Semaglutide dosage chart, titration schedule, and dosing in units.

The complete guide to semaglutide dosing — the 5-step titration from 0.25 mg starting dose to 2.4 mg maximum maintenance dose, injection sites, dosing in units for compounded vials, and what to expect at each stage of the escalation protocol.

Semaglutide dosing schedule

Semaglutide uses a 5-step dose escalation protocol designed to minimize gastrointestinal side effects while reaching therapeutic levels. The titration takes approximately 16–20 weeks. Every patient starts at the lowest dose regardless of target weight loss.

This schedule applies to both brand-name and compounded semaglutide formulations. Compounded formulations allow more flexible dose adjustments between standard steps when needed.

Starting dose: 0.25 mg

The semaglutide starting dose is 0.25 mg injected subcutaneously once weekly. This introductory dose is below the therapeutic threshold for weight loss — its purpose is to allow your GI system to adapt to GLP-1 receptor activation before escalating.

Most patients experience minimal side effects at 0.25 mg. If you do experience nausea, it typically resolves within the first 1–2 weeks. Do not skip the starting dose period even if you feel no effects — the titration schedule exists to reduce side effect intensity at higher doses.

Maximum dose of semaglutide

The maximum approved dose of semaglutide for weight management is 2.4 mg per week (weight loss dosing). For type 2 diabetes (weight loss dosing), the max dose is 2.0 mg per week.

Not all patients require the maximum dose. Some reach their target weight at 1.0 mg or 1.7 mg weekly. With compounded semaglutide, providers can prescribe intermediate doses (e.g., 1.25 mg, 1.5 mg) that are not available in brand-name pre-filled pens.

Semaglutide dosing in units

Compounded semaglutide is supplied as a multi-dose vial at concentrations of 1 mg/mL, 2.5 mg/mL, or 5 mg/mL. The number of units you draw depends on your prescribed dose and vial concentration.

Always confirm your vial concentration with your pharmacy before drawing your dose. Using the wrong concentration is the most common dosing error with compounded semaglutide.

Semaglutide injection sites

Semaglutide is administered as a subcutaneous injection into the fat layer just beneath the skin. The three recommended injection sites are:

• Abdomen — at least 2 inches from the navel. Most popular site due to accessibility and consistent absorption.
• Upper thigh — front of the thigh, midway between knee and hip. Good alternative if abdominal injection is uncomfortable.
• Upper arm — back of the upper arm. May require assistance for proper technique.

Rotate injection sites weekly to prevent lipodystrophy. Use the same general area but move the exact point by at least 1 inch each week.

Week-by-week: what to expect

Weeks 1–4: 0.25 mg (initiation)

Below therapeutic threshold. Minimal appetite suppression. Some patients report mild nausea in the first 48 hours. Weight loss: 0 to 2 lbs.

Weeks 5–8: 0.5 mg (low therapeutic)

Appetite suppression becomes noticeable. Reduced hunger and earlier satiety at meals. Typical loss: 3–5 lbs during this period.

Weeks 9–12: 1.0 mg (therapeutic)

Significant appetite reduction. Food noise diminishes substantially. Weight loss accelerates — average 4–8 lbs during this period.

Weeks 13–16: 1.7 mg (escalation)

Most dramatic change in relationship with food. Portions shrink naturally. Cravings for high-calorie foods decrease. GI side effects are most common during this transition.

Weeks 17+: 2.4 mg (maintenance)

Maximum dose. Clinical trials showed 15–17% total body weight loss at this dose over 68 weeks. Not all patients need to reach 2.4 mg — your provider may maintain you at a lower dose with fewer side effects.

When to take semaglutide

Inject once weekly on the same day each week. Time of day does not matter. If nausea is an issue, injecting before bedtime lets you sleep through the peak GI effects (6–12 hours post-injection).

If you miss a dose by less than 5 days, take it as soon as you remember. If more than 5 days have passed, skip and resume your regular schedule.