What’s the right Wegovy dosage?

Wegovy (the brand name for the active ingredient semaglutide) is an injectable drug prescribed for chronic weight management, used in tandem with lifestyle changes including a reduced-calorie diet and increased physical activity. It works by mimicking a hormone in the body called glucagon-like peptide-1 (GLP-1), which helps curb hunger and increase satiety. Wegovy is approved to treat adults with a body mass index (BMI) of 30 or above or adults with a BMI of 27 or above with at least one comorbidity (such as Type 2 diabetes or high blood pressure). Children age 12 and older with a BMI in the 95th percentile for age and sex may also be prescribed Wegovy.

While Wegovy and Ozempic are produced by the same manufacturer (Novo Nordisk) and contain the same drug (semaglutide), they are prescribed at different doses and approved by the Food and Drug Administration (FDA) for different functions: Wegovy for weight management and Ozempic for the treatment of Type 2 diabetes. 

What are the different doses of Wegovy?

Wegovy is a liquid solution that comes in a single-dose pen injector. The prescribed dosage of Wegovy starts off small and increases over time, according to Cecilia Low Wang, MD, an endocrinologist at UCHealth in Aurora, Colorado. Wegovy comes in five strengths:

• .25 mg, the Wegovy starting dose
• .5 mg
• 1 mg
• 1.7 mg
• 2.4 mg, the highest dosage of Wegovy

“We titrate up the doses of Wegovy so the patient’s GI system can get used to it,” Dr. Low Wang explains. “They start at .25 mg once a week and stay on that dose for at least four weeks. If they tolerate that, then they go up to the next level.” Patients should remain on the same dose for at least 4 weeks before increasing the dose to the next level.

The highest dose for Wegovy is 2.4 mg, but your healthcare provider may choose to titrate you up to only 1.7 mg for your maintenance dose, which you would stay on indefinitely. 

Here’s what the Wegovy dose escalation schedule looks like: 

What factors affect my dosage?

Wegovy doses are titrated to hopefully avoid common side effects, such as nausea, vomiting, diarrhea, constipation, upset stomach, gas, belching, and heartburn, among other gastrointestinal concerns. (During a 68-week clinical trial, GI issues were the most commonly reported side effect.) More serious side effects can include pancreatitis, gallstones, hypoglycemia (low blood sugar levels), kidney problems, increased heart rate, and suicidal thoughts.

If your body handles Wegovy well, your healthcare provider will continue to increase your dosage until you hit the maintenance dosage of 1.7 or 2.4 mg. If you experience side effects of Wegovy, they may keep you at a particular dosage longer to allow your body time to acclimate before increasing or, if you experience severe side effects, they may lower your dose or take you off the drug altogether. 

Wegovy dosage for children

Wegovy dosage for children is the same as for adults with one exception: While the adult maintenance phase is either a 1.7 or 2.4 mg dose, the recommended child maintenance phase is a 2.4 mg dose. However, if the 2.4 mg dose is not tolerated, the manufacturer suggests dropping down to the 1.7 mg for a maintenance dose. The Wegovy dosing schedule looks like this:

Wegovy dosage FAQs

How do I use Wegovy?

Wegovy is administered once a week at home as a subcutaneous (i.e., the fatty tissue of the body) injection into the abdomen, thigh, or upper arm. Ideally, you should inject Wegovy on the same day and at the same time each week to keep dosing consistent. Wegovy can be taken with or without food. Patients with Type 2 diabetes should monitor their blood glucose levels before and after their injection. See the prescribing information for full instructions on how to administer the semaglutide injection.

What happens if I miss a dose of Wegovy?

Your next steps after missing a weekly dose will depend on how much time remains until your next dose. If you are more than two days away from your next scheduled dose, take your missed dose as soon as possible. If you are less than two days away from your next scheduled dose, wait and take the next dose as scheduled. 

