What counts as a maintenance dose of Wegovy, and how do you get there?

Why 'maintenance dose' means something specific, and something personal

There is a technical answer and a practical one. Technically, 2.4 mg is the standard Wegovy maintenance dose defined in the licence: the target all five steps of the titration schedule are pointing towards. Practically, maintenance means the dose you stay on once you and your prescriber agree you are getting the benefit you need without side effects that make continuing unreasonable.

Those two answers do not always match. Some people reach 2.4 mg without difficulty and stay there. Others plateau at 1.7 mg because their GI symptoms at 2.4 mg are too disruptive, or because 1.7 mg is already delivering the results their prescriber considers adequate. A minority will now be assessed for 7.2 mg if 2.4 mg has not produced sufficient progress after enough time at that dose.

One quick check worth doing: look at your most recent clinical review notes and confirm which dose you are currently on and when your next review is scheduled. If those details are not clear, that is worth raising with your prescriber before the next escalation.

The NHS semaglutide patient information page describes the standard dose steps and when to contact your care team if you have questions about your schedule.

How the titration ladder leads to (or away from) 2.4 mg

The five-step schedule exists for tolerability, not as a formality. Semaglutide slows gastric emptying and suppresses appetite through GLP-1 receptor activation, and those mechanisms can produce nausea, vomiting and digestive discomfort that is most pronounced at the start or after each increase. Stepping up slowly gives your system time to adjust before the dose climbs again.

The standard timing for the Wegovy dose increases is roughly one month at each level: 0.25 mg for four weeks, 0.5 mg for four weeks, 1 mg for four weeks, a step that some people find is where their tolerance and progress reach a useful balance, 1.7 mg for four weeks, then 2.4 mg as the target maintenance. That is about sixteen weeks from first injection to standard maintenance, assuming no pauses.

Pauses happen. If side effects are significant, a prescriber may hold the current dose for an extra four weeks before attempting the next step, or bring the dose back down temporarily. This is not a failure of treatment, it is the schedule working as intended. Arriving at 2.4 mg a few weeks later than the textbook timeline is clinically unremarkable. The question your prescriber is answering at each step is whether the balance of benefit and tolerability supports moving forward.

Understanding the full range of Wegovy doses in the licensed schedule helps frame where 2.4 mg sits, and why 1 mg, for instance, is a step rather than a destination.

The 7.2 mg dose: when it might become your maintenance dose instead

The MHRA's approval of the 7.2 mg single-dose pen on 14 April 2026 added a new possible maintenance point above 2.4 mg. Clinical trials at this higher dose reported approximately 20.7% average weight loss over 72 weeks, narrowing the gap with tirzepatide's headline figures. That is a meaningful difference from the approximately 15% average seen at 2.4 mg in the STEP 1 trial.

Not everyone will be assessed for 7.2 mg. The licensed indication for this dose specifies BMI 30 or above, the cardiovascular and other indications that cover a lower BMI threshold do not extend to 7.2 mg at this stage. Whether a move from 2.4 mg to 7.2 mg is appropriate is a clinical decision based on your progress, your tolerance of semaglutide so far, and any relevant medical history. If you are on 2.4 mg and wondering whether a higher dose could be considered, that conversation belongs in your next prescriber review, not in the pharmacy.

Thinking about whether weight loss continues at maintenance is a common question at this stage, the answer is nuanced and worth reading before that review.

What happens after you reach your maintenance dose

Reaching maintenance is not the end of clinical oversight, it is a different phase of it. NICE's appraisal of Wegovy under TA875 specifies a maximum treatment duration of two years on the NHS, and flags that if less than 5% weight loss is achieved after six months at the maintenance dose, continuing treatment should be reviewed. Private prescribing follows the same clinical logic even without the two-year cap.

Long-term maintenance also raises questions about what happens to weight if treatment eventually stops. That is a real concern and one worth discussing openly with a prescriber, what weight maintenance looks like after stopping Wegovy is a separate topic with its own evidence base.

At nume, every repeat order is reviewed by a GPhC-registered Independent Prescriber before it is dispensed. There are no auto-renewals. If you are at maintenance and want to understand your options, checking your eligibility for a clinical consultation is the straightforward next step.