When do you go up a dose on Wegovy, and how does the schedule work?

Picture yourself four weeks in on 0.25 mg, here's what happens next

You've been on Wegovy for a month. You may have noticed some queasiness in the first week or two, possibly some loose stools or a drop in appetite. By now, most of that has settled. This is exactly the moment the dose schedule is designed to reach: 0.25 mg is a starting dose, its job is to let your system adjust, not to produce significant weight loss on its own. The Wegovy overview page explains the medicine's mechanism in more detail, but in short: the GLP-1 receptor agonist pathway slows gastric emptying and reduces appetite signals, and ramping that effect up gradually is what keeps side effects manageable.

At the four-week mark your prescriber will review how you're getting on. If you've tolerated 0.25 mg without significant problems, the next step is 0.5 mg for another four weeks. Then 1.0 mg. Then 1.7 mg. Then the standard maintenance dose of 2.4 mg. NHS England's guidance on weight-management injections sets out how this gradual titration sits within a broader programme of dietary and lifestyle support.

The full dose picture (including the newer 7.2 mg option approved by the MHRA in April 2026) is covered on the Wegovy doses page if you want to see the complete ladder in one place.

What actually causes a dose increase to be delayed or paused

A question our prescribers hear most weeks is something along the lines of: "My four weeks are up, can I just go up?" The honest answer is: only if you're ready. The schedule is a minimum between steps, not a guarantee. Two things typically push a dose increase back.

First, side effects that haven't settled. Nausea is the most common; vomiting and diarrhoea less so, but they matter more because of the risk of dehydration. If you're still experiencing significant GI symptoms on week four of a given dose, staying at that level for another four weeks (or longer) is the safer path. Pushing through a dose increase while your gut is still unhappy rarely ends well. Our guide to when you should up the dose of Wegovy walks through the signs that you're genuinely ready to move to the next step.

Second, a missed-dose situation. If you've had to skip injections during a step, your prescriber may want to see a fuller, uninterrupted period at that dose before moving forward. If you're unsure whether the timing is right, our page covering when to increase your Wegovy dose sets out the key factors your prescriber will weigh up, including how gaps in your injection schedule are taken into account. You can also read about when you increase your Wegovy dose, which covers the decision in practical terms and helps you understand what to expect at each step of the process. The patient information leaflet (and the Wegovy SmPC on the electronic Medicines Compendium) covers what to do if a dose is missed; your prescriber can advise on whether that affects your titration timeline. These decisions are always individual.

What the 2.4 mg maintenance dose means, and whether 7.2 mg comes after it

Reaching 2.4 mg is the point the clinical trials built their evidence around. The STEP 1 trial (published in the New England Journal of Medicine) recorded an average weight reduction of around 15% over 68 weeks at this dose, alongside lifestyle changes. That figure comes from a large, controlled trial; individual results vary, and your prescriber will discuss what's realistic for you.

For most people, 2.4 mg is where the titration ends. The 7.2 mg dose, approved by the MHRA in April 2026 as a dedicated single-dose pen, is a clinically supervised step beyond that. It carries a BMI threshold of 30 or above and is not a default next rung; whether it's appropriate is a prescriber decision made in light of your response to 2.4 mg and your overall health picture. Never assume it's the automatic next step.

If you're thinking about the cost of staying on treatment as your dose increases, the Wegovy price page gives honest context on how private pricing is structured in the UK.

Getting a dose change right: the prescriber's role and yours

There is no version of going up a Wegovy dose that doesn't involve a prescriber. These are prescription-only medicines; the titration schedule exists precisely because GLP-1 medicines need individual clinical oversight, not a one-size calendar. Your job is to track how you're feeling, be honest about side effects, and flag anything unexpected, severe or persistent stomach pain, especially if it spreads toward your back, needs urgent medical attention and should not wait for your next review.

At nume, a GPhC-registered Independent Prescriber reviews your case before every repeat order and every dose change. There are no auto-renewals and no automatic upgrades; each step is a fresh clinical assessment. If you'd like that kind of support, or if you're considering starting Wegovy and want to understand the titration process before you do, you can speak to our prescribers, the consultation is free and happens the same day.