Can I start Wegovy at 2.4 mg?

Wegovy is a weekly injectable prescription drug used along with lifestyle changes, including a reduced-calorie meal plan and increased physical activity, for chronic weight management. Made by the pharmaceutical company Novo Nordisk, Wegovy is classified as a glucagon-like peptide-1 receptor agonist (GLP-1 agonist). The active ingredient in Wegovy is called semaglutide—the same ingredient in the medication Ozempic (which is used to manage blood sugar in people with Type 2 diabetes). 

More specifically, Wegovy is for:

• Adult patients with a starting body mass index (BMI) of 30  or higher (obesity); or
• Adult patients with a starting BMI of 27–29 (overweight) with at least one weight-related risk factor like Type 2 diabetes, high blood pressure, or high cholesterol
• Pediatric patients ages 12 and older with a starting BMI at the 95th percentile or higher

Once you and your healthcare provider decide on Wegovy as a weight loss medication as part of your treatment plan, you may be excited to start your weight loss journey. Many people ask if they can start Wegovy at the highest dosage of 2.4 mg once weekly rather than slowly increasing the dosage. But the answer is no. You’ll have to follow the instructions to slowly increase the dose of Wegovy. This article will discuss the reasons for this dosing schedule more and provide other important information about Wegovy. 

Understanding Wegovy dosage

The Wegovy dosing schedule is designed as a titration, meaning that you start with a low dose of Wegovy and increase the dose over time. This allows your body to get used to the medicine and its side effects.  

You’ll use the Wegovy pen to inject semaglutide once a week, the same day each week, by subcutaneous injection (under the skin) into the stomach, thigh, or upper arm. Although your healthcare provider will tell you how to increase your medication, here’s a quick overview of the general dosing schedule:

• Month 1: You will start at the lowest dose of 0.25 mg per week.
• Month 2: You will increase to a dose of 0.5 mg per week.
• Month 3: You will increase to a dose of 1 mg per week.
• Month 4: You will increase to a dose of 1.7 mg per week.
• Month 5: Your healthcare professional will advise you whether to continue with the 1.7 mg weekly dose as a maintenance dose or increase to a higher dose of 2.4 mg weekly.

RELATED: Wegovy injection site: Recommended locations and tips

Starting Wegovy at 2.4 mg

When you see the dosing schedule, it may seem disappointing to have to wait four or five months to get to your highest dose of 1.7 or 2.4 mg weekly. You may wonder, why not just jump right in and start at 2.4 mg weekly to accelerate the weight loss? 

Here’s why: Wegovy, like any medication, has possible side effects. The gastrointestinal side effects can range from mild to more severe. Starting the medication at the lowest dose and slowly increasing the dose every four weeks allows your body to adjust to its side effects. During the adjustment period, you’ll gradually see how Wegovy affects your appetite at every step and how well you tolerate the dose and related side effects.

What’s more, although the highest Wegovy dose is 2.4 mg weekly, some individuals will be advised to continue with the 1.7 mg dose because, for them, it is effective and well-tolerated. So, you may not even need to go up to the 2.4 mg dose.

Wegovy 2.4 side effects

Even with a gradual increase in dosage, side effects while on the Wegovy 2.4 mg weekly dose are still likely. Common side effects are listed below, with the percentage of people on the 2.4 mg dose who experienced these side effects in clinical trials:

• Nausea (44%)
• Diarrhea (30%)
• Vomiting (24%)
• Constipation (24%)
• Stomach pain (20%)
• Headache (14%)
• Fatigue (11%)
• Indigestion (9%)
• Dizziness (8%)
• Bloating (7%)
• Burping (7%)
• Gas (6%)

Do you lose more weight with higher doses of Wegovy?

In a clinical trial published in NEJM, study participants took Wegovy for a total of 68 weeks. The dosage was slowly increased over four months, as recommended, to a total of 2.4 mg per week. People who could not tolerate the 2.4 mg weekly dose stayed on lower doses when needed. The average weight loss with Wegovy was 15% over the 68-week period (compared to 2.4% for people who took a placebo, or inactive medicine). For example, people who started the study at 200 pounds lost an average of 30 pounds. 

Increasing the dose gradually is par for the course with this medication. Consider this titration a necessary part of a long-term journey—you may still lose a significant amount of weight, but you will have to start out with a lower dose and work your way up to a higher dose. 

What is the boxed warning for Wegovy weight loss injections?

A boxed warning, also called a black box warning, is the most serious warning required by the FDA. All GLP-1 receptor agonist medicines have the same boxed warning. The warning states that animal studies have shown semaglutide-containing products to cause thyroid tumors. It is not known whether these tumors occur in humans. People who have a history of medullary thyroid carcinoma (MTC) or a family history of MTC should not take Wegovy. Also, people with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) should not take Wegovy. Anyone who takes Wegovy should be alert to symptoms of possible thyroid tumors, such as a lump in the neck, a hoarse voice, or trouble breathing or swallowing. 

Bottom line

Wegovy can be an effective medication to help you lose weight, along with a reduced-calorie diet and exercise. It is important to follow the dosing schedule closely. This helps your body get used to the medication and its side effects. Consult your healthcare provider with any questions or for personalized medical advice on using Wegovy.