If you miss your Wegovy dose for two weeks, the manufacturer recommends either taking the next dose as scheduled or calling your healthcare provider for further instructions. If the Wegovy drug is out of your system for too long, you run the risk of experiencing adverse side effects, says Minisha Sood, MD, a board-certified endocrinologist at Northwell Lenox Hill Hospital in New York.

“Practically speaking, what we tell patients is, if they’ve missed more than four weeks, they likely will feel ill if they return to their prior dose,” she says. “They may have to start back again at a lower dose and work up from there. It’s done on a case-by-case basis.” 

Is Wegovy used long-term?

The short answer is yes. The maintenance dose (1.7 or 2.4 mg) is meant to be taken for long-term weight management. 

“​​We think of obesity as a chronic illness,” Dr. Low Wang says. “Just like with hypertension and other chronic illnesses, when very effective medications are discontinued, then it’s quite likely that the condition is going to come back. We would love to be able to have our patients not take medications for the rest of their lives—sometimes it can’t be avoided. Setting those expectations is important for people, and especially with such potent medications, the effects of stopping can be pretty dramatic.” When you stop taking medications like Wegovy, a surge in hunger may occur along with gaining back the weight you lost while taking the medication. 

What happens if I take too much Wegovy?

If you take too much Wegovy, you may experience side effects like severe nausea, severe vomiting, or low blood pressure. If you experience any of these, you should call a healthcare professional right away for medical advice or go to the nearest emergency room. 

“There’s not a direct antidote, but we may treat that person with anti-nausea medications and medications to help them go to the bathroom if they’re severely constipated as a result,” Dr. Sood says. “And we’d have to keep a close eye in terms of if they are developing pancreatitis, which would present with upper abdominal pain, maybe radiating to the mid-back and maybe associated with some nausea and vomiting.” 

What should I ask my doctor about Wegovy?

If your healthcare provider is considering prescribing you Wegovy, you may want to ask the following questions.

How will Wegovy interact with other prescription drugs or supplements I’m taking? It’s always a good idea to let your healthcare provider know what drugs, vitamins, herbs, or supplements you take in case there is a risk of interactions. 

How will Wegovy affect my mental health? Let your healthcare provider know if you have a history of depression, suicidal ideation, or other mental health concerns. 

Can I take Wegovy if I have a history of thyroid cancer? It depends on the type of thyroid cancer. You should not take Wegovy if you or someone in your family has had medullary thyroid carcinoma (MTC). (Though Wegovy caused thyroid tumors in studies with rodents, it is not known whether it can cause thyroid tumors in humans.) Also, let your healthcare provider know if you have had Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) or issues with your kidney and/or pancreas.

Will Wegovy make my GI issues worse? Because Wegovy can cause GI issues, let your healthcare provider know if you already have GI concerns.  

How will Wegovy affect potential pregnancies? You should tell your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding, as Wegovy may cause birth defects. (It’s not known whether Wegovy passes through the breast milk or not.) For both men and women, it’s recommended to stop taking Wegovy at least two months before trying to conceive. 

How can I save money on Wegovy?

The out-of-pocket cost for Wegovy is not cheap: You can expect to pay about $1,800 for four Wegovy auto-injector pens with 0.75 mL of 2.4 mg/0.75 mL solution—equivalent to a month’s supply of the drug. Thankfully, there may be ways to save on your prescription:

• Check your insurance policy: Some providers will cover weight-loss drugs like Wegovy. You’ll need to check your formulary to find out whether it’s covered. (Medicare does not cover Wegovy though some Medigap and Medicare Advantage plans do, so check with your administrator. Medicaid coverage varies state by state.) 
• Use a SingleCare card: With the SingleCare card, the cost of Wegovy drops significantly: You can expect to pay $1,215.70 for four Wegovy auto-injector pens with 0.75 mL of 2.4 mg/0.75 mL solution. That’s a savings of about $585/month.
• Try a manufacturer’s coupon: Novo Nordisk’s Wegovy Savings Offer could save you around $500/month if you pay for your prescription with cash. Visit the website to find out more.