The Wegovy dosage chart for weight management
The Wegovy prescribing information (revised 06/2026) states that the recommended starting dosage is 0.25 mg injected subcutaneously once weekly, and that the escalation steps exist "to reduce the risk of gastrointestinal adverse reactions." Here is Table 1 from the label, reproduced as written.
| Phase | Weeks | Once-weekly subcutaneous dose |
|---|---|---|
| Starting dosage | 1 through 4 | 0.25 mg |
| Dosage escalation | 5 through 8 | 0.5 mg |
| Dosage escalation | 9 through 12 | 1 mg |
| Dosage escalation | 13 through 16 | 1.7 mg |
| Maintenance dosage | 17 and onward | See the indication for the recommended maintenance dosage |
Source: WEGOVY (semaglutide) prescribing information, Table 1, accessdata.fda.gov, revised 06/2026.
For weight reduction in adults, the label sets the maintenance dosage at "either 1.7 mg or 2.4 mg (recommended) injected subcutaneously once weekly." It adds that for patients who tolerate 2.4 mg for at least 4 weeks and for whom additional weight reduction is clinically indicated, the dosage may be increased to a maximum of 7.2 mg once weekly. For pediatric patients aged 12 years and older, the maintenance dosage is 2.4 mg (recommended) or 1.7 mg once weekly.
Two more lines in the label are worth noticing, because they show that the chart is a framework, not a race. If a patient does not tolerate a dose during escalation, the label says to "consider delaying dosage escalation for 4 weeks." And when choosing a maintenance dose, it says to "consider treatment response and tolerability." Even on the branded schedule, the steps bend to the person.
The label also covers Wegovy tablets, a once-daily oral form with its own schedule. This guide covers the weekly injection.
The Ozempic schedule, for comparison
Ozempic is the same molecule approved for a different purpose: glycemic control in adults with type 2 diabetes, along with listed cardiovascular and kidney outcomes. Its schedule is shorter and tops out lower, because it was studied for a different goal. From the Ozempic prescribing information (revised 05/2026):
| Step | Once-weekly subcutaneous dose | When, per the label |
|---|---|---|
| Initiation | 0.25 mg | For 4 weeks |
| First maintenance step | 0.5 mg | After 4 weeks on 0.25 mg |
| Optional increase | 1 mg | If additional glycemic control is needed after at least 4 weeks on 0.5 mg |
| Optional increase | 2 mg | If additional glycemic control is needed after at least 4 weeks on 1 mg |
Source: OZEMPIC (semaglutide) prescribing information, section 2.2, accessdata.fda.gov, revised 05/2026. The maximum recommended dosage is 2 mg once weekly.
This is a diabetes chart, not a weight management chart. Each label is written for its own indication.
How a compounded semaglutide prescription is dosed
A compounded prescription does not come with an FDA label schedule. It comes with your label: the dose and schedule your provider writes, prepared by the pharmacy for you. That schedule may look like the branded steps, or it may differ from them, and your provider adjusts it based on how you are tolerating the medication and how you are responding.
That flexibility is also why supervision matters. FDA has reported receiving adverse event reports that may be related to patients prescribed compounded GLP-1 medications, including semaglutide, in doses beyond the FDA approved label, which it describes as more product in a single dose, more frequent doses, or faster increases. FDA's guidance to providers is to be "vigilant" when setting doses and titration schedules. In practice, that means a provider who knows your history, reviews how you are doing, and changes the plan when something is not working.
Dosing is not one-size-fits-all. The dose that matters is the one on your prescription label.
How units work on an insulin syringe
Compounded semaglutide usually arrives in a vial, and you draw each dose with a syringe, often measured in "units." This is where confusion happens.
Units measure volume, not drug. On a U-100 insulin syringe, 100 units equals 1 milliliter (mL), so 5 units is 0.05 mL. How much semaglutide is in that volume depends entirely on the concentration of your vial, written in mg per mL. Two vials with different concentrations will need different numbers of units to deliver the same mg dose.
The conversion is simple arithmetic:
units = mg dose ÷ concentration in mg/mL × 100
Worked example (hypothetical concentration). Suppose a vial were labeled 2.5 mg/mL and the prescribed dose were 0.25 mg. Then 0.25 ÷ 2.5 = 0.1 mL, and 0.1 × 100 = 10 units. At a different concentration, the same 0.25 mg dose would be a different number of units.
This is not your dose, and your vial may not be this concentration. Compounding pharmacies offer different concentrations, and a single pharmacy may offer more than one. Always use the dose on your own prescription label.
FDA has documented why this matters. It has received reports of patients drawing up five to 20 times the intended dose, including patients told to inject 5 units who injected 50, and of clinicians miscalculating a conversion from mg to units. FDA encourages patients to talk with their provider or pharmacy about how to measure the intended dose.
If the units and the mg on your label do not seem to match, or your syringe looks different from the last one, stop and message your care team before you inject. Belle's dosage calculator can help you check the arithmetic, and your prescription label always takes priority.
