 mg: the middle rungs

After the starter month, doses increase roughly every four weeks: from 0.5 mg, then 1.0 mg, then 1.7 mg. You can read about the 0.5 mg step and what changes at that point on its own page; similarly, the 1.7 mg stage is worth reading before you reach it. Each interval gives your body another month to adapt. Weight loss tends to become more noticeable as you climb through these middle doses, though individual response varies considerably, trial data, not personal prediction, is the right frame here.

Side effects, if they appear, are most common after a dose increase and usually settle within a week or two. Nausea is the most frequently reported, followed by changes in bowel habit, indigestion and fatigue. Slow titration is the main tool for keeping these manageable. If side effects are significant at a given step, a prescriber may pause the increase rather than push forward, that is a clinical decision, not a sign that treatment has failed.

The middle of the schedule is also where some people ask about cost. For context on how private Wegovy pricing works across doses, the Wegovy prices page covers what to expect and what a legitimate private price should include.

Step 3, reaching 2.4 mg (and the newer 7.2 mg): the maintenance picture

The standard maintenance dose has been 2.4 mg since Wegovy's UK launch. At this level, the STEP 1 trial reported an average body-weight reduction of around 15% over 68 weeks in adults without diabetes, a figure from the STEP 1 paper published in the New England Journal of Medicine. Averages conceal wide individual variation; some people lose considerably more, others less.

In 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. Trials at this dose reported around 20.7% average weight loss over 72 weeks, narrowing the gap with tirzepatide results. The 7.2 mg pen is licensed for adults with a BMI of 30 or above; it is not approved for the cardiovascular indication or for BMI below that threshold. Reaching 7.2 mg still begins at 0.25 mg, the titration schedule does not compress because the target is higher. More detail on the 2.4 mg dose and the full dose comparison is on the Wegovy doses overview page.

NICE's appraisal of semaglutide (TA875) recommends it for up to two years within specialist weight management services for eligible adults. Private treatment through a regulated pharmacy like nume sits outside that NHS pathway, no waiting list, clinical assessment still required, different eligibility criteria apply. If you're curious whether you'd qualify, this page on when Wegovy starts working explains what to expect in the early weeks once treatment is under way.

Step 4, what happens if a dose increase doesn't go ahead

Titration is not automatic. If nausea or another side effect is still significant at week four of a new dose, a prescriber may hold you at the current strength for another four weeks before reassessing. This is appropriate and common. Rushing to the next milligram when your body hasn't settled serves no one well. Some people reach maintenance at 2.4 mg; others, because of tolerability, stay at a lower dose long-term. That is a clinical outcome, not a failed course. The prescriber's job is to find the highest dose you tolerate well, not necessarily the highest dose on the schedule.

Every repeat order through nume is reviewed by a prescriber before it is dispatched. There is no auto-renewal; each check is a genuine clinical re-review, which means dose changes, pauses and holds are all managed through the same channel. The weight-loss treatment overview explains how that process fits into a broader approach to long-term weight management. If you'd like to understand how our clinical team handles these decisions, our prescribers' profile sets that out. When you're ready to see whether treatment is right for you, the first step is a free consultation, no obligation, reviewed the same day by a GPhC-registered prescriber.

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