Semaglutide Dosage Chart: Weekly Doses, Units, Compounded vs Brand

Key takeaways

• The label schedule is 0.25 mg once a week for 4 weeks, then 0.5 mg, 1 mg and 1.7 mg for 4 weeks each, then 2.4 mg as the maintenance dose (Wegovy). Ozempic stops at 2 mg.
• In a 2.5 mg/mL compounded vial those doses are 10, 20, 40, 68 and 96 units on a U-100 insulin syringe. In a 5 mg/mL vial they are 5, 10, 20, 34 and 48 units. Only the concentration on your label tells you which column applies.
• Brand pens deliver a fixed milligram dose and have no units to count. Every FDA-documented overdose of 5 to 20 times the intended dose happened with a vial and a syringe.
• Missed a Wegovy dose? Take it if the next one is more than 2 days away, skip it if not. Ozempic: take it within 5 days. Two or more missed doses in a row: restart the escalation at a lower dose.
• "Microdosing" charts are not based on any study. The 0.25 mg starting dose was never tested as a treatment dose; it is the tolerability ramp.

The short answer

Semaglutide for weight management starts at 0.25 mg once a week for four weeks, then rises every four weeks through 0.5 mg, 1 mg and 1.7 mg to a maintenance dose of 2.4 mg once a week, the dose that produced about 15% weight loss in the trials. For type 2 diabetes the Ozempic schedule follows the same first steps and tops out at 2 mg. In a compounded vial at the common 2.5 mg/mL concentration, those doses are 10, 20, 40, 68 and 96 units on an insulin syringe. The compounded semaglutide hub covers what the product is, what it costs and where the law stands; compounded semaglutide side effects covers what to expect at each step.

The label schedule: Wegovy and Ozempic

Both labels say the escalation exists to reduce gastrointestinal side effects and allow a step to be delayed four weeks if it is not tolerated. The weekly dose can be taken at any time of day, with or without food, in the abdomen, thigh or upper arm, and the injection day can be moved as long as two doses are at least 48 hours apart (Wegovy label) (Ozempic label). The 2.4 mg maintenance dose is the one the obesity trials used: in STEP 1, 1,961 adults without diabetes lost an average of 14.9% of their body weight over 68 weeks on this schedule, against 2.4% on placebo (Wilding 2021). No maintenance dose below 2.4 mg was tested for weight loss in people without diabetes, and nothing below 0.25 mg was tested in anyone, which matters for the microdosing section below.

The Wegovy tablet

The pill approved in December 2025 has its own ladder in days: 1.5 mg once daily for days 1 to 30, 4 mg for days 31 to 60, 9 mg for days 61 to 90, then 25 mg from day 91. It is taken in the morning on an empty stomach with up to 4 ounces of water, 30 minutes before food or other medicines. In its 64-week trial, 25 mg daily produced 13.6% weight loss against 2.2% on placebo (Wharton 2025). The sublingual drops and dissolving tablets some pharmacies sell are not equivalents and have no trial data.

Missed doses, from the labels

Never double a dose to catch up. Semaglutide has a half-life of about a week, so one missed week lowers the level only modestly; two doses on one day do the opposite.

Units per dose at the common compounded concentrations

Compounded semaglutide comes in a multi-dose vial labeled by concentration, and you draw a volume with a U-100 insulin syringe, on which 100 units = 1 mL. The conversion is:

units = dose in mg ÷ concentration in mg/mL × 100

Two practical notes:

1. Use the concentration on your label, not the one on a chart. Pharmacies also dispense 1 mg/mL, 2 mg/mL and 10 mg/mL vials and combination vials with B12, where the semaglutide concentration sets the volume and the B12 simply follows (Chun 2025). The same 20 units is 0.5 mg in one vial and 2 mg in another. The reconstitution calculator does the arithmetic for any concentration, and how many units are in 1 mL explains the syringe scale.
2. Match the syringe to the dose. A 0.3 mL syringe stops at 30 units and a 0.5 mL syringe at 50, so the 1.7 and 2.4 mg doses from a 2.5 mg/mL vial need a 1 mL syringe. The reverse error is worse: a 5-unit dose is a tiny mark on a 1 mL syringe, and FDA's 2024 alert described patients who drew 50 units instead (FDA dosing-error alert 2024).

Brand pen doses versus vial units

The brand products have no units at all, and that is their main safety feature.

Two errors follow from mixing the systems. A units chart applied to a pen is meaningless: the Ozempic 2 mg/3 mL pen holds 0.68 mg per mL, so "10 units" of it would be 0.068 mg. A milligram habit applied to a vial is worse: a prescriber in FDA's alert wrote 25 units when 5 units (0.25 mg from a 5 mg/mL vial) was intended, and the patient took five times the dose and developed severe vomiting; another wrote 20 units instead of 2, and three patients were sick (FDA dosing-error alert 2024). When you switch between a vial and a pen, carry the milligram dose across, never the units.

Microdosing, clinic protocols and what was actually studied

Three dosing patterns circulate online that are not on any label.

Microdosing means doses below 0.25 mg, or staying at 0.25 or 0.5 mg for months, usually to limit side effects, stretch a vial, or lose a few "vanity" pounds. No trial has tested a dose below 0.25 mg for weight loss, and the 0.25 mg step was never evaluated as a treatment dose; it exists to let the gut adapt. A 2026 brief report for nurse practitioners describes the practice as driven by tolerability and cost since the shortage ended, and lists the side effects, pen manipulation and vial dosing errors that come with it (Trainer 2026). Lower doses do produce less nausea, and some people lose weight on 0.5 or 1 mg; how much, nobody can say, because the data stop at the label.

