What happens with your Wegovy pen after each dose — and what to do next

Step 1, your first pen: settling in at 0.25 mg

The lowest dose, 0.25 mg, exists entirely for your comfort. It is not expected to produce significant weight loss on its own; its job is to introduce semaglutide gently so that your digestive system has time to adapt. Nausea, loose stools and indigestion are the side effects people notice most in the early weeks, and starting low keeps those experiences manageable for the majority of people. The NHS medicines page for semaglutide explains that GI symptoms are usually most noticeable in the first few days after a dose increase, then tend to settle.

Each pen holds four weekly doses, so after roughly a month you will have completed your starter pen. Once that fourth injection is done, the pen is finished, it will not click again because the mechanism locks. Put it straight into your sharps container rather than the household bin. Never recap the needle or try to extract any remaining fluid; the pen is engineered to be single-use per dose and the locking mechanism is a patient-safety feature, not a malfunction. If you are curious about what the very first injection typically feels like, our page on the experience after your first dose covers it in more detail.

Toward the end of your starter pen (around week three or four) your prescriber at nume will review how you are getting on before your next pen is issued. If side effects have been significant, your prescriber may recommend staying at 0.25 mg for another four weeks rather than stepping up. That flexibility is there deliberately.

Step 2, dose increases: what changes pen by pen

Once your prescriber is satisfied that you have tolerated the starter dose, the schedule moves upward: 0.5 mg, then 1.0 mg, then 1.7 mg, with 2.4 mg as the standard maintenance dose and 7.2 mg now available as the highest approved option following MHRA approval in January 2026. Each increase typically happens at the start of a new pen, roughly every four weeks, though your prescriber adjusts this based on your response.

The practical reality of each new pen is straightforward: same injection technique, different dose cartridge, potentially a little more nausea in the first few days at the new level. Most people find the GI effects become less pronounced with each step as their body adjusts. At each repeat, nume's prescribers review your progress before issuing the next supply, that is a clinical re-check, not an automatic dispatch. There is no subscription that sends pens out without anyone looking at your case. For an overview of the full dose range and what each step involves, our Wegovy doses guide has the complete picture.

One thing our prescribers hear fairly often: people feel a little anxious about whether a new dose will hit harder. That concern is completely understandable. The titration ladder is designed precisely to make each step incremental enough that serious discomfort is the exception rather than the rule, but if you are struggling, the right move is to contact our aftercare team rather than push through alone.

Step 3, the maintenance pen and what consistency looks like

Once you reach your maintenance dose, the pen-after-pen rhythm stabilises. You inject once a week, on a day you choose, rotating the site between your abdomen, thigh or upper arm. Consistency on the day matters less than consistency with the rotation, injection-site reactions are more likely if you use the same spot repeatedly. NICE's appraisal of semaglutide (TA875) notes that the medicine is intended to be used alongside reduced-calorie eating and increased physical activity, and the clinical evidence reflects that combination rather than the injection alone.

Storage at maintenance is the same as at every earlier stage: keep unused pens in the fridge between 2°C and 8°C. There is a limited window during which a pen can be kept at room temperature once removed from the fridge, refer to the Patient Information Leaflet packed with your medication for the exact figure, because that detail can change between product batches and formulations, and a general website is not the right place to quote it as a fixed number.

If a dose is missed, the decision on whether to take it late depends on how many days have passed since your scheduled day. The Patient Information Leaflet sets out the cut-off clearly, the standard guidance is that if more than five days have passed, skip that dose and resume on your next regular day. Do not inject twice in one week to compensate. The question of what happens specifically around your second or fourth pen is something people ask about a lot; what to expect after two doses, what to expect after three doses, and the experience around your fourth dose each cover those moments in more detail.

Disposing of each finished pen and what comes next

A used Wegovy pen is classified as a sharps waste item. It goes into a proper sharps container (not a recycling bin, not a carrier bag) before going to your local authority's sharps disposal point. Most councils collect small sharps containers or have drop-off points at GP surgeries or pharmacies; your local council website will list the nearest option.

When a pen runs out, your next supply from nume requires a repeat clinical review. That is not bureaucracy for its own sake: it is the point at which your prescriber checks that treatment is still appropriate, that side effects are manageable, and that your dose is right for where you are now. The cost of that review is included in your treatment price, there is no separate consultation charge for repeat orders. You can find a transparent summary of what is included on our Wegovy cost page. And if you have questions between deliveries, our aftercare team is available seven days a week through the contact page.

If you are weighing up whether Wegovy is the right treatment for you, or want to understand how the titration schedule would work for your circumstances specifically, starting a free consultation with our prescribers is the straightforward next step. A real clinician (not software) reviews your answers the same day.