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GLP-1 planning

Last updated: June 2026 · Reviewed June 2026 · Built by the InjectBuddy team

What is the semaglutide titration schedule? the week-by-week dose ladder

The standard semaglutide titration schedule steps the dose up every four weeks: for weight management (Wegovy) it runs 0.25 mg, then 0.5, 1, 1.7 and finally 2.4 mg once weekly; for type 2 diabetes (Ozempic) it runs 0.25, 0.5, 1 and up to 2 mg. Each step holds for at least four weeks so gut side effects settle before the dose climbs, and the 0.25 mg start is a tolerance ramp, not a treatment dose. This guide walks through the week-by-week dose ladder for both labels, explains the maths behind each draw, and answers the questions people ask most about titrating semaglutide.

Key takeaways

  • Both Wegovy and Ozempic begin at 0.25 mg once weekly for 4 weeks, then escalate one step at a time.
  • Wegovy tops out at 2.4 mg (16 weeks of titration); Ozempic tops out at 2 mg.
  • Hold each step for at least 4 weeks; if a step is rough, the label allows delaying escalation rather than stopping.
  • The mg is the dose; the syringe units are volume. Plan the calendar and the draw with the GLP-1 titration calculator.

The week-by-week ladder

Titration means raising the dose in fixed steps instead of starting at the target. Semaglutide is titrated because its gastrointestinal effects (nausea, fullness, occasional vomiting) are dose-related and ease with exposure. The Wegovy label sets a 16-week escalation before the 2.4 mg maintenance dose, and the Ozempic label uses the same four-weeks-per-step rhythm up to 2 mg. The numbers below are taken directly from those two FDA labels.

WeeksWegovy (weight)Ozempic (T2D)Units at 1 mg/mL*
1–40.25 mg0.25 mg25 units
5–80.5 mg0.5 mg50 units
9–121 mg1 mg100 units
13–161.7 mg2 mg (max)170 / 200 units
17+2.4 mg (max)—240 units

*The units column assumes a reconstituted compounded vial at 1 mg/mL drawn on a U-100 insulin syringe, purely to show the scale. Branded pens dial the dose for you, so you never count units with a Wegovy or Ozempic pen. The maintenance dose is the last row each column reaches.

Why the four-week steps matter

The four-week hold is deliberate. In the STEP 1 trial of semaglutide 2.4 mg, participants reached the top dose only after a 16-week run-in, and the gradual climb is part of why the dose was tolerable enough to study at scale. The Wegovy label states plainly: follow the escalation to reduce the risk of gastrointestinal reactions, and if a patient cannot tolerate a step, consider delaying escalation by four weeks rather than discontinuing.

Two unit systems collide here, so keep them separate. The milligram is the dose the label prescribes; the syringe unit is a volume mark where 100 units equal 1 mL. They only line up once you know the concentration, which is why a 0.25 mg step can be 25 units in one vial and 13 units in another.

How this is calculated

For anyone using a reconstituted vial rather than a pen, the draw for each titration step is one division. Convert the prescribed dose and the vial concentration to the same mass unit, divide dose by concentration to get milliliters, then multiply by 100 for U-100 units:

units = (dose mg ÷ concentration mg/mL) × 100

The arithmetic never changes across the ladder — only the dose number does. That is the whole point of a titration calculator: it re-runs the same division for each week's target so you do not move a decimal place by hand. Every worked example below uses that one formula.

Step 1 · week 1–4

0.25 mg ÷ 1 mg/mL = 0.25 mL → 25 units. The opening step on a 1 mg/mL vial.

Step 2 · week 5–8

0.5 mg ÷ 1 mg/mL = 0.5 mL → 50 units. The dose doubles, so the draw doubles.

Step 3 · week 9–12

1 mg ÷ 1 mg/mL = 1.0 mL → 100 units — a full 1 mL U-100 syringe.

Wegovy step 4 · week 13–16

1.7 mg ÷ 1 mg/mL = 1.7 mL → 170 units, which needs two draws on a 1 mL syringe.

