Wegovy dosage, forms, and strengths

Wegovy is a prescription drug for weight loss used along with lifestyle changes like a reduced-calorie meal plan and exercise to treat obesity, specifically in those with a body mass index (BMI) 30 or higher or a BMI 27 or higher with at least one weight-related medical condition such as heart disease, high blood pressure, or Type 2 diabetes. Its active ingredient is semaglutide, a drug originally developed by Novo Nordisk as Ozempic to control blood sugar levels in people with Type 2 diabetes. 

Belonging to a family of drugs called glucagon-like peptide-1 receptor agonists (GLP-1 agonists), these medicines work by stimulating insulin secretion and increasing people’s sense of fullness when eating, which promotes weight loss. People prescribed Wegovy will start with a low dose of 0.25 milligrams (mg) administered subcutaneously once per week for four weeks, after which the dose will gradually increase over the next several months until a maximum maintenance dose of 2.4 mg once weekly is reached.

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Wegovy dosage for chronic weight management

Wegovy is prescribed for weight management as an adjunct to dietary changes like a reduced-calorie diet and physical activity. The use of Wegovy may be preferred over other weight loss medications in those at risk of major cardiovascular events, like a heart attack, because it has demonstrated a reduction in both these events; Wegovy may also improve kidney problems in those with established cardiovascular disease. The first month’s dosage is 0.25 mg weekly for four weeks. That’s followed by four weeks at a 0.5 mg weekly dose. Then people will take a 1 mg weekly dose for another four weeks, followed by 1.7 mg weekly for four weeks. After four months of gradually increasing doses, people may begin the final and maximum dose of 2.4 mg weekly. However, in those individuals who cannot tolerate the 2.4 mg once weekly dosage, they may utilize a maintenance dose of 1.7 mg once weekly. The manufacturer generally recommends discontinuation of Wegovy in those individuals who cannot tolerate the 1.7 mg once weekly dosage, but guidelines support continuation of the maximum tolerated dose, even if less than 1.7 mg once weekly. 

Wegovy is a long-term option as part of a treatment plan for weight loss that may be continued even once goal weight loss is achieved for maintenance, but for those interested in stopping the medication, there are crucial considerations to keep in mind. Studies have shown that individuals stopping semaglutide may regain up to 67% of the weight lost after 1 year of discontinuation, so it is critical to discuss with a healthcare professional an individualized plan to maintain the weight loss achieved. In addition, discontinuation may impact its effect on reducing cardiovascular events like non-fatal myocardial infarction and even cardiovascular death in those with cardiovascular disease. Therefore, one must adhere to dietary changes and increase physical activity as part of weight loss maintenance. Maintenance dose is an ongoing area of research, with new research exploring the benefits of personalized doses of Wegovy as part of a potential taper off the medication, either through reduced doses or increased administration intervals. 

• Standard adult dosage for chronic weight management: 2.4 mg taken as a subcutaneous injection once weekly

Wegovy safety information

Wegovy has no dosage restrictions for renal impairment, hepatic impairment, or age, and is approved for use in pediatric patients as young as 12 years old. Wegovy is contraindicated in pregnant women, people with a history of a specific type of thyroid cancer known as medullary thyroid cancer (MTC), or even a family history of MTC, people with multiple endocrine neoplasia syndrome type 2 (a type of thyroid and adrenal gland cancer), or people who have had serious allergic reactions to semaglutide or any of the ingredients in the injection. Report any sudden changes like a lump in the neck, difficulty swallowing or breathing, or changes to your voice to a health care provider, as these may be symptoms of thyroid cancer. Wegovy should also not be taken by those with current or past mental health issues like suicidal thoughts, as suicidal behavior has been reported with some medications used for weight management. 

Other possible serious side effects associated with Wegovy use include reports of acute kidney injury, sometimes requiring dialysis, gallbladder disease, including cholelithiasis and cholecystitis, diabetic retinopathy, and acute pancreatitis. It’s important that health care professionals counsel patients on symptoms of these adverse reactions, like clay-colored stools representing potential gallbladder issues or persistent, severe abdominal pain, as may be experienced with pancreatitis. Patients suffering from loss of fluids, possibly even due to the adverse effects of nausea and vomiting with Wegovy, or any other reason, like certain drug combinations, are at greater risk of acute kidney injury or worsening of chronic renal failure.

For those undergoing surgical or endoscopic procedures, use of medications like Wegovy may increase the risk of serious adverse events during general anesthesia and deep sedation due to its mechanism of delayed gastric emptying, with published reports of pulmonary aspiration of gastric contents. 

Given its mechanism of action in delaying gastric emptying, Wegovy may cause drug interactions in that it can alter the absorption of other medications. Wegovy may also increase the risk of low blood sugar when taken with other common medications, such that you may be advised to monitor blood glucose. Always provide your healthcare provider or pharmacist with a complete list of medications prior to initiation of Wegovy so that these concurrent drug therapy issues can be addressed. Other less common side effects include increased heart rate and possible low blood sugar, usually if taken along with other medications for endocrine system conditions. 

By far, however, the most common side effects of Wegovy are severe adverse gastrointestinal reactions, in partdue to the delayed stomach emptying this prescription medication causes, such as severe nausea. These severe symptoms may diminish over time, but may also be reignited with each dose increase, which is part of the rationale for the gradual increase in dose over time. 

