Semaglutide Dosing Chart: Weekly Titration for Ozempic, Wegovy, and Rybelsus

A semaglutide dosing chart shows the step-by-step dose increases used to start and then maintain semaglutide. Most charts begin at 0.25 mg once weekly and add a step about every four weeks until a maintenance dose is reached. The steps differ by product: Ozempic tops out at 2 mg weekly, Wegovy at 2.4 mg weekly, and Rybelsus is a daily tablet that moves from 3 mg to 7 mg to 14 mg.

Why Semaglutide Is Started Low and Increased Slowly

Semaglutide slows stomach emptying and changes how the body signals appetite and blood sugar. Jumping straight to a full dose makes nausea, vomiting, diarrhea, and constipation far more likely. Titration gives the body time to adjust while a clinician watches how each step is tolerated.

Climbing the chart is not a race. If side effects are strong, prescribers often hold the current dose for another four weeks or drop back a step. Staying at a lower dose longer is a normal part of a semaglutide dosing schedule, not a sign that treatment is failing.

Dose increases also depend on why the drug was prescribed. Someone using semaglutide for type 2 diabetes may never need the top weight-management dose, while someone using it for chronic weight management usually keeps moving up until reaching 2.4 mg or the highest dose they tolerate.

Semaglutide Dosing Chart by Product

Product	Form	Starting dose	Titration steps	Maintenance dose
Ozempic	Weekly injection	0.25 mg for 4 weeks	0.5 mg, 1 mg, 2 mg	0.5-2 mg weekly
Wegovy	Weekly injection	0.25 mg for 4 weeks	0.5 mg, 1 mg, 1.7 mg (4 weeks each)	2.4 mg weekly
Rybelsus	Daily tablet	3 mg for 30 days	7 mg for 30 days	14 mg daily

The 0.25 mg starting dose of Ozempic and Wegovy is not meant to do much on its own; it exists to get the body used to the drug. Rybelsus is taken once each morning on an empty stomach with no more than 4 ounces of plain water, followed by at least 30 minutes before any food, drink, or other medication.

Ozempic and Wegovy are not interchangeable even though both are weekly semaglutide injections. They use different pens, have different maximum doses, and carry different FDA-approved indications. Wegovy also includes a 1.7 mg step that Ozempic does not use, which is one reason the two products should never be swapped or dose-matched by counting pen clicks.

Compounded Semaglutide Dosing in Units

Compounded semaglutide is not FDA-approved for human use, and regulators have moved to restrict compounded copies now that brand-name supply has caught up. When a compounded vial is used, the dose is drawn in units on a U-100 insulin syringe, and the number of units depends entirely on the concentration printed on that vial.

Confusion about semaglutide dosing in units is one of the most common sources of dosing mistakes in telehealth care. A 5mg semaglutide dosing chart built for one pharmacy's vial does not transfer to a vial with a different strength.

Dose (mg)	Volume at 5 mg/mL	Units on a U-100 syringe
0.25 mg	0.05 mL	5 units
0.5 mg	0.10 mL	10 units
1 mg	0.20 mL	20 units
1.7 mg	0.34 mL	34 units
2.4 mg	0.48 mL	48 units

The numbers change as soon as the concentration changes. On a 2.5 mg/mL vial, 0.25 mg is 10 units and 1 mg is 40 units, which is double the volume shown above. That is why a semaglutide 5mg/ml dosage chart only applies to a 5 mg/mL vial, and why a 10 mg/mL vial takes half the volume for the same milligram dose.

Never convert milligrams to units using a chart from a different pharmacy, a different vial, or a social media post. Use the concentration on your own label, and confirm the math with your prescriber or pharmacist before the first injection.

Oral vs. Injectable: Two Very Different Charts

Oral semaglutide follows a daily rhythm rather than a weekly one. Some people search for a wegovy pill dosing chart, but Wegovy is currently an injectable product; oral semaglutide is sold as Rybelsus. The two charts are not interchangeable, and there is no standard conversion from a weekly injection to a daily tablet.

Weekly injections are given on the same day each week, and the day can be shifted as long as at least two days pass between doses. Daily tablets are taken every morning, and skipping days quickly lowers the amount of drug in the body.

Missed Doses and Side Effects to Watch

For weekly injections, a missed dose can usually be taken if the next scheduled dose is more than two days away. If more than two days have passed, most labels advise skipping that dose and returning to the normal schedule. Never take two doses to catch up.

Common side effects include nausea, vomiting, diarrhea, constipation, stomach pain, and fatigue, and they are most likely right after a dose increase. Serious risks include pancreatitis, gallbladder problems, kidney injury from dehydration, and low blood sugar when semaglutide is combined with insulin or sulfonylureas.

Semaglutide carries a boxed warning about thyroid C-cell tumors and is not recommended for people with a personal or family history of medullary thyroid carcinoma or MEN 2 syndrome. Contact a healthcare professional promptly for severe or persistent abdominal pain, signs of dehydration, or vision changes.

What to Confirm Before You Follow Any Chart

• Your exact product name, strength, and formulation
• The concentration on your vial if the medication is compounded
• Your starting dose and how many weeks to stay at each step
• Which syringe size and unit markings your prescription calls for
• What to do about missed doses and which side effects require a call

Dosing charts are a reference, not a prescription. Dose changes should always come from the clinician who prescribed the medication, and questions about a specific number belong with that clinician or a pharmacist.

COMMON QUESTIONS

Frequently Asked Questions

What is the starting dose of semaglutide?

For the weekly injections, the starting dose is 0.25 mg once a week for four weeks. Oral semaglutide (Rybelsus) starts at 3 mg once daily for 30 days. The starting dose is chosen for tolerability, not for full treatment effect.

How many units is 0.5 mg of semaglutide?

It depends entirely on the concentration of the vial. In a 5 mg/mL vial, 0.5 mg equals 0.1 mL, which is 10 units on a U-100 insulin syringe. In a 2.5 mg/mL vial, the same 0.5 mg dose equals 20 units.

How long do you stay on each semaglutide dose?

Most titration steps last about four weeks for the weekly injections and about 30 days for oral semaglutide. A prescriber may hold a dose longer if side effects are bothersome. The maintenance dose is generally continued long term.