Wegovy doses: The complete UK guide to the titration schedule, pen counts, and dose conversion

DoktorABC editorial team

Accurate, up-to-date health information written by our editorial team and reviewed by UK-registered prescribers.

What are the Wegovy doses?

Wegovy is available in six dose strengths: 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, 2.4 mg, and 7.2 mg. All patients begin at 0.25 mg per week and increase gradually every four weeks. The standard maintenance dose is 2.4 mg per week, reached after approximately 16 weeks of treatment. A higher maintenance dose of 7.2 mg was approved by the MHRA on 6 January 2026 for patients with a BMI of 30 or above who have reached and tolerated the 2.4 mg dose.

The titration schedule exists for a clinical reason. Introducing semaglutide at full dose immediately causes pronounced gastrointestinal side effects in most people. Stepping up gradually allows the digestive system to adapt and significantly reduces the likelihood of nausea, vomiting, and diarrhoea. The schedule is not optional, and doses should not be skipped or accelerated without clinical guidance.

Wegovy dose chart: Full titration schedule

The table below shows the standard Wegovy dose escalation schedule as per the MHRA-licensed dosing protocol, referenced in the Wegovy Summary of Product Characteristics (medicines.org.uk). 

Each pen is colour-coded to help distinguish dose strengths clearly. Always check the label and colour before injecting.

How many doses are in a Wegovy pen?

Each Wegovy pen contains four doses. Because Wegovy is injected once weekly, one pen lasts four weeks. This means each pen aligns with one step on the titration schedule, making it straightforward to track your progress.

Source: Wegovy European Public Assessment Report, European Medicines Agency (EMA)

How does the 7.2 mg dose work?

The 7.2 mg dose is not currently available as a single pen in all formats. Until a dedicated 7.2 mg pen is widely distributed, the dose is administered as three consecutive injections of the 2.4 mg pen on the same day, once per week. This means patients on the 7.2 mg dose require three 2.4 mg pens per month rather than one. A dedicated single-dose 7.2 mg pen was approved by the MHRA on 14 April 2026 and is beginning to become available through UK private providers. Confirm current availability with your provider.

How do you count remaining doses in a Wegovy pen?

Each pen is pre-filled and designed for single-dose delivery. There is no dose counter on the Wegovy FlexTouch pen. The most reliable way to track remaining doses is to record each injection date in a diary or app, noting the day you started each new pen. Since each pen delivers exactly four doses at weekly intervals, the maths is straightforward: if you used your first dose on a Monday, your four doses fall on weeks one, two, three, and four. On week five, you start your next pen.

At what dose does Wegovy start working?

Wegovy begins acting from the first dose. Many people notice subtle changes in appetite within 24 to 48 hours of their first 0.25 mg injection. However, the 0.25 mg starting dose is sub-therapeutic, meaning it is not intended to produce significant weight loss. Its purpose is to allow the body to adjust to semaglutide and minimise side effects.

What happens at each dose stage?

• 0.25 mg (weeks 1–4): Mild appetite changes for some patients. This stage is about tolerability, not results.
• 0.5 mg (weeks 5–8): Appetite suppression typically becomes more consistent. Some patients begin losing weight at this stage.
• 1 mg (weeks 9–12): Most people experience meaningful appetite reduction and begin to see early weight loss results.
• 1.7 mg (weeks 13–16): Appetite suppression strengthens further with each dose increase.
• 2.4 mg (week 17 onwards): The full therapeutic maintenance dose. The most significant weight loss phase typically runs from months three to twelve.

In SURMOUNT-1 trial data, average weight loss at one month was approximately 4% of starting body weight, rising to around 9% by month three, and reaching approximately 14.9% by 68 weeks on the 2.4 mg dose (STEP 1 trial, New England Journal of Medicine, 2021).

Can you start Wegovy at 1.7 mg?

No, not as a standard starting point. The licensed and clinically recommended starting dose for Wegovy is 0.25 mg per week. This is consistent across the MHRA-approved dosing schedule and applies to all new patients, regardless of body weight or prior experience with other medications.

Starting at 1.7 mg without completing the titration steps would significantly increase the risk of severe gastrointestinal side effects, including nausea, vomiting, and diarrhoea, because the body has not had the opportunity to adapt to semaglutide.

There is one partial exception: patients switching from another GLP-1 medicine, such as Mounjaro, may in some cases be clinically assessed to start Wegovy at a higher dose than 0.25 mg, based on their treatment history and tolerability profile. This decision must always be made by a registered prescriber on an individual basis. Requesting a specific starting dose does not guarantee it will be prescribed.

Can you stay on a low dose of Wegovy long-term?

Yes. There is no clinical requirement to titrate to the maximum dose. The prescribing guidance in the Wegovy Summary of Product Characteristics states clearly that doses can be maintained at lower strengths if tolerated and if clinical outcomes are satisfactory.

