What are the doses for semaglutide used in weight management?

What does the Wegovy injection dose ladder actually look like?

The subcutaneous injection follows five steps. Weeks 1–4 use 0.25 mg, a dose chosen to settle the digestive system rather than produce meaningful weight loss. Weeks 5–8 move to 0.5 mg. At weeks 9–12 the dose rises to 1.0 mg, then 1.7 mg at weeks 13–16, and if you want to understand what people experience at the 1.7 mg stage, including before and after accounts, those real-world reviews are worth reading before you reach that point. From week 17 onwards the standard maintenance target is 2.4 mg weekly, which is where the weight-management evidence sits. In April 2026 the MHRA approved a dedicated single-dose 7.2 mg weekly pen as a higher maintenance option, though it carries a BMI ≥30 restriction and the same gradual titration beginning from 0.25 mg still applies. You can read the full Wegovy injection dose breakdown to see how each step is used in practice.

One thing worth clearing up: some people arrive expecting the 2.4 mg pen to work quickly precisely because the number looks large. It does not work that way. The clinical results from the STEP 1 trial, published in the New England Journal of Medicine, reflect the full 68-week period at maintenance dose alongside lifestyle changes, not the first few weeks at the starter level. Patience with the schedule is part of the treatment.

Injection sites are the abdomen, thigh or upper arm. Rotating sites each week helps reduce injection-site reactions. Storage requires refrigeration between 2–8°C; consult the Patient Information Leaflet for the specific room-temperature window if you need to take a pen out of the fridge temporarily.

How do the Wegovy tablet doses differ from the injection?

Oral semaglutide for weight loss follows a different ladder entirely. The tablet schedule runs 1.5 mg daily for the first month, then 4 mg, then 9 mg, reaching 25 mg as the maintenance dose. Each level lasts a minimum of four weeks before any step up is considered, and a prescriber must judge each transition. In clinical trials (the OASIS 4 programme, 64 weeks), participants who stayed fully adherent to the 25 mg dose saw around 17% average weight loss compared with roughly 2.4% on placebo, though the overall average across all participants, regardless of adherence, was approximately 13.6%. Both figures come from Novo Nordisk's data submitted at UK approval in June 2026.

A common mix-up: the 3 mg, 7 mg and 14 mg semaglutide tablet strengths are Rybelsus, licensed for type 2 diabetes, not weight management. They are not steps in the Wegovy tablet ladder and should never be used interchangeably. If you have been prescribed Rybelsus for diabetes, that is a separate clinical discussion from weight management. The Wegovy tablet dosage guide covers the distinction in more detail.

Unlike the injection, Wegovy tablets require no refrigeration, making them genuinely convenient for travel. They must be taken first thing in the morning on an empty stomach, swallowed whole with a small amount of plain water, and at least 30 minutes must pass before eating, drinking anything other than water, or taking other oral medicines.

Who decides when you move to the next dose level?

Your prescriber does, based on how you are tolerating the current level and what progress looks like. The four-week minimum at each step is a guide, not a guarantee of progression. If nausea or other gastrointestinal symptoms are still significant, a prescriber may hold the dose longer before stepping up, or (in some cases) step back temporarily. The NHS guidance on weight-management injections is clear that the schedule should be managed by a clinician, not self-directed. The Patient Information Leaflet and SmPC, available through the electronic medicines compendium, are the definitive references for storage, missed doses and titration windows.

At nume, a GPhC-registered Independent Prescriber personally reviews every consultation, including repeat orders and dose-change requests. Evidence of your current weight and treatment history is part of any dose-increase review. There are no automated sign-offs. You can read about our clinical team if you want to know more about who oversees your care.

On the question of cost, private semaglutide pricing in the UK reflects the dose level and provider. If you are thinking through what treatment involves financially, the Wegovy price guide sets out the context honestly. At nume (we mean at nume) one transparent price covers consultation, prescription, delivery and seven-day aftercare. No subscriptions, no renewal surprises.

NICE's guidance on semaglutide (TA875) specifies that NHS prescribing for weight management is restricted to a maximum of two years, within a specialist service. Private prescribing through a regulated pharmacy like ours follows the licensed eligibility criteria in the SmPC, adults with a BMI of 30 or above, or from 27 with a qualifying weight-related condition, assessed individually by a prescriber. Lower BMI thresholds apply for some ethnic backgrounds under NICE guidance (TA875).

If you want a clear overview of how the Wegovy dosages work across both the injection and tablet formats, that guide brings together the full picture in one place. If you are ready to find out whether semaglutide is appropriate for you, start your free consultation and a prescriber will review your details the same day.