How to take Wegovy

Patients self-inject each Wegovy dose. Although it comes in a convenient single-dose injector pen, the process is a bit complex at first. A healthcare provider will demonstrate how to administer injections. If you have any questions or doubts, ask the healthcare provider before leaving. Additionally, the Wegovy website has instructions (see below) on the injection process. Watch this video before administering the first injection.

This medication comes packaged with a Medication Guide and Instructions for Use. Please review both of these before administering the first injection. If one of them is missing, ask a pharmacist for a copy. 

Wegovy can be taken with or without food.

Here are the steps per the Wegovy website:

• Take the Wegovy injection once per week on the same day of the week, or at any time on the scheduled day.

• If the injection day needs to be changed, this can be done provided the next scheduled dose is not two days (48 hours) away.

Preparation

• Wash your hands.

• Do not remove the pen cap until ready to inject.

• Check the Wegovy pen to make sure it’s undamaged. If it appears damaged or broken, do not use it. Dispose of it safely in an FDA-cleared sharps disposal container.

• Check the pen injector to make sure that it’s the correct medicine and the correct dose.

• Check the expiration date. If the medicine has exceeded its expiration date, do not use it. Dispose of it safely in an FDA-cleared sharps disposal container.

• Check the medicine in the pen window to make sure it is clear and colorless. If it is discolored, cloudy, or has particles in it, do not use it. Air bubbles are okay.

• Make sure the needle is hidden.

Injection site

• The medicine can be injected in the front of the thighs, upper arm, and lower abdomen (below and at least two inches away from the belly button).

• Do not inject Wegovy into a muscle or vein.

• Although the same area of the body can be used each week, do not inject the medicine in the exact same spot each week.

• Don’t inject the medicine through skin that is red, bruised, tender, hard, or scarred.

• Clean the injection area with soap and water or an alcohol swab before injecting a Wegovy dose.

Injection

• Remove the pen cap by pulling it straight down when ready to administer the injection.

• Push the pen firmly against the skin where the injection is to be made. Keep pressing firmly throughout the injection process.

• The Wegovy pen will click and the injection will start when pressure is put on the bottom of the pen.

• The pen will click a second time as the injection proceeds. The yellow bar will slowly fill the pen window to show the injection's progress.

• When the yellow bar has completely filled the window, the injection is finished. You can release the pressure on the pen.

• Dispose of the pen in an FDA-cleared sharps disposal container, as the pens are one-time use devices.

Wegovy dosage FAQs

How long does it take Wegovy to work?

Weight loss is a long-term process, even with effective weight management drugs like Wegovy. Dietary changes and physical activity are required. It may take weeks or months to notice significant weight loss or meet weight loss goals. 

What happens if I miss a dose of Wegovy?

Wegovy is taken weekly. A missed dose of Wegovy can be taken, provided the next scheduled dose is more than two days (48 hours) away. If the next dose is due to be taken within the next two days, skip the missed dose and take the next dose on schedule. 

If a missed dose is more than two days late, the next dose should be taken as scheduled, but you should contact the prescribing healthcare provider in case treatment needs to be restarted at a lower dose, as the gastrointestinal side effects may be intolerable.

How long can you take Wegovy?

Wegovy is intended for long-term use. Clinical trials were 68 weeks in duration. New, long-term weight loss effects were published in a 208-week study involving over 17,000 participants on 2.4 mg once weekly. Weight loss continued for over 65 weeks and was maintained for up to 4 years. 

What happens when you mix Wegovy and alcohol?

Alcohol does not interact with Wegovy, and Wegovy does not interact with alcohol. In general, drinking alcohol when trying to meet weight loss goals is not recommended. However, if you are aware of the calorie content of the alcohol you’re drinking and keep to each day’s calorie goals while getting enough nutrients, moderate consumption of alcohol when taking Wegovy probably won’t be a problem.

Is it safe to take Wegovy during pregnancy or breastfeeding?

Wegovy should not be given to pregnant women. Animal studies have shown that Wegovy causes death and developmental defects in fetuses. Wegovy and any other weight loss medications should be stopped during pregnancy. The American Association of Clinical Endocrinologists and the American College of Endocrinology (AACE/ACE) recommend that any woman of childbearing age taking weight loss medications use contraception to prevent pregnancy.

Ask a doctor for medical advice about taking Wegovy while breastfeeding. Healthcare professionals believe very little semaglutide is present in human milk and that it’s poorly absorbed when taken orally. However, there is currently no clinical evidence for its effects on breastfeeding infants.

Sources

• AGA clinical practice guideline on pharmacological interventions for adults with obesity, Gastroenterology (2022)

• Long-term kidney outcomes of semaglutide in obesity and cardiovascular disease in the SELECT trial, Nature Medicine (2024)

• Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension, Diabetes, Obesity and Metabolism (2022)

• Is coming off semaglutide slowly the key to preventing weight regain?, The European Association for the Study of Obesity (2024)

• Long-term weight loss effects of semaglutide in obesity without diabetes in the SELECT trial, Nature Medicine (2024)

• Glucagon-like peptide-1 receptor agonists, StatPearls

• Semaglutide, Drugs and Lactation Database

• Semaglutide drug summary, Prescriber’s Digital Reference

• Wegovy prescribing information, NIH National Library of Medicine

• GLP-1 agonists may raise risk of pulmonary aspiration during surgery, MHRA warns, BMJ (2025)

• Wegovy website, Novo Nordisk