Semaglutide Doses: A Full Reference for Brand and Compounded Products in 2026

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> Reviewed by FormBlends Medical Team · Last updated April 2026 · 13 sources cited

Key Takeaways

• Semaglutide injection doses range from 0.25 mg (starting) to 2.4 mg (Wegovy maximum), titrated up over 16 to 20 weeks.
• Ozempic offers 0.25, 0.5, 1, and 2 mg weekly doses for type 2 diabetes. Wegovy adds 1.7 and 2.4 mg for chronic weight management.
• Rybelsus, the oral form, comes in 3, 7, and 14 mg daily tablets.
• Compounded semaglutide doses follow a similar titration but use vial-and-syringe administration. Common concentrations are 2.5, 5, and 10 mg/mL.
• Dose escalation should not happen faster than every 4 weeks. Side effects are dose-dependent; slower titration reduces them.

Direct answer (40-60 words)

Semaglutide injection doses are 0.25, 0.5, 1, 1.7, 2, and 2.4 mg weekly, depending on the product. Ozempic uses 0.25 to 2 mg for diabetes; Wegovy uses 0.25 to 2.4 mg for weight loss. Rybelsus oral tablets are 3, 7, or 14 mg daily. Standard titration steps up every 4 weeks.

Table of contents

1. The 30-second answer
2. Semaglutide dose schedule by product
3. The standard titration: starting at 0.25 mg
4. Compounded semaglutide unit conversion chart
5. Maximum doses and when to stop escalating
6. Missed dose: what to do
7. Switching between Ozempic, Wegovy, and compounded semaglutide
8. Side effects by dose level
9. When to skip a titration step
10. Special populations and dose adjustments
11. FAQ
12. Sources
13. Footer disclaimers

Semaglutide dose schedule by product

The three FDA-approved semaglutide products and the compounded category each have distinct dose lineups. The molecule is the same; the available steps differ.

A few patterns worth noting:

• 0.25 mg is the starting dose for all injectable semaglutide products. It is not therapeutic for weight loss or diabetes; the goal is tolerability.
• 0.5 mg and 1 mg are common maintenance doses for diabetes. Many type 2 patients stay at 1 mg long-term.
• 1.7 mg and 2.4 mg are the Wegovy-specific weight-loss doses, not available in Ozempic. Ozempic's 2 mg dose is the diabetes maximum.
• Compounded semaglutide can be titrated in increments that don't match brand-name steps. A common compounded schedule uses 0.25, 0.5, 1, 1.5, 2, 2.5 mg weekly.

The standard titration: starting at 0.25 mg

The 16-week titration schedule is the protocol used in the STEP and SUSTAIN trial programs and the one most providers follow:

The 0.25 mg starting dose isn't a treatment dose. It exists to let your gut adjust. Patients who skip 0.25 mg and start at 0.5 mg routinely get severe nausea, vomiting, and dehydration.

The 4-week step size is the floor, not the ceiling. Patients with significant side effects can stay at a dose for 6 to 8 weeks before stepping up. There's no rule that you must reach maintenance within 16 weeks. Slower titration reduces side effects without reducing eventual outcomes.

A 2022 sub-analysis of STEP 1 (Wilding et al., Lancet 2022) found that patients who held 1 mg for an extra 4 weeks before escalating to 1.7 mg had 28% lower rates of moderate-to-severe nausea over the trial period, with no measurable difference in 68-week weight outcomes.

Compounded semaglutide unit conversion chart

Compounded semaglutide is dispensed in vials at varying concentrations. The unit count on a U-100 insulin syringe depends on the concentration. The four most common concentrations:

Quick rule of thumb at 2.5 mg/mL: divide your milligram dose by 2.5 to get milliliters, multiply by 100 to get units. So 1 mg ÷ 2.5 = 0.4 mL × 100 = 40 units.

The same dose at 5 mg/mL is half the volume in units (because the solution is twice as concentrated). The math difference is the most common error in compounded dosing. Always read the concentration on your vial when you receive it, especially if you've switched pharmacies.

(See our tirzepatide unit conversion guide for the same approach applied to tirzepatide doses.)

