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Complete Dosing Guide

Semaglutide Dosage Chart: All Forms & Formulations

Comprehensive guide to semaglutide dosing including Ozempic, Wegovy, and compounded formulations. Learn escalation schedules, maintenance doses, and optimal titration for diabetes and weight loss.

Quick Dosage Overview

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.

Semaglutide Formulation Comparison

FormulationIndicationDose RangeMaintenance DoseKey Difference
OzempicType 2 Diabetes0.25 mg - 2 mg0.5 mg, 1 mg, or 2 mgFDA max 2 mg (not 2.4 mg)
WegovyWeight Management0.25 mg - 2.4 mg2.4 mg weeklyIncludes 2.4 mg dose for weight loss
CompoundedWeight Loss (Off-Label)0.25 mg - 2.5+ mg1 mg, 2 mg, or 2.5 mgFlexible dosing, often more affordable

Important Note

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.

Standard Semaglutide Escalation Schedule

MonthDosePurposeA1C ReductionWeight Loss
10.25 mgStarting dose - adaptationMinimal2-4 lbs
20.5 mgFirst therapeutic dose-1.0 to -1.4%8-10%
31 mgEnhanced therapeutic-1.5 to -1.8%10-13%
41.7 mgHigher therapeutic-1.7 to -2.0%12-15%
5+2.4 mgMaximum dose - weight loss-1.8 to -2.2%15-17%
Note on Ozempic: Ozempic is FDA-approved only up to 2 mg for diabetes. The 2.4 mg dose is available only through Wegovy (for weight loss) or compounded semaglutide. Many providers prescribe Ozempic 2 mg off-label for weight loss when 2.4 mg options aren't available.

Compounded Semaglutide Dosing

What is Compounded Semaglutide?

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.

Advantages:

  • Much lower cost ($150-300/month vs $1,000+)
  • Flexible dosing - can customize to exact needs
  • Available when brand names are in shortage
  • Can go above 2.4 mg if provider recommends

Considerations:

  • Not FDA-approved (though ingredient is identical)
  • Quality varies by compounding pharmacy
  • Usually requires self-injection (vials vs pens)
  • Availability depends on FDA shortage designations

Typical Compounded Dosing:

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.

When to Use Each Semaglutide Formulation

Ozempic

  • Best for: Type 2 diabetes
  • Insurance: Usually covered for diabetes
  • Max dose: 2 mg weekly
  • Weight loss: 14-15% at 2 mg

Wegovy

  • Best for: Weight loss primary goal
  • Insurance: Sometimes covered for weight loss
  • Max dose: 2.4 mg weekly
  • Weight loss: 15-17% at 2.4 mg

Compounded

  • Best for: Cost-conscious weight loss
  • Insurance: Usually not covered, but cheaper
  • Max dose: Flexible (2.4-3 mg typical)
  • Weight loss: Same as brand (15-17%)

Adjusting Your Semaglutide Dose

Increase Dose When:

  • You've been at current dose for 4+ weeks with minimal side effects
  • Weight loss has plateaued (less than 0.5 lb/week for 2+ weeks)
  • A1C remains above target for diabetes management
  • Appetite suppression effects are wearing off
  • You haven't reached goal weight or A1C target

Stay at Current Dose When:

  • Experiencing moderate to severe GI side effects
  • Losing 1-2 pounds per week consistently
  • A1C and blood sugars are well-controlled
  • You've reached your weight or diabetes goals
  • Appetite control is excellent at current dose
Critical: Never adjust your semaglutide dose without provider approval, regardless of formulation. The monthly escalation schedule is designed for safety and efficacy. Jumping doses or escalating too quickly can cause severe nausea, vomiting, and other dangerous side effects.

Frequently Asked Questions

Is the semaglutide in Ozempic, Wegovy, and compounded versions the same?

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.

Can I switch between Ozempic, Wegovy, and compounded semaglutide?

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.

Which semaglutide formulation is most affordable?

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.

How long does it take to reach the maximum semaglutide dose?

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.

Do I need to reach 2.4 mg for good weight loss results?

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.

Can I use a higher dose than 2.4 mg with compounded semaglutide?

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.

How is semaglutide dosing different from tirzepatide (Mounjaro/Zepbound)?

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.

What if I can only afford the 0.25 mg or 0.5 mg dose?

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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