Semaglutide dosage, as the trials and the label recorded it.

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This page describes the semaglutide dosage and titration (the gradual step-up in dose) exactly as they appear in the clinical trials and the approved labeling. It is written in the third person and it is not advice for any individual. Nobody should change how they take a medicine based on a reading room.

Why step the dose up at all? Because the gut side effects are worst when the body first meets the drug. Starting low and climbing slowly over weeks gives the stomach time to adapt, which is why every schedule below begins small. The drug is also unusually long-lived — its half-life is about a week — so it is dosed once weekly by injection, or once daily as a tablet built to survive the stomach. Every number here is tied to a study in the Semaglutide references.

Semaglutide injection: the weekly titration

For chronic weight management, the documented subcutaneous schedule climbs in steps: 0.25 mg once weekly for weeks 1-4, then 0.5 mg, then 1.0 mg, then 1.7 mg, reaching a 2.4 mg once-weekly maintenance dose. This is the regimen behind the STEP trials' weight results ^[1]. The escalation exists for tolerability: a pooled STEP analysis found the gastrointestinal side effects cluster around exactly these dose-increase weeks and are mostly mild-to-moderate and transient ^[14].

Semaglutide dose for type 2 diabetes

For type 2 diabetes, the documented subcutaneous semaglutide dose begins at 0.25 mg once weekly for initiation, then 0.5 mg, then 1.0 mg as a maintenance dose. SUSTAIN FORTE established that a higher 2.0 mg weekly dose lowered HbA1c more than 1.0 mg, supporting an approved higher diabetes dose ^[13]. These diabetes doses are generally lower than the 2.4 mg used for weight management — the same molecule, titrated to a different target.

Oral semaglutide: the daily tablet

Oral semaglutide is dosed differently. The documented schedule starts at 3 mg once daily for 30 days, then 7 mg, then 14 mg daily ^[11]. Higher oral doses (25 mg and 50 mg) were studied in the PIONEER PLUS and OASIS programs for diabetes and obesity respectively ^[11]. The tablet must be taken on an empty stomach, 30 minutes before the first food, drink, or other oral medicine, with no more than about 120 mL of water — a strict rule that exists because the tablet is co-formulated with an absorption enhancer (SNAC) and its oral bioavailability is only about 0.4-1% ^[24]. Administration errors can substantially reduce the absorbed dose ^[24].

Semaglutide dosage and the one-week half-life

The whole dosing rhythm follows from pharmacokinetics. Semaglutide's elimination half-life is approximately one week (commonly cited as ~165-168 hours), for both the injection and the tablet, with effectively complete clearance roughly five weeks after the last dose ^[9][23]. That long half-life is engineered: a fatty-acid side chain binds the peptide reversibly to albumin in the blood, slowing its removal, while a single amino-acid substitution makes it resist the enzyme that degrades natural GLP-1 ^[9]. The practical consequences are real — once-weekly dosing is possible, missed doses do not vanish immediately, and the multi-week washout underlies the pregnancy-planning guidance noted on the effects page ^[23].

Storage, as documented

The labeling describes specific storage handling. Commercial pre-filled pens are typically stored refrigerated at 2-8 C before first use and may then be kept at room temperature (at or below 30 C) for a defined in-use period, commonly cited as up to 56 days. Oral semaglutide is supplied as a tablet and is not reconstituted. These are labeling and stability facts, recorded here for completeness — not handling instructions for any individual.