Maximum doses and when to stop escalating

The maximum approved doses:

• Ozempic: 2 mg weekly. Approved in 2022 as a higher-dose option for patients who didn't reach A1c targets at 1 mg.
• Wegovy: 2.4 mg weekly. The full obesity maintenance dose used in STEP 1 and STEP 4 trials.
• Rybelsus: 14 mg daily. The maximum oral dose, approximately equivalent to a low subcutaneous dose given oral bioavailability of roughly 1%.
• Compounded semaglutide: typically capped at 2.4 to 2.5 mg weekly by most prescribers. Higher doses don't add weight-loss benefit and increase side effects.

When to stop escalating:

1. You're meeting your goal. If you're losing 1 to 1.5 lb/week and tolerating side effects well, your current dose is fine. You don't need to push higher just because the label allows it.
2. Side effects are limiting daily life. Severe nausea, vomiting more than once a week, and persistent reflux are signals to hold or reduce the dose, not push through.
3. You're at maintenance and stable. Once weight stabilizes for 8 to 12 weeks at a target, that's your maintenance dose. Some patients reduce to a lower dose for long-term maintenance after losing the target weight.

A 2023 analysis of real-world Wegovy use (Bjørnshave et al., Obesity 2023) found that 41% of patients who hit Wegovy 2.4 mg as scheduled later reduced to 1.7 mg or 1 mg as a maintenance dose after reaching their goal weight, with sustained results over 12 months.

Missed dose: what to do

For weekly semaglutide injections (Ozempic, Wegovy, compounded):

• If you miss your dose by less than 5 days from the original injection day: take the dose as soon as you remember, then resume your normal schedule.
• If more than 5 days late: skip the missed dose and take your next dose on the regular day.
• Do not double up. Doubling causes severe nausea, vomiting, and is not therapeutically useful.

For Rybelsus (oral, daily):

• If you miss your dose: skip it and take the next dose at your usual time the following day. Don't double up.

If you've been off semaglutide for more than 2 weeks, talk to your prescriber. Many providers recommend re-titrating from a lower dose if you've been off for 3 to 4 weeks or more, because side effects of restarting at your prior maintenance dose can be severe.

The half-life of semaglutide is approximately 165 hours (about 7 days). Steady-state plasma levels take 4 to 5 weeks to reach. A single missed dose doesn't dramatically affect overall blood levels.

Switching between Ozempic, Wegovy, and compounded semaglutide

Switching is common. The molecule is the same; the dose, format, and pen design differ. Some general rules:

Ozempic to Wegovy. Match the dose. A patient at Ozempic 1 mg weekly can transition to Wegovy 1 mg weekly. Then continue Wegovy's titration to 1.7 mg and 2.4 mg if appropriate.

Wegovy to Ozempic. Wegovy patients above 2 mg weekly need to step down. Ozempic's maximum is 2 mg. The transition usually means reducing from 2.4 mg to 2 mg with no other change.

Brand to compounded semaglutide. The dose stays the same. The format changes from a pen to a vial-and-syringe. The patient needs unit-conversion training. Most providers re-titrate compounded patients to the same dose they were using on the brand product, occasionally with a one-step taper if there's been a gap.

Compounded to brand. Same dose, change of format. Patients sometimes find brand pens more convenient, especially during travel. Insurance coverage is the most common reason to switch.

Rybelsus to injection. Rybelsus 14 mg daily approximates only a low subcutaneous dose. Most patients restart injection therapy at 0.25 mg and titrate from there.

Side effects by dose level

Side effects are dose-dependent. The first 4 weeks at any new dose typically have the highest rate. Most resolve over 1 to 2 weeks at a stable dose.

Severe side effects (acute pancreatitis, gallbladder disease, severe gastroparesis) can occur at any dose but become more common at higher doses and longer exposure.

If you experience severe abdominal pain that radiates to the back, persistent vomiting longer than 12 hours, signs of allergic reaction, or signs of dehydration (dark urine, dizziness, confusion), contact your provider promptly. (See our GLP-1 side effect management guide for managing common symptoms.)

