GLP-1 Dose Chart: The Semaglutide and Tirzepatide Schedules, Explained

the short answer

Both medications start at a low dose and step up about every four weeks so the stomach can adjust. Semaglutide for weight loss steps 0.25, 0.5, 1, 1.7, and 2.4 mg once weekly. Tirzepatide steps 2.5, 5, 7.5, 10, 12.5, and 15 mg once weekly. Your physician decides how fast you move and where you stop.

Those are the schedules printed in the FDA prescribing information for Wegovy® (semaglutide) and Zepbound® (tirzepatide), and compounded versions of the same molecules follow the same milligram steps. This article lays both schedules out, explains why the dose climbs, what a maintenance dose is, what to do about a missed dose, and how the schedule is set when you're prescribed through Pepvio.

The charts below are the published standard. Your own schedule is set by your physician, who can keep you on a step for longer than four weeks, and some people never take the top dose.

why the dose steps up

Nausea, loose stool, and constipation are the most common side effects of both medications, and in the trials most of them showed up in the weeks right after a dose increase and then faded.^[4][5] The reaction follows the change in dose more than the dose itself. A person who has been on 1 mg for a month usually feels fine at 1 mg; the same person started on 1 mg on day one would have a rough first week.

That is why the labels build in four weeks per step. Four weeks is about how long the stomach takes to settle at a new level, and it is also about how long a once-weekly injection takes to reach a steady level in the blood, so each increase comes after the body has adjusted to the previous one.^[2][3] What to expect month by month on a GLP-1 walks through the typical pattern.

Both labels also say what to do when a step does not go well: hold. The Wegovy® prescribing information tells physicians to consider delaying the next increase by four weeks if a dose is not tolerated, and the Zepbound® information says to increase only after at least four weeks on the current dose and to weigh how the patient is doing before each move.^[1][3] Staying on a step is part of the schedule, and your physician decides when you move.

the semaglutide schedule

This is the escalation printed in the Wegovy® prescribing information for weight reduction in adults.^[1] Every dose is a single injection under the skin, once a week, on the same day each week.

The label lists 2.4 mg as the recommended maintenance dose and 1.7 mg as the maintenance dose for people who do not tolerate 2.4 mg. Compounded semaglutide follows the same steps, and 2.4 mg is the usual endpoint.^[1]

Ozempic® is the same molecule labeled for type 2 diabetes, and its schedule stops lower: 0.25 mg for four weeks, then 0.5 mg, with 1 mg and 2 mg as the next steps if blood sugar needs them. The maximum on that label is 2 mg.^[2] Searches for the maximum dose of Ozempic® for weight loss run into this difference: the weight-loss schedule is the Wegovy® one above, and both are the same molecule.

the tirzepatide schedule

This is the escalation from the Zepbound® prescribing information.^[3] Same pattern: once a week, under the skin, same day each week.

The label frames this a little differently from semaglutide's. It fixes only the first move: 2.5 mg for four weeks, then 5 mg. After that, the dose may go up by 2.5 mg after at least four weeks on the current dose, and the physician weighs response and tolerability before each increase. The recommended maintenance doses are 5, 10, or 15 mg, and 15 mg is the maximum. The 2.5 mg starting dose is for the first month only and is not approved as a maintenance dose.^[3]

So the table above is the fastest version the label allows. A schedule that reaches 10 mg by week 13 and stays there is equally standard, and so is one that pauses at 7.5 mg for two months before moving.

what "maintenance dose" means

The maintenance dose is the step where you stop climbing and stay, because weight loss and side effects are in balance for you. Your physician sets it, and the labels give a range rather than a single number for a reason: higher doses produce more weight loss on average, and more side effects on average, and the right trade differs from person to person.

The tirzepatide trial shows the dose-response clearly. In SURMOUNT-1, adults with obesity were assigned to a fixed 5, 10, or 15 mg weekly dose for 72 weeks. Average weight loss was 15.0 percent at 5 mg, 19.5 percent at 10 mg, and 20.9 percent at 15 mg, against 3.1 percent on placebo. Most of the difference is between 5 and 10 mg; the step from 10 to 15 mg added about 1.4 points on average. Discontinuation for side effects was lowest in the 5 mg group.^[5]

For semaglutide, STEP 1 tested the 2.4 mg maintenance dose: average weight loss of 14.9 percent over 68 weeks against 2.4 percent on placebo, with nausea and diarrhea the most common side effects, typically mild to moderate and fading with time.^[4]

The lowest maintenance dose of tirzepatide is a full-strength treatment. Reaching the top dose is a decision about whether more is needed, made after you have been on a lower dose long enough to judge. If you settle at a dose and want to move again later, in either direction, that is a conversation with your physician.

what happens if you miss a dose

The labels give a rule for a single missed dose, and the rule differs between the two molecules.

Semaglutide (Wegovy® label). If the next scheduled dose is more than 2 days away, take the missed dose as soon as you remember. If the next dose is less than 2 days away, skip it and take the next dose on the usual day. If you miss two or more weeks in a row, contact your physician before restarting; the label calls for restarting the escalation at a lower dose to reduce stomach side effects.^[1] The Ozempic® label states the same idea as a window: take the missed dose within 5 days, and skip it after that.^[2]

Tirzepatide (Zepbound® label). Take the missed dose within 4 days (96 hours). After 4 days, skip it and take the next dose on the usual day.^[3]

For both. A missed dose is either taken inside the window or skipped; neither label has you take two doses to catch up. Go back to your usual weekly day afterward. You can change your injection day if you need to, as long as the two doses are at least 2 days apart for semaglutide and at least 3 days apart for tirzepatide.^[1][3] Your physician's instructions and the pharmacy label take precedence over anything here.

how compounded dosing works

Compounded semaglutide and compounded tirzepatide follow the same milligram schedule as the brand-name labels. The molecule is the same, so the escalation is the same. What differs is the container. Brand products come in single-dose pens, one strength per pen. A compounded prescription is usually a vial of solution, and you draw each dose with an insulin syringe up to the line your instructions name, in units.

Units are the marks printed on the syringe, and the number of units for a given milligram dose depends on the concentration of your vial. Your physician sets the dose in milligrams; the pharmacy label converts it to units for your vial. You follow the number on the pharmacy label and your physician's instructions, over any chart in an article, including this one. When the dose steps up, the instruction changes to a higher line on the same syringe from the same vial.

Some providers price by dose, so the monthly cost rises at each step. Pepvio's Price Lock means the price stays the same at every dose level, each increase is at no extra cost, and there is no increase in the second year. The details are on the GLP-1 page. For what "compounded" means and how it differs from a generic, the compounded vs. generic guide covers it.

how Pepvio sets your schedule

The online visit takes about 2 minutes: health history, current medications, weight, and goals. A licensed U.S. physician reviews it and, if a GLP-1 medication is appropriate for you, writes the prescription with your starting dose and the plan for each step. You are charged only after the physician approves. The medication is compounded by a licensed U.S. pharmacy with your name on the label and shipped to you.

Each dose increase is the physician's call, made on your check-ins. If a step is harder than you expected, you message your care team, and the physician can hold you at the current dose for another few weeks, or bring you down a step, before moving on. If you are doing well at a middle dose, staying there is a normal outcome, and the price is the same either way.

Tirzepatide for weight loss covers how that molecule works and what the head-to-head research shows against semaglutide. The GLP-1 page has the current details for both. If you want to know whether either fits you, the visit below is where that starts.

---