How Wegovy pens and doses work: the UK titration schedule

Step 1, starting at 0.25 mg: settling your system, not treating it yet

The first pen delivers 0.25 mg of semaglutide once a week. This is a tolerability step. Its job is to introduce the medicine gradually so that gastrointestinal side effects (nausea, bloating, loose stools) are kept to a manageable level. Most people notice some GI sensitivity in the first couple of weeks; it tends to ease as the body adapts. After roughly four weeks, a prescriber assesses whether you are ready to move up.

Injection technique matters from the start. The pen goes into the fatty tissue of your abdomen, thigh or upper arm; rotating the site each week reduces irritation. Storage is refrigerated at 2–8°C, but once you are using a pen, a limited window at room temperature applies, the full Wegovy overview covers storage details, and the Patient Information Leaflet should always be your reference for the exact window.

A question our prescribers hear most weeks: "Can I stay on 0.25 mg for longer if I feel fine?" The answer is yes, if your clinician agrees, the schedule is a guide, not a mandate. Rushing through steps is rarely worthwhile.

Step 2, building through 0.5 mg, 1.0 mg and 1.7 mg: the escalation phase

After the starter dose, the titration moves through 0.5 mg, then 1.0 mg, then 1.7 mg, each held for a minimum of around four weeks. The NHS patient information for semaglutide sets out this schedule clearly, and your prescriber may slow it further if you are still experiencing significant nausea at a given level. Pushing ahead while side effects are prominent tends to make things worse, not better.

At each step, the appetite-suppressing effect of semaglutide becomes progressively stronger. GLP-1 receptor agonists slow gastric emptying and signal fullness to the brain, the mechanism is consistent across all doses, but the degree of effect scales with dose. If you want a closer look at the evidence behind those outcomes, the semaglutide dose and results breakdown covers the trial data in more detail.

Missed a dose? The guidance in the leaflet is the right place to check, not general internet advice. Your prescriber can also clarify what to do based on where you are in the schedule, and if you are unsure which pen doses apply at your current stage of treatment, that page sets out the full picture. If you would like a broader guide to how Wegovy pens and dosage work across the full schedule, that page explains what to expect at each step. The frequently asked questions page addresses some of the most common practical queries.

Step 3, reaching 2.4 mg maintenance: the standard long-term dose

For most people following the licensed schedule, 2.4 mg is the maintenance dose. The STEP 1 clinical trial (a 68-week study published in the New England Journal of Medicine) found an average body-weight reduction of around 15% at this dose, alongside a reduced-calorie diet and increased activity. That figure comes from a large randomised trial and is a population average, not a guarantee for any individual.

Once at 2.4 mg, the goal shifts to sustaining the effect. Protein intake, hydration and physical activity all support long-term results; your prescriber or a dietitian can advise on specifics. If you are thinking about the private cost of staying on treatment, the guide to where and how to access Wegovy in the UK puts pricing in context. The treatment page shows what is currently available through our pharmacy.

If you have not lost at least 5% of your body weight after six months at the maintenance dose, your prescriber will review whether continuing is the right call. NICE's recommendation for semaglutide under technology appraisal TA875 explicitly includes this stopping criterion. It is a clinical safeguard, not a punitive rule.

Step 4 (the 7.2 mg dose: what the MHRA's 2026 approval means for patients

On 14 April 2026, the MHRA approved a dedicated single-dose 7.2 mg Wegovy pen) one pre-set weekly injection with an auto-dosing mechanism and a built-in covered needle that locks after use. This followed the January 2026 approval of 7.2 mg delivered across three 2.4 mg pens weekly. The higher dose is licensed for adults with a BMI of 30 or above; it is not approved for the cardiovascular indication at this strength.

Trial data for 7.2 mg reported average weight loss of around 20.7% over 72 weeks, narrowing the gap with tirzepatide 15 mg results from the SURMOUNT programme. The starting dose is still 0.25 mg; a prescriber titrates you up, and 7.2 mg is the ceiling. If you want to understand how the injector devices themselves differ at each stage, our page on Wegovy dose pens walks you through the formats used across the full titration schedule. For questions about which dose or pen format is right for you, the place to start is a consultation rather than a product page, our clinical team reviews every case individually.

Side effects at higher doses tend to mirror the GI pattern seen across the titration: nausea and digestive discomfort are most common, typically most pronounced after each increase. Severe or persistent stomach pain that radiates to the back should be assessed promptly, this is the symptom pattern associated with pancreatitis, which the MHRA highlighted in a January 2026 Drug Safety Update. Any suspected side effect can be reported at the Yellow Card scheme.