Dr. Taylor on semaglutide dosing
"I start semaglutide low and move up slowly, because the early weeks are when stomach side effects are most likely and a patient who feels well is a patient who stays on the plan. Every dose I prescribe is written for that person's history and adjusted as we go, and I would rather hold a dose for a few extra weeks than push to the next step on a calendar. The one thing I ask of every patient using a vial is simple: if the units on your syringe and the mg on your label ever seem out of step, message us before you inject."
What "microdosing" semaglutide means
Microdosing is a term you will see often online. It does not have a medical definition. A Cedars-Sinai obesity medicine specialist puts it plainly: "Microdosing is not a medical term. It's a term that has been popularized on social media." Cedars-Sinai describes microdosing semaglutide as taking doses lower than those typically prescribed or studied, and notes that "Microdosing is not an FDA-approved dosing strategy for semaglutide or other GLP-1 medications."
The same article draws a useful line: what people call microdosing is often titration, the ordinary practice of starting low and adjusting under supervision. A lower dose set by a provider is normal care. A self-directed dose measured from a vial at home is where the dosing errors above tend to happen. This guide does not offer a microdose schedule, because a lower dose is a prescribing decision.
If you miss a dose
For the Wegovy injection, the label says that if one dose is missed and the next scheduled dose is more than 2 days away, take it as soon as possible. If the next dose is less than 2 days away, skip the missed dose and resume on your regular day. If 2 or more consecutive doses are missed, the label says to restart escalation at a lower dosage to reduce the risk of gastrointestinal side effects.
The Ozempic label uses a different window: take a missed dose within 5 days, and if more than 5 days have passed, skip it. With a compounded prescription, ask your care team which instruction applies to you, especially after more than one missed week.
Side effects, and who should talk to a provider first
The Wegovy label lists the most common side effects as nausea, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue and others. The escalation schedule exists to reduce gastrointestinal effects, which is one reason not to rush the steps. The label also describes warnings including acute pancreatitis, gallbladder disease, and low blood sugar when semaglutide is used with insulin or an insulin secretagogue.
Who should talk to a provider first
- Personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- Known hypersensitivity to semaglutide
- Pregnancy, planned pregnancy, or breastfeeding
- Diabetes treated with insulin or an insulin secretagogue
- History of pancreatitis, gallbladder disease, or severe gastroparesis
- History of diabetic retinopathy
- A planned surgery or procedure with anesthesia or deep sedation
How Belle prescribes semaglutide
Belle offers compounded semaglutide as a prescription. It begins with an online intake reviewed by a licensed provider, who decides whether a prescription is appropriate. If it is, the medication is prepared by a licensed compounding pharmacy and shipped with a patient-specific label that states your dose. A prescription is never guaranteed, and if semaglutide is not the right fit, the answer is no. That review is the point.
On the branded label, the first four weeks are at the starting dose, the escalation steps run through week 16, and maintenance typically begins at week 17. A compounded plan may follow a similar pace, hold longer at a step, or move differently, depending on how you tolerate each dose. Timelines and outcomes vary by individual, and your provider will monitor your progress and adjust your plan as needed.
Related reading: compounded semaglutide cost, compounded semaglutide vs Wegovy, our GLP-1 comparison and the dosage chart for the other GLP-1 Belle prescribes.
Nothing here is medical advice. Decisions about your own dose belong with a licensed provider who knows your history.
Common questions
Is compounded semaglutide FDA approved?
No. Semaglutide is FDA approved as Wegovy and Ozempic, but compounded semaglutide is not an FDA approved finished product. It is prescribed off label by a licensed provider after a medical intake and informed consent, and prepared by a licensed compounding pharmacy for you specifically.
Does Belle offer semaglutide?
Yes. Belle offers compounded semaglutide as a prescription, available after an online intake and review by a licensed provider. A prescription is never guaranteed.
What is the starting dose of semaglutide for weight loss?
The Wegovy label's recommended starting dosage is 0.25 mg injected once weekly for weeks 1 through 4. A compounded prescription follows the starting dose your provider writes on your label.
What is the maximum dose of semaglutide?
For weight reduction in adults, the Wegovy label allows up to 7.2 mg once weekly for patients who have tolerated 2.4 mg for at least 4 weeks and for whom additional weight reduction is clinically indicated. The Ozempic label's maximum is 2 mg once weekly. Your own maximum is a decision for your provider.
How many units of semaglutide should I take?
It depends entirely on the concentration of your vial. Units measure volume, so the same mg dose can be a different number of units from one vial to another. Use the dose on your prescription label, and ask your care team if the units and mg do not seem to match.
Is microdosing semaglutide safe?
Microdosing is not a medical term and is not an FDA approved dosing strategy. Lower doses set and monitored by a provider are ordinary titration. Self-directed dosing from a vial is where FDA has documented dosing errors, so any change to your dose belongs with your provider.
What should I do if I miss a dose?
For the Wegovy injection, the label says to take a missed dose if the next one is more than 2 days away, skip it if the next one is less than 2 days away, and restart escalation at a lower dose after 2 or more consecutive missed doses. With a compounded prescription, check with your care team.