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Comprehensive guide to semaglutide dosing including Ozempic, Wegovy, and compounded formulations. Learn escalation schedules, maintenance doses, and optimal titration for diabetes and weight loss.
All semaglutide formulations (Ozempic, Wegovy, compounded) use similar dosing: start at 0.25 mg weekly for 4 weeks, increase to 0.5 mg, then escalate monthly through 1 mg, 1.7 mg, and 2.4 mg weekly as the maximum dose for weight loss. For diabetes, most people maintain at 0.5-2 mg. The medication is identical across brands - only the indication and maximum dose differ.
Semaglutide delivers 15-17% average weight loss at 2.4 mg and -1.5 to -2.0% A1C reduction. It's one of the most effective GLP-1 medications available for both weight loss and diabetes management.
| Formulation | Indication | Dose Range | Maintenance Dose | Key Difference |
|---|---|---|---|---|
| Ozempic | Type 2 Diabetes | 0.25 mg - 2 mg | 0.5 mg, 1 mg, or 2 mg | FDA max 2 mg (not 2.4 mg) |
| Wegovy | Weight Management | 0.25 mg - 2.4 mg | 2.4 mg weekly | Includes 2.4 mg dose for weight loss |
| Compounded | Weight Loss (Off-Label) | 0.25 mg - 2.5+ mg | 1 mg, 2 mg, or 2.5 mg | Flexible dosing, often more affordable |
All forms contain the same active ingredient - semaglutide. The medication works identically regardless of brand. The main differences are FDA indication (diabetes vs weight loss), maximum approved dose, and price/insurance coverage. Effectiveness for weight loss and diabetes control is equivalent across formulations at the same dose.
| Month | Dose | Purpose | A1C Reduction | Weight Loss |
|---|---|---|---|---|
| 1 | 0.25 mg | Starting dose - adaptation | Minimal | 2-4 lbs |
| 2 | 0.5 mg | First therapeutic dose | -1.0 to -1.4% | 8-10% |
| 3 | 1 mg | Enhanced therapeutic | -1.5 to -1.8% | 10-13% |
| 4 | 1.7 mg | Higher therapeutic | -1.7 to -2.0% | 12-15% |
| 5+ | 2.4 mg | Maximum dose - weight loss | -1.8 to -2.2% | 15-17% |
Compounded semaglutide is the same active ingredient as Ozempic/Wegovy but prepared by specialty pharmacies rather than pharmaceutical manufacturers. It's typically much more affordable and often used for weight loss when brand-name options are too expensive or unavailable.
Follows the same escalation as Ozempic/Wegovy: 0.25 mg → 0.5 mg → 1 mg → 1.7 mg → 2.4 mg. Some providers prescribe 2.5 mg or even 3 mg for patients who need higher doses, though evidence above 2.4 mg is limited. Always follow your provider's specific dosing instructions.
Yes, all contain identical semaglutide as the active ingredient. Ozempic and Wegovy are brand names from Novo Nordisk with the same formulation - the only difference is FDA indication (diabetes vs weight loss) and maximum approved dose (2 mg vs 2.4 mg). Compounded semaglutide uses the same active ingredient from different sources but isn't FDA-approved as a complete product. Effectiveness is equivalent across all forms at the same dose.
Yes, you can switch between formulations at the same dose without re-titrating. For example, if you're on Ozempic 1 mg, you can switch directly to Wegovy 1 mg or compounded 1 mg. The medication is identical so your body is already adapted. Many people switch based on insurance coverage, cost, or availability. Always inform your provider when switching formulations to ensure proper dosing continuity.
Compounded semaglutide is typically most affordable at $150-300/month. Brand-name Ozempic and Wegovy cost $900-1,350/month without insurance but may be covered (Ozempic for diabetes, Wegovy sometimes for weight loss with BMI ≥30 or ≥27 with comorbidities). If you have good insurance covering Ozempic or Wegovy, that may be cheapest. Without insurance, compounded semaglutide offers identical effectiveness at a fraction of the cost.
Following the standard escalation schedule, it takes 5 months to reach 2.4 mg: Month 1 (0.25 mg), Month 2 (0.5 mg), Month 3 (1 mg), Month 4 (1.7 mg), Month 5 (2.4 mg). This gradual titration minimizes side effects. You may stay at any intermediate dose longer if needed - many people remain at 1 mg or 1.7 mg for months if experiencing good results. Only escalate when you've tolerated the current dose for at least 4 weeks.
No, many people achieve excellent results at lower doses. Clinical data shows 8-10% weight loss at 0.5 mg, 10-13% at 1 mg, and 12-15% at 1.7 mg - all meaningful outcomes. The 2.4 mg dose delivers maximum weight loss (15-17% average) but isn't necessary for everyone. If you're satisfied with your weight loss and tolerate a lower dose well, you can maintain there long-term. Work with your provider to find your optimal dose.
Some providers prescribe compounded semaglutide at 2.5 mg or 3 mg for patients who plateau at 2.4 mg, though clinical evidence above 2.4 mg is limited. Higher doses may produce additional weight loss but also increase side effect risk. Most people achieve their goals at 2.4 mg or below. If considering doses above 2.4 mg, work closely with your provider and understand this is off-label use beyond studied dosing.
Completely different medications and doses. Semaglutide ranges from 0.25-2.4 mg while tirzepatide ranges from 2.5-15 mg - but you can't compare them directly because they're different drugs. Semaglutide is a GLP-1 agonist, while tirzepatide is a dual GIP/GLP-1 agonist. Both use weekly injections with gradual escalation. Tirzepatide typically produces slightly better results (20-25% weight loss vs 15-17%) but has a different side effect profile and cost structure.
The 0.25 mg dose is a starter only and won't provide meaningful weight loss or diabetes control. The 0.5 mg dose is therapeutic and can provide 8-10% weight loss and -1.0 to -1.4% A1C reduction - both beneficial outcomes. If higher doses aren't affordable, staying at 0.5 mg is better than nothing. Consider compounded semaglutide which may allow higher doses at lower cost, or discuss alternative GLP-1 medications with your provider.
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