Staying on a lower dose may be appropriate in the following situations:

• You are achieving your weight loss goals at a dose below 2.4 mg and side effects are well managed
• You experience intolerable side effects at higher doses that do not resolve with time
• Your prescriber determines that the clinical benefit at your current dose outweighs the potential gains from escalation
• You are managing cost considerations in consultation with your prescriber

Clinical trial data confirms that meaningful weight loss occurs at all doses above 0.25 mg, with results strengthening at higher doses. In STEP 1 trial data, patients on 1 mg doses still achieved meaningful weight reduction, though not as substantial as those who reached 2.4 mg. Staying at a lower dose may therefore mean somewhat slower or more modest progress, but it is not a clinically incorrect approach when done in consultation with your prescriber.

Mounjaro to Wegovy dose conversion guide

Switching from Mounjaro to Wegovy is something many UK patients are considering following Eli Lilly's September 2025 price increase. Because the two medicines contain different active ingredients (tirzepatide and semaglutide respectively) and work through different mechanisms, there is no direct milligram-to-milligram equivalence. The conversion is a clinical approximation based on tolerability and treatment history, not a mathematical formula.

The table below reflects the conversion approach used by a number of UK regulated prescribers as a general guide. Your prescriber may advise differently based on your individual circumstances.

This table is a general clinical guide only. Your prescriber will assess your individual history and determine the appropriate starting dose. Requesting a specific dose does not guarantee it will be prescribed.

How long should you wait between doses when switching?

Most UK prescribers recommend a washout period of seven days between your last Mounjaro injection and your first Wegovy dose. This allows overlapping side effects to subside and gives the body time to adjust before introducing semaglutide. If you have experienced significant side effects on Mounjaro, your prescriber may recommend a longer gap or a more conservative starting dose.

Wegovy vs Mounjaro doses: How do they compare?

Although both treatments follow a four-weekly titration schedule, the dose numbers, active ingredients, and mechanisms differ significantly.

The higher numerical dose figures for Mounjaro do not mean it is a stronger medicine in the way those numbers might suggest. The dose figures reflect differences in molecular structure and potency between the two active ingredients. The clinical outcomes, rather than the dose numbers, are the meaningful basis for comparison.

Do you lose weight on the maintenance dose of Wegovy?

Yes. The maintenance dose of 2.4 mg is where the most sustained and significant weight loss occurs. Clinical trial data from the STEP 1 trial (New England Journal of Medicine, 2021) showed that average weight loss continued to accumulate throughout the 68-week trial period, with the largest gains in body weight reduction occurring between months three and twelve at the 2.4 mg maintenance dose.

Reaching the maintenance dose does not mean weight loss stops. It means the medication is now at a stable, therapeutically effective level in the bloodstream, and the body continues to respond. Weight loss typically slows after month six as the body approaches a new set point, but this is physiologically normal and does not indicate the medicine has stopped working.

Do you lose more weight on a higher Wegovy dose?

Yes, the clinical evidence shows that higher doses are associated with greater average weight loss.

In the STEP 1 trial, participants on the 2.4 mg dose lost an average of 14.9% of their body weight over 68 weeks. The STEP UP trial, which supported the January 2026 MHRA approval of the 7.2 mg dose, showed average weight loss of 20.7% over 72 weeks, compared to 17.5% on the standard 2.4 mg dose in the same trial.

This means the 7.2 mg dose produces meaningfully greater weight loss than the 2.4 mg dose for eligible patients. However, the 7.2 mg dose is not suitable for everyone. It is indicated only for patients who have been established on the 2.4 mg dose, tolerate it well, and have not yet reached their treatment goals or have plateaued. It also carries a higher rate of a side effect called dysaesthesia (altered skin sensation, including burning or tingling), reported in approximately 23% of participants in the STEP UP trial.

The decision to escalate to 7.2 mg should always be made with your prescriber rather than on your own initiative.

What should you do if you miss a Wegovy dose?

Missing an occasional dose is manageable if you follow the correct protocol. The guidance in the Wegovy patient information leaflet (medicines.org.uk) is as follows:

If fewer than five days have passed since your missed dose: Inject the missed dose as soon as you remember, then resume your normal weekly schedule.

If five or more days have passed since your missed dose: Skip the missed dose entirely and take your next scheduled dose on the usual day. Do not double up doses.

If you miss doses for two or more consecutive weeks: Contact your prescriber before resuming treatment. They may advise restarting at a lower dose to avoid side effects, as missing multiple doses can reduce your body's current tolerance to semaglutide.

Never inject two doses at the same time to compensate for a missed one. This significantly increases the risk of nausea, vomiting, and other gastrointestinal side effects.

Final thoughts

The Wegovy dosing schedule is structured, predictable, and designed with tolerability in mind. Understanding where you are in the titration process, what each pen contains, and what to expect at each stage takes much of the uncertainty out of treatment. The most important principles are straightforward: follow the schedule, inject on the same day each week, do not skip dose stages without clinical guidance, and speak to your prescriber if side effects are making escalation difficult.

Whether you are starting treatment for the first time or switching from another GLP-1 medicine, the right dose for you is the one determined by your prescriber based on your individual health profile and progress, not the highest available option.

FAQ

The DoktorABC medical advisory board

Dr. Roland Ruiken

Medical advisor, Norway

Dr. Viktor Simunovic

Medical advisor, Croatia

To the medical advisory board