GLP-1 dosing schedules: every step on every label
Every GLP-1 starts low and climbs on a schedule printed in its FDA label, not chosen by the program you buy from. Wegovy goes 0.25, 0.5, 1, 1.7 then 2.4 mg, four weeks a step. Zepbound starts at 2.5 mg and rises 2.5 mg at a time, never faster than every four weeks. Here is the full ladder for six drugs, what each label says when you miss a dose, and what a step up does to your bill.
- Four weeks a step. Every weekly injectable holds a dose for at least four weeks before the next increase. Saxenda is daily and moves every week instead.
- All six give the same reason. The ladder is there, in almost the same words each time, to reduce the risk of gastrointestinal adverse reactions.
- The starting dose is for initiation only. The Zepbound and Mounjaro labels say the 2.5 mg dose is for initiation and is not a maintenance or glycemic-control dose. Rybelsus says the same of its 3 mg tablet.
- Missed doses have hard windows. Four days on tirzepatide, five on Ozempic, and a two-day rule on Wegovy that is written backwards from the others.
- Every dosage sentence here is addressed to a prescriber. The labels are written to the person writing the prescription. Nothing on this page is medical advice.
The dose ladder for each drug
Six drugs, six schedules, all read off the current FDA prescribing information on DailyMed. Two of them print a week-by-week table. The other four write a rule instead: start here, wait at least four weeks, then step up by this much.
| Drug | Starting dose | How it climbs | Maintenance | Maximum |
|---|---|---|---|---|
| Wegovy injection semaglutide, weekly | 0.25 mg, weeks 1 to 4 | 0.5 mg weeks 5 to 8, 1 mg weeks 9 to 12, 1.7 mg weeks 13 to 16, maintenance from week 17 | 1.7 mg or 2.4 mg, with 2.4 mg marked recommended | 7.2 mg weekly |
| Wegovy tablets semaglutide, daily | 1.5 mg, days 1 to 30 | 4 mg days 31 to 60, 9 mg days 61 to 90, then maintenance | 25 mg daily | 25 mg daily |
| Zepbound tirzepatide, weekly | 2.5 mg for 4 weeks | To 5 mg after 4 weeks, then 2.5 mg increments after at least 4 weeks on the current dose | 5 mg, 10 mg or 15 mg. For sleep apnea, 10 mg or 15 mg | 15 mg weekly |
| Mounjaro tirzepatide, weekly | 2.5 mg | To 5 mg after 4 weeks, then 2.5 mg increments after at least 4 weeks, if more glycemic control is needed | The label names no maintenance list, only a maximum | 15 mg in adults, 10 mg in pediatric patients |
| Ozempic injection semaglutide, weekly | 0.25 mg for 4 weeks | To 0.5 mg, then 1 mg, then 2 mg, each after at least 4 weeks and only if more glycemic control is needed | 0.5 mg, 1 mg or 2 mg, based on glycemic control | 2 mg weekly |
| Saxenda liraglutide, daily | 0.6 mg for one week | 1.2 mg week 2, 1.8 mg week 3, 2.4 mg week 4, 3 mg from week 5 | 3 mg daily. The label says lower dosages are for titration only | 3 mg daily |
| Rybelsus semaglutide, daily tablet | 3 mg, days 1 to 30 | 7 mg days 31 to 60, then 14 mg from day 61 if more glycemic control is needed | 7 mg or 14 mg daily | 14 mg daily |
Two entries in that table are new this year. The Wegovy label was revised in June 2026 into a single document covering the injection and a tablet, and it carries a 7.2 mg weekly maximum for patients who tolerated 2.4 mg for at least four weeks and need further weight reduction. Rybelsus shares its label with a separate oral Ozempic tablet at different strengths, which the label says are not substitutable on a milligram-for-milligram basis.
Why the ladder exists at all
The labels do not leave this to interpretation. Wegovy, Zepbound, Mounjaro, Ozempic, Saxenda and Rybelsus all instruct the prescriber to follow the escalation "to reduce the risk of gastrointestinal adverse reactions." The ladder is there to manage nausea. The dose you end on is a separate question from how fast you get there.