Faster or slower clinic ladders. Some programs step up every two weeks, others hold each dose for eight. The label's four-week steps are the only schedule with trial data. Slowing down is within the label, which says to delay a step if it is not tolerated; speeding up is not. Splitting a weekly dose into two injections has no label support either, and doubles the chances for an arithmetic error.

The trials measured outcomes at the label doses, and everything outside that range is a guess. A poison-center series on compounded semaglutide found that the patients who overdosed had been thinking in milliliters and units rather than milligrams, with no pharmacist counseling (Lambson 2023); the safest dosing chart is the one your pharmacist walked you through with the vial in hand.

Bottom line

The semaglutide dosage chart is short: 0.25, 0.5, 1, 1.7 and 2.4 mg, four weeks per step, 2 mg maximum for Ozempic, 2.4 mg maintenance for Wegovy with a 7.2 mg option on the 2026 label. The units version only exists relative to a concentration: 10, 20, 40, 68 and 96 units at 2.5 mg/mL, half those at 5 mg/mL. Pens remove the arithmetic; vials put it on you. Print the chart that matches your label, check the syringe size, and treat any dose outside the label as untested rather than gentle.

Frequently asked questions

+−What is the starting dose for semaglutide?

0.25 mg once a week for the first four weeks, on both the Wegovy and Ozempic labels. The starting dose is there to let the gut adapt, not to cause weight loss; the label then moves to 0.5 mg. In a 2.5 mg/mL compounded vial, 0.25 mg is 0.1 mL, which is 10 units on an insulin syringe.

+−How many mg is 40 units of semaglutide?

It depends entirely on the concentration of the vial. 40 units is 0.4 mL. At 2.5 mg/mL that is 1 mg; at 5 mg/mL it is 2 mg; at 1 mg/mL it is 0.4 mg. Never convert units to milligrams without the concentration printed on your label.

+−What is the maximum dose of semaglutide?

For weight management, the Wegovy label's recommended maintenance dose is 2.4 mg once a week, and since 2026 it allows an increase to a maximum of 7.2 mg for adults who have tolerated 2.4 mg for at least four weeks and need more weight reduction. For type 2 diabetes, Ozempic's maximum is 2 mg once a week. The Wegovy tablet's maintenance dose is 25 mg once a day.

+−What should I do if I miss a dose?

On the Wegovy label: if the next scheduled dose is more than 2 days away, take the missed dose as soon as possible; if it is less than 2 days away, skip it and resume on the usual day. If you miss two or more doses in a row, the label says to restart the escalation at a lower dose. On the Ozempic label, take a missed dose within 5 days, otherwise skip it. Never take two doses to catch up.

+−What is microdosing semaglutide?

Taking doses below the label's 0.25 mg starting dose, or staying at 0.25 or 0.5 mg indefinitely, usually to limit side effects or stretch a vial. No trial has tested doses below 0.25 mg for weight loss, and the 0.25 mg step exists on the label as a tolerability ramp, not a treatment dose. Microdosing charts circulating online are not based on any study.

+−Can I switch from a compounded vial to a Wegovy pen at the same dose?

The milligram dose is the same; the measurement is not. A Wegovy pen delivers a fixed 0.25, 0.5, 1, 1.7 or 2.4 mg, so you simply pick the pen that matches your current step. Tell the prescriber the exact milligram dose you were taking, not the units, because 20 units can mean 0.5 mg or 1 mg depending on the vial.

+−Is the semaglutide B12 dosage chart different?

No. In a combination vial the semaglutide concentration drives the dose, and the cyanocobalamin simply comes along; one published series used 0.25 mg of semaglutide with 0.125 mg of B12 per dose, titrated to 2.4 mg with 0.24 mg. Use the semaglutide concentration on the label for the units calculation and ignore the B12 figure.

Sources

1. LabelNovo Nordisk. Wegovy (semaglutide) injection and tablets: prescribing information, revised June 2026 (DailyMed setid ee06186f-2aa3-4990-a760-757579d8f77b). (2026)
2. LabelNovo Nordisk. Ozempic (semaglutide) injection: prescribing information, revised June 2026 (DailyMed setid adec4fd2-6858-4c99-91d4-531f5f2a2d79). (2026)
3. StudyWilding JPH et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). N Engl J Med 2021;384:989-1002. (2021)
4. StudyWharton S et al. Oral semaglutide at a dose of 25 mg in adults with overweight or obesity (OASIS 4). N Engl J Med 2025;393:1119-30. (2025)
5. StudyChun E et al. Weight loss and body composition after compounded semaglutide treatment in a real world setting. Diabetes Obes Metab 2025;27:1554-7. (2025)
6. RegulatoryFDA. FDA alerts health care providers, compounders and patients of dosing errors associated with compounded injectable semaglutide products. July 26, 2024 (examples as summarized by Patient Care Online, July 30, 2024). (2024)
7. StudyLambson JE et al. Administration errors of compounded semaglutide reported to a poison control center: case series. J Am Pharm Assoc 2023;63:1643-5. (2023)
8. ReviewTrainer N. The 'microdosing' dilemma: balancing patient anecdotes with clinical safety amid GLP-1 compounding restrictions. J Am Assoc Nurse Pract 2026. (2026)