Semaglutide Dose Calculator
FDA-approved dose escalation schedules for semaglutide. Select the indication, enter your current week of treatment, and see the recommended dose with titration guidance.
Inputs
Dose Escalation Schedule
| Phase | Weeks | Dose | Frequency |
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Disclaimer: For educational purposes only. Not a substitute for clinical judgment. Always refer to official prescribing information.
About This Tool
What Is Semaglutide?
Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist administered as a once-weekly subcutaneous injection. It is approved under two brand names: Ozempic® for the treatment of type 2 diabetes mellitus as an adjunct to diet and exercise, and Wegovy® for chronic weight management in adults with obesity (BMI ≥ 30) or overweight (BMI ≥ 27) with at least one weight-related comorbidity. Semaglutide works by mimicking the incretin hormone GLP-1, which stimulates insulin secretion, suppresses glucagon release, slows gastric emptying, and promotes satiety.
Why Dose Escalation Matters
Semaglutide requires gradual dose titration to minimize gastrointestinal side effects, primarily nausea, vomiting, and diarrhea. Starting at a low dose (0.25 mg) and increasing every 4 weeks allows the body to adapt to the medication. Skipping the titration schedule or escalating too quickly significantly increases the risk and severity of GI adverse effects, potentially leading to dehydration, treatment discontinuation, and poor outcomes.
Ozempic® Dose Schedule (Type 2 Diabetes)
Ozempic is initiated at 0.25 mg once weekly for the first 4 weeks. This is not a therapeutic dose — it is intended to reduce GI side effects during initiation. After 4 weeks, the dose is increased to 0.5 mg once weekly. If additional glycemic control is required after at least 4 weeks on 0.5 mg, the dose may be increased to 1 mg once weekly, and subsequently to 2 mg once weekly if further glycemic improvement is needed. The maximum recommended dose is 2 mg per week.
Wegovy® Dose Schedule (Weight Management)
Wegovy follows a fixed 16-week titration to the maintenance dose: 0.25 mg (weeks 1–4), 0.5 mg (weeks 5–8), 1 mg (weeks 9–12), 1.7 mg (weeks 13–16), and 2.4 mg weekly from week 17 onward. Unlike Ozempic, the Wegovy titration is not based on clinical response — it is a standard schedule that all patients follow to reach the target maintenance dose of 2.4 mg.
Important Safety Information
Semaglutide carries a boxed warning for thyroid C-cell tumors based on rodent studies. It is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Other important warnings include risk of pancreatitis, gallbladder disease, hypoglycemia (especially when used with insulin or sulfonylureas), acute kidney injury (from dehydration due to GI effects), diabetic retinopathy complications, and suicidal behavior/ideation. Semaglutide should not be used during pregnancy.
🔑 Clinical Pearls
- The 0.25 mg starting dose is sub-therapeutic for both indications — its sole purpose is GI tolerability during initiation.
- If a patient cannot tolerate a dose increase, the FDA prescribing information permits remaining at the current dose for an additional 4 weeks before reattempting escalation.
- Semaglutide has a half-life of approximately 1 week, supporting once-weekly dosing. Steady state is reached after 4–5 weeks at a given dose.
- For Ozempic, the increases to 1 mg and 2 mg are clinically driven (based on HbA1c response). For Wegovy, the escalation to 2.4 mg is the default protocol.
- Monitor for signs of pancreatitis (severe abdominal pain), gallbladder events, and rapid heart rate. Discontinue if pancreatitis is confirmed.
Key References
- Ozempic® (semaglutide injection) Prescribing Information. Novo Nordisk Inc. Revised 2024. Available at: novo-pi.com/ozempic.pdf
- Wegovy® (semaglutide injection) Prescribing Information. Novo Nordisk Inc. Revised 2024. Available at: novo-pi.com/wegovy.pdf
- Wilding JPH, et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). N Engl J Med. 2021;384(11):989–1002.
- Marso SP, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes (SUSTAIN-6). N Engl J Med. 2016;375(19):1834–1844.
Formula last verified: February 2026