What the clinical trials add is timing. SURMOUNT-1 put 2,539 adults on tirzepatide or placebo for 72 weeks, with a 20-week escalation period at the front, and reported that the most common adverse events were gastrointestinal, mostly mild to moderate, "occurring primarily during dose escalation." Treatment discontinuation from adverse events ran 4.3 percent at 5 mg, 7.1 percent at 10 mg and 6.2 percent at 15 mg, against 2.6 percent on placebo. That is not a clean dose-response curve. The 10 mg arm dropped out more than the 15 mg arm did.
STEP-1 describes semaglutide the same way with a different emphasis: nausea and diarrhea were the most common events, "typically transient and mild-to-moderate in severity," and they "subsided with time." STEP-1 ties the fade to time rather than explicitly to the escalation. Its discontinuation figure, 4.5 percent against 0.8 percent on placebo, counts gastrointestinal events only, so it does not sit in the same column as the SURMOUNT-1 numbers above, which count all adverse events.
The cleanest read on whether a bigger dose means more side effects arrived with the June 2026 Wegovy label, which added the 7.2 mg dose and printed the three-arm table behind it.
| Adverse reaction | Placebo | 2.4 mg weekly | 7.2 mg weekly |
|---|---|---|---|
| Nausea | 13% | 35% | 39% |
| Vomiting | 6% | 16% | 22% |
| Constipation | 8% | 19% | 20% |
| Hair loss | 1% | 3% | 6% |
| Stopped treatment because of an adverse reaction | 2% | 5% | 5% |
Nearly tripling the dose moved nausea four points, constipation one, vomiting six and hair loss three. It did not move the number of people who quit: 5 percent on both doses, against 2 percent on placebo. Every gap between a dose and placebo in that table is wider than the gap between the two doses.
What the label allows when a step goes badly
This is where the six labels stop agreeing, and the differences matter more than the ladders do.
| Drug | Does the label allow a pause? | What it says about a dose you cannot tolerate |
|---|---|---|
| Wegovy | Yes, explicitly | "If patients do not tolerate a dose during dosage escalation, consider delaying dosage escalation for 4 weeks." |
| Saxenda | Yes, explicitly | Consider delaying escalation "for approximately one additional week." If the patient cannot tolerate 3 mg, discontinue. |
| Zepbound | No pause sentence | Four weeks is written as a minimum, so time on a dose is open-ended. For intolerance the remedy given is different: "If patients do not tolerate a maintenance dosage, consider a lower maintenance dosage." |
| Mounjaro | No pause sentence | Escalation is conditional on needing more glycemic control, with a four-week floor. Nothing on tolerability-driven pauses. |
| Ozempic | No pause sentence | Same structure as Mounjaro. Steps past 0.5 mg happen only if more glycemic control is needed. |
| Rybelsus | Nothing in the dosing section | The label gives a fixed 30-day escalation and no tolerability provision. |
Two of the six labels let a prescriber slow down, and both belong to Novo Nordisk. The tirzepatide labels carry no pause sentence. What they carry is a minimum interval: at least four weeks between steps, with no upper limit on time at a dose. Zepbound names 5 mg, 10 mg and 15 mg as maintenance dosages, so stopping the climb at 5 mg or 10 mg is inside the label.
None of this is a decision to make on your own. Every sentence above is addressed to a prescriber, and holding, dropping back or stopping changes what the drug is doing to your blood sugar as well as your appetite. Take the label language to the appointment.