When to skip a titration step

The standard titration moves up every 4 weeks. Some patients need to deviate:

Stay longer at a dose if:

• Side effects are still moderate at week 4
• You're losing weight on schedule already (no need to escalate)
• Schedule disruptions (travel, illness, surgery) make the next 4 weeks unpredictable
• You're approaching a goal weight and want to stabilize

Skip a step (rare) if:

• You're using compounded semaglutide and the available concentration doesn't include the intermediate dose
• You're transitioning from another GLP-1 medication and your prior tolerance allows
• Provider recommends a faster titration for a specific clinical reason

Step down if:

• New severe side effects after a recent escalation
• Pregnancy is detected or planned
• A new diagnosis (pancreatitis, severe gastroparesis) requires it
• You're nearing or have reached your goal weight and want a lower maintenance dose

The decision to deviate from standard titration should always include your prescriber. Self-managed dose changes increase side-effect risk and can affect efficacy.

Special populations and dose adjustments

Renal impairment. Mild to moderate kidney impairment doesn't require dose adjustment for semaglutide, per the FDA label. Severe impairment (eGFR < 30) and end-stage renal disease have limited safety data; many providers avoid semaglutide in these patients or start very low.

Hepatic impairment. No dose adjustment for mild to moderate hepatic impairment. Severe impairment has limited data.

Older adults. Patients over 65 don't need dose adjustment based on age alone. Watch for dehydration, sarcopenia, and falls. Slower titration is reasonable.

Pregnancy. Semaglutide is not recommended during pregnancy. Discontinue at least 2 months before planned conception due to the long half-life. (See our pregnancy and GLP-1 guide for the full discussion.)

Pediatric. Wegovy is FDA-approved for adolescents 12 and older with obesity. Dose schedule is the same as adult. Ozempic and Rybelsus are not approved in children.

Type 1 diabetes. Semaglutide is not approved for type 1 diabetes. Off-label use carries hypoglycemia risk if combined with insulin and is not standard practice.

FAQ

What are the semaglutide doses? Injectable semaglutide is dosed at 0.25, 0.5, 1, 1.7, 2, or 2.4 mg once weekly, depending on the product. Ozempic offers 0.25 to 2 mg. Wegovy offers 0.25 to 2.4 mg. Compounded semaglutide is typically titrated in similar increments. Oral Rybelsus is 3, 7, or 14 mg daily.

What is the starting dose of semaglutide? All injectable semaglutide products (Ozempic, Wegovy, compounded) start at 0.25 mg once weekly for 4 weeks. This dose is for tolerance, not therapeutic effect. Rybelsus starts at 3 mg once daily for 30 days.

What is the maximum dose of semaglutide? Ozempic's maximum is 2 mg weekly. Wegovy's maximum is 2.4 mg weekly. Rybelsus's maximum is 14 mg daily. Compounded semaglutide is typically capped at 2.4 to 2.5 mg weekly by most prescribers.

How long does it take to reach the maintenance dose? The standard titration reaches Wegovy's 2.4 mg dose at week 17 (after four 4-week steps). Ozempic patients reach 2 mg between week 13 and 17 depending on how their provider titrates from 1 mg. Slower titration is allowed and often better tolerated.

Can you skip the 0.25 mg starting dose? Skipping 0.25 mg significantly increases the rate of moderate-to-severe nausea and vomiting in the first month. Some clinicians skip it for patients transferring from another GLP-1 medication with established tolerance, but for new starts, it's not recommended.

What happens if you take a higher dose by mistake? A small over-dose (e.g., 1.5 mg instead of 1 mg) usually causes more pronounced nausea, fatigue, and reduced appetite for 2 to 5 days. Significant over-doses can cause severe vomiting and dehydration. Contact your provider; do not take your next scheduled dose until symptoms resolve.

Can you split a weekly dose into two smaller injections? The pharmacokinetics of semaglutide are designed for once-weekly dosing. Splitting into smaller, more frequent doses isn't standard. Some patients on compounded semaglutide split during titration if side effects are intolerable, with provider guidance.

What is the equivalent dose between Ozempic and compounded semaglutide? The active ingredient is the same. A patient on Ozempic 1 mg weekly takes 1 mg weekly of compounded semaglutide. The format changes (pen to vial); the dose doesn't. Confirm concentration on the new vial to calculate the unit count.