Wegovy maintenance · week 17+

2.4 mg ÷ 1 mg/mL = 2.4 mL → 240 units at this dilution. See 2.4 mg units by concentration for stronger mixes.

Same step, stronger vial

0.25 mg ÷ 2 mg/mL = 0.125 mL → 12.5 units. Identical dose, half the units, because the vial is twice as strong.

Ozempic max · week 13+

2 mg ÷ 5 mg/mL = 0.4 mL → 40 units. A concentrated 5 mg/mL vial keeps even the top dose under half a milliliter.

mg-to-mcg sanity check

0.25 mg = 250 mcg. Mixing mg and mcg is the classic 10× error — convert before you divide, every time.

Semaglutide titration schedule staircase A rising staircase showing the semaglutide dose climbing from 0.25 mg to 2.4 mg in four-week steps. 0.25 0.5 1.0 1.7 2.4 mg wk 1–4 wk 5–8 wk 9–12 wk 13–16 wk 17+
The Wegovy semaglutide titration staircase: each tread is four weeks, the dose rises until 2.4 mg becomes the maintenance plateau.

Adjusting and tracking the schedule

If a step brings on rough nausea, the labelled option is to stay on the current dose for an extra four weeks before trying the next one — escalation is paused, not abandoned. Missing an injection has its own rules; see the missed GLP-1 dose guide for the label's window before you skip or double up. Whatever your plan, write the dates down: a titration that drifts loses the four-week structure that makes it tolerable.

To map your own calendar and, if you compound, the units for each step, use the GLP-1 titration calculator. For the wider rationale on why these medicines escalate at all, the semaglutide dosing guide and GLP-1 titration planner guide go deeper.

So, what is the semaglutide titration schedule?

The semaglutide titration schedule is a stepwise dose-escalation plan that runs for 16 weeks before the maintenance dose is reached. Both Wegovy and Ozempic begin at 0.25 mg once weekly for four weeks, then increase one step every four weeks — Wegovy tops out at 2.4 mg and Ozempic at 2 mg. The formula for each draw on a reconstituted vial is: units = (dose mg ÷ concentration mg/mL) × 100. To map out your own calendar and syringe units for every step, use the GLP-1 titration calculator.

FAQs

What is the semaglutide titration schedule?
The semaglutide titration schedule is a structured dose-escalation plan that increases the weekly dose every four weeks. Wegovy runs 0.25, 0.5, 1, 1.7, then 2.4 mg over 16 weeks; Ozempic runs 0.25, 0.5, 1, then up to 2 mg on the same four-week-per-step rhythm.
How long does the full semaglutide titration take?
Per the Wegovy label, escalation takes 16 weeks: four weeks each at 0.25 mg, 0.5 mg, 1 mg and 1.7 mg, then 2.4 mg as the maintenance dose from week 17. Ozempic reaches its 2 mg maximum on a similar four-weeks-per-step ladder.
Can I skip a titration step if I feel fine?
No. The minimum four weeks per step exists to let gut-related side effects settle before the dose rises. Jumping ahead is a prescriber decision, not a self-directed one, and this page is a maths reference, not medical advice.
What if I cannot tolerate the next dose?
The Wegovy label says you can delay escalation for an extra four weeks at the current dose rather than stopping treatment. Decisions about pausing or stepping back belong to your prescriber.
How many units is 0.25 mg semaglutide on a 1 mg/mL vial?
On a 1 mg/mL vial drawn with a U-100 insulin syringe, 0.25 mg equals 25 units. The formula is: units = (0.25 mg divided by 1 mg/mL) multiplied by 100. The unit count changes if your vial is a different concentration; always check the label before drawing.

Related guides

Sources

This guide is for general educational purposes only and does not constitute medical advice. Dose, schedule, and titration decisions belong to your prescriber. InjectBuddy performs volume and ratio maths only. Always follow your prescriber's specific instructions and the product label.

InjectBuddy/Guides/What Is the Semaglutide Titration Schedule?
Built by the InjectBuddy team - developers, not medical professionals. InjectBuddy performs standard volume and ratio calculations based on your inputs. These guides do not constitute medical advice - always verify dosing with your prescribing doctor or pharmacist.

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