If you miss a dose
Every label answers this and the windows differ by drug. Ozempic gets five days, the two tirzepatide products get four, and Wegovy states its rule from the other direction.
| Drug | The label's missed-dose rule | Moving your dosing day |
|---|---|---|
| Wegovy injection | Take it if the next scheduled dose is more than 2 days away. Skip it if the next dose is less than 2 days away, and resume on the regular day. | The label says the time of day and the injection site can change without a dosage modification. |
| Zepbound | Within 4 days (96 hours), take it. Past 4 days, skip it and take the next dose on the regular day. | Allowed if at least 3 days (72 hours) separate the two doses. |
| Mounjaro | Identical to Zepbound: 4 days, 96 hours. | Allowed if at least 3 days (72 hours) separate the two doses. |
| Ozempic injection | Within 5 days, take it. Past 5 days, skip it. | Allowed if at least 2 days, more than 48 hours, separate the two doses. |
| Saxenda | Resume the once-daily regimen at the next scheduled dose. Do not take an extra dose or a bigger one to catch up. | Daily dosing, so the question does not arise. |
| Rybelsus and Wegovy tablets | Skip the missed dose and take the next one the following day. | Daily dosing. Both labels require an empty stomach in the morning with up to 4 ounces of water and nothing else. |
Coming back after a longer gap
Missing several weeks is common, whether because a pharmacy ran dry, a prior authorization lapsed or the money ran out. Two of the six labels tell the prescriber what to do about it and four say nothing at all.
- Wegovy. If two or more consecutive doses are missed, the label says to reinitiate dosage escalation at a lower dosage, again to reduce the risk of gastrointestinal adverse reactions. It does not name which lower dosage, so that part is the prescriber's judgment.
- Saxenda. The strictest of the six. More than three days since the last dose and the label says to restart at 0.6 mg daily and climb the whole table again. The patient Medication Guide puts it as a phone call: three days or more, ask your provider how to restart.
- Zepbound, Mounjaro, Ozempic and Rybelsus. Silent. We searched the full structured product labels for every form of reinitiate, re-escalate, restart and interruption and found nothing. A restart protocol for tirzepatide comes from clinical practice, because the label does not contain one.
What a step up does to your bill
This part needs price data rather than a label. The dose you land on changes what you pay on some programs and changes nothing on others.
5 of the 27 active programs on our chart publish a single price that does not move with your dose: Calibrate, Eden, Medvi, Mochi Health, Shed. Those are compounded or membership-plus-copay models, and the price you see at the starting dose is the price you keep at maintenance. The rest publish a band. Some of that band is the dose, some of it is which medication you picked, and the notes on each chart row say which.
The clearest dose-linked price on the market right now is the branded Wegovy tablet. NovoCare lists it at $149 a month at the 1.5 mg and 4 mg starter doses and $299 at the 25 mg maintenance dose. The medication bill doubles between day 1 and day 91, so a program advertising "from $149" is quoting a titration price. Our chart lists every program at its maintenance cost.
We publish no price per milligram. No program on the chart publishes the milligrams it dispenses per month, and the 5 flat-priced programs above charge the same amount at every dose, so a per-milligram figure would have to be built on a dose we assumed. The field is open in our data and renders nothing until a program publishes one.
Switching drugs, and the conversion that does not exist
No FDA label gives a dose conversion between semaglutide and tirzepatide. We checked all five injectable labels for it. The Wegovy label is the only one of the six with a switching section at all, and it covers switching between its own two forms: from the 2.4 mg injection, wait one week then start 25 mg tablets; from 25 mg tablets, start the 2.4 mg injection the next day; and for a patient who cannot tolerate the 25 mg tablet, consider the 1.7 mg injection instead.
Everything else is practice. A prescriber moving you from 1 mg semaglutide to tirzepatide is using clinical judgment, not a published equivalence table, which is one reason a switch usually restarts near the bottom of the new ladder. If you are switching programs rather than molecules, the continuity problem is different and how to switch without losing dose continuity covers it.
Compounded doses are not these doses
Compounded semaglutide and tirzepatide are not FDA-approved products and carry no FDA label, so not one of the schedules on this page belongs to them. Compounding pharmacies set their own ladders. Some dose in milligrams, some in units on an insulin syringe, and the same unit count can mean different milligrams at two pharmacies because the concentration differs. Microdose plans, which several telehealth programs now sell as a cheaper tier, sit below the lowest dose any of these labels describe.