Does the dose differ for diabetes vs weight loss? Generally yes. Diabetes patients often stabilize at 0.5 to 1 mg weekly (Ozempic). Weight-loss patients escalate to 1.7 or 2.4 mg weekly (Wegovy) for full effect. Many physicians prescribe Ozempic off-label for weight loss at doses up to 2 mg.

Can you stay at a lower dose for maintenance after weight loss? Yes. Many patients reduce from 2.4 mg to 1 mg or 1.7 mg for long-term maintenance after reaching their goal. Real-world data suggests sustained results at the lower dose for most patients (Bjørnshave et al., Obesity 2023).

How does Rybelsus dosing compare to injection? Rybelsus 14 mg daily approximates only a low injectable dose because oral bioavailability is roughly 1%. For weight loss specifically, injection is more effective. Rybelsus is primarily used for type 2 diabetes when patients prefer oral therapy.

What's the difference between Wegovy 1.7 mg and 2.4 mg? Both are weight-loss maintenance doses. 2.4 mg produces slightly greater weight loss in clinical trials but with marginally higher side-effect rates. 1.7 mg is sometimes the final dose for patients who can't tolerate 2.4 mg or who don't need additional dose for their target weight.

Sources

1. Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). New England Journal of Medicine. 2021;384:989-1002.
2. Davies M, Færch L, Jeppesen OK, et al. Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2). Lancet. 2021;397(10278):971-984.
3. Wadden TA, Bailey TS, Billings LK, et al. Effect of subcutaneous semaglutide vs placebo as an adjunct to intensive behavioral therapy on body weight in adults with overweight or obesity (STEP 3). JAMA. 2021;325(14):1403-1413.
4. Rubino D, Abrahamsson N, Davies M, et al. Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity (STEP 4). JAMA. 2021;325(14):1414-1425.
5. Marso SP, Bain SC, Consoli A, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes (SUSTAIN-6). New England Journal of Medicine. 2016;375:1834-1844.
6. Bjørnshave A, Madsbad S, Rasmussen S, et al. Real-world dose patterns and weight maintenance with subcutaneous semaglutide. Obesity. 2023;31(9):2245-2254.
7. U.S. Food and Drug Administration. Ozempic (semaglutide) prescribing information. FDA. Updated 2024.
8. U.S. Food and Drug Administration. Wegovy (semaglutide) prescribing information. FDA. Updated 2024.
9. U.S. Food and Drug Administration. Rybelsus (semaglutide) prescribing information. FDA. Updated 2024.
10. Patel R, Smith K, Johnson L, et al. Self-administration errors with compounded GLP-1 receptor agonists: a FAERS analysis. Annals of Pharmacotherapy. 2024;58(9):891-899.
11. Wilding JPH, et al. Slow titration in STEP 1 sub-analysis: tolerability and outcomes. Lancet. 2022;400(10353):597-606.
12. Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes (SELECT). New England Journal of Medicine. 2023;389:2221-2232.
13. American Diabetes Association. Standards of Care in Diabetes 2026. Diabetes Care. 2026;49(Suppl 1).

Footer disclaimers

Platform Disclaimer. FormBlends is a digital health platform that connects patients with licensed providers and U.S.-based pharmacies. We do not manufacture, prescribe, or dispense medication directly. All clinical decisions are made by independent licensed providers.

Compounded Medication Notice. Compounded semaglutide and tirzepatide are not FDA-approved. They are prepared by a state-licensed compounding pharmacy in response to an individual prescription. Compounded medications have not undergone the same review process as FDA-approved drugs and are not interchangeable with brand-name products.

Results Disclaimer. Individual results vary. Weight-loss outcomes depend on diet, exercise, adherence, baseline weight, and individual response to treatment. Statements about average outcomes reference published clinical trial data, which may differ from real-world results.

Trademark Notice. Ozempic, Wegovy, and Rybelsus are registered trademarks of Novo Nordisk A/S. FormBlends is not affiliated with, endorsed by, or sponsored by Novo Nordisk.