# Semaglutide Dosage: The Titration Schedule Explained

**By TelosRX Editorial Team** · 2026-08-17

**Semaglutide dosage follows a stepwise titration rather than one fixed number. The FDA-approved labels start low and step up at set intervals, and every plan, including [compounded semaglutide at Telos Rx](https://www.telosrx.com/pages/semaglutide), is written by a licensed provider.**

Ozempic, Wegovy, Rybelsus and compounded preparations do not share one schedule, and the gaps between them are the whole story. What follows reports what the approved labels document. It is background, not a plan to follow.

## One Molecule, Several Labels, Several Schedules

Semaglutide is a single GLP-1 receptor agonist from Novo Nordisk, marketed under separate brand names for separate indications. Each brand carries its own dosing section with its own numbers.

So an Ozempic dose and a Wegovy dose are not interchangeable figures, even though the active molecule is identical. The brand question is unpacked in [Is Ozempic semaglutide?](https://www.telosrx.com/blogs/glp1/is-ozempic-semaglutide-explained), and the molecule itself in [What is semaglutide?](https://www.telosrx.com/blogs/glp1/what-is-semaglutide-complete-guide)

Product

Form and frequency

Documented escalation

Labeled maximum

**Wegovy** (chronic weight management)

Subcutaneous injection, once weekly

0.25, 0.5, 1, 1.7, then 2.4 mg in 4-week steps

2.4 mg weekly maintenance, with a 7.2 mg weekly option documented for adults

**Ozempic** (type 2 diabetes)

Subcutaneous injection, once weekly

0.25 mg for 4 weeks, then 0.5 mg, then 1 mg, then 2 mg, each step at least 4 weeks apart

2 mg once weekly

**Rybelsus** (type 2 diabetes)

Oral tablet, once daily

3 mg for the first 30 days, then 7 mg, with 14 mg available after at least 30 days at 7 mg

14 mg once daily

**Compounded semaglutide**

Varies by prescription

Not FDA-approved, so no brand label governs it; set case by case

Set by the prescribing provider

## The Wegovy Titration Schedule, Step by Step

Wegovy is the weight-management brand, and its label sets out the escalation most people mean when they search for a semaglutide dosing schedule. Each step lasts four weeks.

Weeks

Dose once weekly

Stage

1 to 4

0.25 mg

Run-in

5 to 8

0.5 mg

Step up

9 to 12

1 mg

Step up

13 to 16

1.7 mg

Step up

17 onward

2.4 mg

Maintenance

Reaching 2.4 mg weekly, the dose studied in the STEP 1 trial, therefore takes about four months. The [current Wegovy prescribing information](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b) lists 1.7 mg as an alternative maintenance dosage for adults who do not tolerate 2.4 mg, and documents a higher 7.2 mg weekly option for adults who have tolerated 2.4 mg for at least four weeks and need additional weight reduction.

Wegovy is approved for chronic weight management, and its label also carries the cardiovascular risk-reduction indication that followed the SELECT trial and an accelerated approval for noncirrhotic MASH with moderate to advanced liver fibrosis. The schedule above is still a prescriber's framework rather than a self-service chart.

## Ozempic Dosing Stops Lower, and That Is Deliberate

Ozempic is the type 2 diabetes brand, and its maintenance range sits below Wegovy's. The [Ozempic label](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adec4fd2-6858-4c99-91d4-531f5f2a2d79) starts at 0.25 mg once weekly for four weeks, moves to 0.5 mg, and allows 1 mg and then 2 mg if additional glycemic control is needed, with at least four weeks at each step.

Two mg once weekly is the maximum recommended dosage for Ozempic injection. Anyone searching for a 2.4 mg Ozempic dose is really looking at the Wegovy label, which is the most common mix-up in this category.

The escalation is also driven by a different endpoint. Ozempic steps up when blood glucose targets are not met, while Wegovy follows a fixed calendar to a maintenance dose.

## What the 0.25 mg Starting Dose Is Actually For

Semaglutide 0.25 mg is a run-in dose. Both injectable labels are explicit that the low starting dose exists to reduce the risk of gastrointestinal adverse reactions during escalation.

Semaglutide slows gastric emptying and acts on appetite signaling, and those same actions produce the nausea, vomiting, diarrhea and constipation that cluster in the first weeks and just after each increase. Four-week blocks give the gut time to adapt between them.

A faster ramp is therefore not a better one. Our summary of [the research on GLP-1 nausea](https://www.telosrx.com/blogs/glp1/glp1-side-effects-research-nausea-management) covers the pattern, and [microdosing semaglutide](https://www.telosrx.com/blogs/glp1/microdosing-semaglutide-benefits-risks-guide) looks at the lower-dose end.

Titration is the background. The dose that applies to you is a clinical decision, made at Telos Rx by a licensed provider after a written intake, with no appointment to book.

[See compounded semaglutide at Telos Rx](https://www.telosrx.com/pages/semaglutide)

## Rybelsus and the Oral Schedule Work on Days, Not Weeks

Rybelsus is the original oral semaglutide for type 2 diabetes, taken once daily rather than weekly, so its escalation runs in 30-day blocks. The [Rybelsus prescribing information](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=27f15fac-7d98-4114-a2ec-92494a91da98) documents 3 mg once daily for the first 30 days, then 7 mg, with an increase to 14 mg available after at least 30 days at 7 mg.

A Rybelsus dose also comes with administration rules the injections do not have. The label directs that the tablet is taken on an empty stomach in the morning with no more than four ounces of water, swallowed whole, with at least 30 minutes before food, other drinks or other oral medicines.