Ask for your dose in milligrams and get it in writing, because units alone do not tell you what you are taking. Any adverse-event table for branded Wegovy or Zepbound is branded data, because the clinical trials that produced it ran on the branded product. Postmarket reports on compounded preparations are tracked in the FDA adverse event reporting system, where dosing errors show up as their own category.
Where the label says to inject
- Wegovy. Subcutaneously in the abdomen, thigh or upper arm, once weekly on the same day each week, at any time of day, with or without meals. Rotate the site with each dose.
- Zepbound and Mounjaro. Subcutaneously in the abdomen or thigh, or in the back of the upper arm if someone else is injecting. Once weekly, any time of day, with or without meals. Rotate the site with each dose.
- The tablets. Wegovy tablets and Rybelsus both have to be taken on an empty stomach in the morning, with no more than 4 ounces of water and no other liquid. Absorption is the reason the instruction is that specific.
Storage and travel
Refrigerate everything before first use. What differs, and what catches people out on a trip, is how long a pen may sit at room temperature before it has to be thrown away.
| Product | In the fridge | Out of the fridge |
|---|---|---|
| Wegovy single-dose pen or syringe | 36 to 46 F | Up to 86 F for 28 days before the cap comes off. Keep it in the original carton, away from light. |
| Wegovy FlexTouch single-patient-use pen | 36 to 46 F before first use | 59 to 86 F for 56 days after first use. |
| Zepbound single-dose pen or vial | 36 to 46 F | Up to 86 F for a total of 21 days, then discard it. |
| Zepbound multi-dose vial or KwikPen, unopened | 36 to 46 F until the expiration date | Up to 86 F for 30 days, then throw it away. |
| Zepbound multi-dose vial or KwikPen, in use | 36 to 46 F | Up to 86 F. Throw it away after 30 days at room temperature, 30 days from first use, or four weekly doses, whichever comes first, even with medicine left in it. |
Do not freeze any of them and do not use one that has been frozen. The 28-day room-temperature allowance is Wegovy's. Zepbound single-dose pens get 21 days.
What to do next
If the reason you are here is a symptom rather than a schedule, the side-effects pillar carries the triage list, the trial frequencies and a week-by-week table of what settles when. If it is the price of the dose you are heading for, the chart prices every program at its maintenance cost and the maintenance dose protocols guide covers what happens once you stop climbing.
Compare every program at its maintenance price → · See what is normal at your dose and week →
Frequently asked questions
How long do I stay on each dose?
Four weeks per step on every weekly injectable. Wegovy prints it as a table: 0.25 mg for weeks 1 through 4, 0.5 mg for weeks 5 through 8, 1 mg for weeks 9 through 12, 1.7 mg for weeks 13 through 16, then the maintenance dose from week 17. Zepbound, Mounjaro and Ozempic write it as a minimum instead of a table: at least four weeks on the current dose before the next increase. Saxenda is the exception. It is a daily injection and it steps up every week, 0.6 mg to 1.2 to 1.8 to 2.4 then 3 mg.
What is the maximum dose of each drug?
Wegovy injection now goes to 7.2 mg once weekly, added in the June 2026 label revision for patients who tolerated 2.4 mg for at least four weeks and need more weight reduction. Zepbound stops at 15 mg once weekly for every indication. Mounjaro stops at 15 mg in adults and 10 mg in pediatric patients. Ozempic stops at 2 mg once weekly. Saxenda is 3 mg daily. Rybelsus is 14 mg daily. Wegovy tablets are 25 mg daily.
What happens if I miss a dose?
The label answers this per drug and the windows differ. Zepbound and Mounjaro give you four days, 96 hours, to take the missed injection before you skip it. Ozempic gives you five days. Wegovy is written the other way around: take it if the next scheduled dose is more than two days away, skip it if the next dose is less than two days away. Saxenda and the oral products say skip and carry on the next day.
