The Wegovy weekly dose schedule — what it really means for you

The myth: you start on 2.4 mg and that is the Wegovy dose

This is probably the most widespread misunderstanding about the medicine, and it is worth addressing head-on because it leads people to expect results far sooner than the schedule allows. Wegovy does not begin at 2.4 mg. It begins at 0.25 mg, a dose whose sole purpose is to let your body adjust to the medicine's effects on the gut. At that starting level you are not yet at a dose associated with meaningful weight loss in clinical trials; you are building tolerance. Most people who stop in the first few weeks and report feeling rough are stopping precisely when the dose is at its lowest therapeutic value.

The titration plan described in the Wegovy SmPC calls for roughly a month at each step before moving upward, though your prescriber may slow that pace if side effects are significant. The full schedule to maintenance takes around four to five months for most people. Understanding this changes the question from "why isn't it working yet?" to "am I giving the schedule enough time?" If you want to read the prescribing detail, the NHS medicines page for semaglutide sets out the dose steps clearly.

You can find a fuller breakdown of each step and what to expect from it on the Wegovy dose guide, which covers the reasoning behind the schedule in more depth.

What the weekly injection schedule actually involves

One injection, once a week, on the same day each time. That rhythm matters because semaglutide has a half-life of roughly a week, meaning the medicine's concentration in your body relies on regular, evenly spaced dosing. Shifting your injection day by a day or two occasionally is manageable, but the approach to a missed dose depends on how much time has passed, and your Patient Information Leaflet gives the exact guidance for that situation.

A question the prescribers at our clinical team hear fairly often is whether you could split the weekly amount across two smaller injections to reduce nausea. The honest answer is no: the medicine is not formulated or licensed for twice-weekly splitting, and taking half the intended weekly dose twice introduces dosing uncertainty rather than reducing it. Semaglutide's once-weekly design is an intrinsic part of how it maintains consistent blood levels. The page on halving the Wegovy dose across two days explains the pharmacokinetic reasons in plain terms.

Injection sites (abdomen, thigh, or upper arm) should be rotated each week. Side effects tend to cluster around dose increases rather than persisting indefinitely; nausea and loose stools are most commonly reported in the days after stepping up, then often settle. Most people who get to maintenance report that the first few weeks at each new level were the hardest part.

The 7.2 mg dose: who it applies to and what changed

On 14 April 2026, the MHRA approved a dedicated single-dose 7.2 mg Wegovy pen, following earlier approval of the 7.2 mg dose itself in January 2026. This higher maintenance option is licensed specifically for adults with a BMI of 30 or above; it is not approved for people using Wegovy for its cardiovascular indication or for those whose BMI falls below that threshold. Trial data reported an average weight loss of around 20.7% over 72 weeks at 7.2 mg, which brings semaglutide's results closer to those seen with tirzepatide at its highest doses. The MHRA's announcement of the 7.2 mg pen approval is publicly available on GOV.UK.

The titration journey to 7.2 mg still starts from 0.25 mg; the prescriber decides when, or whether, a patient is a candidate for the higher dose. Whether a specific pen format is available at any given time is confirmed at consultation, stock and dispensing decisions are clinical, not something to lock in from a webpage.

If you are comparing how semaglutide's weekly dosing compares with the approach for tirzepatide, the semaglutide weekly dose overview and the broader weight-loss treatment guide both give relevant context.

What affects how your dose is set and whether it changes

People sometimes arrive at a consultation assuming their dose will follow an automatic month-by-month escalation regardless of how they are getting on. That is not quite how it works. A prescriber reviews your response, your side-effect experience, and your overall health picture before every dose change. Some people stay at an intermediate dose because 2.4 mg produces significant GI disturbance for them; others reach 2.4 mg quickly and tolerate it well.

For context on cost alongside the clinical picture, the guide to getting Wegovy through a regulated UK pharmacy covers what a legitimate private prescription should include. The cost of treatment varies by dose and provider; what a compliant price should always include is the clinical assessment, not just the pen. A breakdown of what to weigh up is also on the Wegovy overview page. If you are thinking about how the first injection step feels before committing, the page on what to expect in the first week is practical reading. And if you want to explore options across the full range of licensed treatments, speaking to our prescribers is the right next step, no referral, no waiting list, just a clinical assessment done the same day.