Semaglutide Dose Chart: The Week-by-Week Titration Schedule Explained
Semaglutide only works when the dose climbs correctly. Too fast and side effects force you to quit; too slow and you wait months for results. Here is the standard week-by-week schedule doctors use, what each dose does, and when to move up.
ALTRcare Medical Team
Clinical Editorial
Every semaglutide journey follows the same shape: start tiny, climb slowly, settle at the lowest dose that works. The schedule below is the standard weight-management titration used worldwide. Your doctor may deliberately move slower, and that is normal, especially for Indian patients on vegetarian diets where nausea management and protein intake need extra attention. What nobody should do is move faster.
The standard schedule
- 1Weeks 1 to 4: 0.25 mg once weekly. Adjustment dose only. Its job is to let your gut adapt, not to cause weight loss. Some appetite reduction is a bonus, not the goal.
- 2Weeks 5 to 8: 0.5 mg once weekly. The first dose with meaningful clinical effect. Many patients begin losing 0.5 to 1 kg a week here.
- 3Weeks 9 to 12: 1.0 mg once weekly. A common long-term maintenance dose. If weight loss is steady and side effects are quiet, many doctors hold here for months.
- 4Week 13 onward, if needed: 1.7 mg, then 2.4 mg once weekly. The full weight-management doses from the STEP trials, used when loss plateaus at lower doses and tolerance allows.
The four-week rule
Never increase your dose before four weeks at the current one, and never increase while side effects are still active. Escalating into nausea is the number one reason people abandon treatment. A plateau is a conversation with your doctor, not a reason to self-escalate.
What each dose actually feels like
At 0.25 mg, most people notice they get full slightly earlier at dinner. At 0.5 mg, the food noise quiets: less snacking, smaller rotis without trying. At 1.0 mg and above, appetite suppression is unmistakable, and the risk flips: now the challenge is eating enough protein so the weight you lose is fat, not muscle. Aim for 1.2 to 1.6 g of protein per kg of target body weight daily, and see our vegetarian protein guide if dal and paneer are doing the heavy lifting.
When your doctor will NOT increase the dose
- You are still losing 0.5 kg or more per week at the current dose. Effective dose found; higher only adds side effects and cost.
- Nausea, vomiting or constipation from the last step has not fully settled.
- You have lost weight very rapidly (more than 1.5 kg a week sustained), where the priority becomes protein and muscle preservation, not acceleration.
- An illness, surgery or major fasting period is coming up, when doses are sometimes held or delayed.
Missed a dose?
If it is within 5 days of your usual day, take it as soon as you remember and continue your weekly schedule. If more than 5 days have passed, skip it and take the next one on the usual day. Never double up. If you have missed two or more weeks, tell your doctor: after long gaps, restarting at a lower dose is often safer than resuming where you left off.
Get a titration plan built for you
ALTRcare doctors set your schedule, adjust it based on your weekly check-ins on WhatsApp, and manage side effects before they derail you. Start with the free assessment.
Frequently asked questions
How long does semaglutide titration take?
Reaching 1.0 mg takes a minimum of 8 weeks. Reaching the full 2.4 mg weight-management dose takes at least 16 weeks. Many patients settle at 0.5 or 1.0 mg long-term and never need the top dose.
Can I stay on 0.5 mg semaglutide forever?
If you are losing steadily and feel well, yes. The correct maintenance dose is the lowest one that works for you, not the highest one on the chart.
What happens if I increase my semaglutide dose too fast?
Severe nausea, vomiting and dehydration become far more likely, and they are the main reason people quit treatment. Escalating faster than 4-week intervals gains nothing clinically.
What if I miss a semaglutide dose?
Within 5 days, take it when you remember. Beyond 5 days, skip and resume the normal schedule. After a gap of 2 or more weeks, ask your doctor whether to restart at a lower dose.
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This article is for general educational purposes and is not a substitute for personalised medical advice. GLP-1 medications are prescription-only and not suitable for everyone. Always consult a qualified doctor before starting, changing, or stopping any treatment.