Can I stay on a lower dose instead of going up?
The labels leave room for it, differently in each case. Wegovy lists 1.7 mg and 2.4 mg as maintenance dosages, with 2.4 mg marked as recommended. Zepbound lists 5 mg, 10 mg and 15 mg as maintenance dosages and says to consider a lower maintenance dosage if a patient does not tolerate one. Ozempic lists 0.5 mg, 1 mg and 2 mg. Saxenda is the strict one: 3 mg daily is the dosage for adults and the label says lower dosages are for titration only. Your prescriber writes the dose.
Does a higher dose cost more?
On some programs, yes. On 5 of the 27 active programs on our chart, no: they publish one price that does not move with the dose. The branded oral route is the clearest case of a price that does move. NovoCare lists the Wegovy tablet at $149 a month at the 1.5 mg and 4 mg starter doses and $299 at the 25 mg maintenance dose, so the medication bill doubles on the way up.
Do compounded semaglutide and tirzepatide follow the same schedule?
No compounded preparation has an FDA label, so none of the schedules on this page belongs to one. Compounders set their own ladders, some in milligrams and some in units on a syringe, and the same number of units can mean different milligrams between two pharmacies. A compounded dose is what the prescription says it is. Ask for the milligrams in writing.
Can I change which day I inject?
Zepbound and Mounjaro allow it as long as at least three days, 72 hours, separate the two doses. Ozempic allows it as long as at least two days, more than 48 hours, separate them. The Wegovy label says the time of day and the injection site can both change without a dosage modification.
What week do the side effects settle?
SURMOUNT-1 reported that the gastrointestinal events were mostly mild to moderate and occurred primarily during dose escalation. STEP-1 described nausea and diarrhea as typically transient and subsiding with time. Neither paper published a week-by-week curve. Our side-effects page carries a week-band table for semaglutide and tirzepatide, labelled as derived rather than measured, which puts the fall at roughly two thirds between the first month and the second half of the year.
Sources
Evidence checked August 17, 2026
Each clinical claim above links to the document it came from, so you can read the source instead of trusting us. GLP Chart has no medical reviewer, and does not borrow a name for one. What that means.
- Wegovy escalation table, maintenance and 7.2 mg maximum, the delay-escalation sentence, missed doses, switching between the injection and the tablet, storageFDA prescribing information for Wegovy, injection and tablets (DailyMed, revised June 2026)
- Zepbound starting dose, the 2.5 mg increment rule, the maintenance list, the 15 mg maximum, missed doses, storageFDA prescribing information for Zepbound (DailyMed, revised April 2026)
- Ozempic escalation, maintenance doses, the 2 mg maximum and the five-day missed-dose windowFDA prescribing information for Ozempic injection (DailyMed)
- Mounjaro starting dose, the increment rule, adult and pediatric maximums and the four-day missed-dose windowFDA prescribing information for Mounjaro (DailyMed, revised April 2026)
- Saxenda weekly escalation table, the 3 mg target, the one-week delay allowance, the three-day restart rule and the 16-week response checkFDA prescribing information for Saxenda (DailyMed, revised February 2026)
- Rybelsus 30-day escalation, the 7 mg and 14 mg maintenance doses and the one-sentence missed-dose ruleFDA prescribing information for Rybelsus and Ozempic tablets (DailyMed)
- Gastrointestinal events concentrated in dose escalation, and discontinuation by tirzepatide dose armSURMOUNT-1: tirzepatide once weekly for the treatment of obesity (NEJM, 2022)
- Nausea and diarrhea described as transient and subsiding with time, and the gastrointestinal discontinuation rateSTEP-1: once-weekly semaglutide in adults with overweight or obesity (NEJM, 2021)
- Published cash price of the Wegovy tablet at the starter doses and at the maintenance doseNovoCare pricing for Wegovy, Novo Nordisk
- Where postmarket side-effect reports are tracked, as distinct from trial-measured ratesFDA Adverse Event Reporting System public dashboard