Oral semaglutide has expanded well beyond those three strengths. The same prescribing information now also covers Ozempic tablets, stepping 1.5 mg then 4 mg then 9 mg once daily for type 2 diabetes, and the Wegovy label covers tablets stepping 1.5 mg, 4 mg, 9 mg then 25 mg once daily in 30-day blocks. The formats are compared in [the semaglutide pill guide](https://www.telosrx.com/blogs/glp1/semaglutide-pill-oral-guide) and in [oral versus injectable semaglutide](https://www.telosrx.com/blogs/glp1/oral-vs-injectable-semaglutide-comparison).

## Why Compounded Protocols Do Not Simply Copy the Label

**Compounded semaglutide is not FDA-approved.** It is prepared by licensed US compounding pharmacies against a prescription written for an individual patient, and it does not carry a brand label with a fixed titration table.

Compounded preparations are also not required to match a brand's concentration. That is why a number copied from someone else's post can mean something different on your own syringe, and why volume in millilitres is no substitute for a dose in milligrams, a trap covered in [tirzepatide dosing in mL](https://www.telosrx.com/blogs/glp1/tirzepatide-dosing-in-ml).

What stays constant is the direction of travel. Start low, hold for weeks, reassess, and move up only when the current step is tolerated. Everything else belongs to the prescriber, and any prescription is subject to medical approval by a licensed provider.

Semaglutide carries a boxed warning for thyroid C-cell tumours seen in rodents, and it is contraindicated for anyone with a personal or family history of medullary thyroid carcinoma or MEN 2. It is not for use in pregnancy. The parallel ramp for the other molecule is in [tirzepatide dosage: the titration schedule explained](https://www.telosrx.com/blogs/glp1/tirzepatide-dosage-schedule).

## Holding a Step Is Normal, Not a Setback

Providers routinely extend time at one step, repeat it, or step back down when side effects are hard to live with. The label calendar describes a route, not a deadline.

Nausea that fades over a week or two is common. Nausea that stops you eating, drinking or sleeping is a reason to report it rather than push through.

Some people settle at a lower step than expected and stay there. The labels anticipate that, which is why alternative maintenance dosages exist.

## What Titration Costs at Telos Rx

Telos Rx is an online-first, asynchronous, LegitScript-certified telehealth pharmacy. You complete a written intake, a US-licensed provider reviews it, often within hours, and there is no appointment to schedule.

Pricing is flat across the titration. As of publication the [semaglutide page](https://www.telosrx.com/pages/semaglutide) shows compounded semaglutide as low as $99 per month, and the monthly cost does not change as a clinician steps the dose up. Plans are FSA and HSA eligible, shipping is free within 48 hours if approved, and you can cancel anytime. The wider cost picture sits in [semaglutide cost compared with Ozempic and Wegovy](https://www.telosrx.com/blogs/glp1/semaglutide-cost-price-guide).

Why this site will not print a self-guided chart is covered in [how titration actually works](https://www.telosrx.com/blogs/glp1/semaglutide-dosage-chart). Approval is subject to evaluation by a licensed provider and is not guaranteed.

## Frequently Asked Questions

### What is the starting dose of semaglutide?

Both injectable labels start at 0.25 mg once weekly. Wegovy holds that dose for weeks 1 through 4, and Ozempic holds it for four weeks before the first increase. Rybelsus, the oral tablet, starts instead at 3 mg once daily for 30 days. Compounded protocols are set by the prescribing provider.

### How long do you stay on 0.25 mg of semaglutide?

Four weeks on the injectable labels. The 0.25 mg step is a run-in intended to reduce the risk of gastrointestinal adverse reactions rather than to deliver a full treatment effect. A provider can extend that step if side effects are difficult, and holding longer is a normal part of titration rather than a failure.

### What is the maximum semaglutide dose?

It depends on the product. Ozempic injection lists 2 mg once weekly as the maximum recommended dosage, Rybelsus lists 14 mg once daily, and Wegovy uses 2.4 mg weekly as its recommended maintenance dosage with a higher 7.2 mg weekly option documented for adults who tolerate 2.4 mg and need additional weight reduction.

### Is the Ozempic dosage the same as the Wegovy dose?

No, even though the molecule is identical. Ozempic injection is labeled for type 2 diabetes and tops out at 2 mg once weekly, while Wegovy injection is labeled for chronic weight management and steps to a 2.4 mg maintenance dosage. Ozempic also escalates in response to glycemic targets rather than on a fixed calendar.

### What is the Rybelsus dose schedule?

The label documents 3 mg once daily for the first 30 days, an increase to 7 mg, and then 14 mg after at least 30 days at 7 mg. It is taken on an empty stomach in the morning with no more than four ounces of water, and at least 30 minutes before food, other drinks or other oral medicines.

### Does compounded semaglutide follow the same titration schedule?

Not automatically. Compounded semaglutide is not FDA-approved and does not carry a brand label, so there is no fixed table attached to it. Protocols vary between pharmacies and prescriptions, concentrations can differ, and the schedule is written by the licensed provider who reviews your history.

_TelosRX is LegitScript-certified. Compounded medications are not FDA-approved and are prepared under federal compounding regulations. Approval is subject to evaluation by a licensed provider; approval is not guaranteed. Individual results vary. TelosRX operates as an online-first, asynchronous telehealth service._

If the next question is whether semaglutide is appropriate for you, start with the [compounded semaglutide page](https://www.telosrx.com/pages/semaglutide), then complete the written intake at [start.telosrx.com](https://start.telosrx.com/start-online-visit/weightloss). A licensed provider reviews every request and sets any titration plan, and approval is not guaranteed.

**Tags:** GLP-1, Ozempic, Rybelsus, semaglutide, semaglutide dosage, titration, Wegovy, weight management

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> Source: [Telos RX](https://www.telosrx.com/blogs/glp1/semaglutide-dosage-schedule)