Semaglutide Dosing Guide & Titration Schedule

The Titration Schedule

Semaglutide treatment follows a carefully designed dose-escalation schedule. Starting at a low dose and gradually increasing minimises gastrointestinal side effects while allowing the body to adjust. Your physician may modify this schedule based on your individual response and tolerance.

Phase	Weeks	Dose	Purpose
Initiation	Weeks 1-4	0.25 mg	Body acclimatisation (not a therapeutic dose)
Titration I	Weeks 5-8	0.5 mg	Initial therapeutic effect begins
Titration II	Weeks 9-12	1.0 mg	Moderate appetite suppression and weight loss
Titration III	Weeks 13-16	1.7 mg	Enhanced therapeutic response
Maintenance	Week 17+	2.4 mg	Full therapeutic dose for sustained weight loss

Note: Not all patients will reach the 2.4mg maintenance dose. If you experience persistent side effects at any dose level, your doctor may extend the time at the current dose before escalating, or maintain you at a lower dose that provides adequate weight loss with acceptable tolerability.

Weekly Injection Timing

Semaglutide is administered once weekly, on the same day each week, at any time of day, with or without food. Consistency in the day of administration helps maintain stable drug levels in the body.

Injection Sites

Abdomen: At least 5cm from the navel (most common site)
Upper thigh: Front of the thigh, midway between knee and hip
Upper arm: Back of the upper arm (may need assistance)

Rotate injection sites each week to prevent lipodystrophy (tissue changes).

Best Practices

Choose the same day each week (e.g., every Monday)
Set a weekly phone alarm as a reminder
Clean the injection site with alcohol before administering
Allow medication to reach room temperature before injecting

What If You Miss a Dose?

Missing an occasional dose is not unusual. The approach depends on how many days have passed since your scheduled injection.

01

Within 5 Days Late

Take the missed dose as soon as possible. Then continue your regular weekly schedule from that day forward.

02

More Than 5 Days Late

Skip the missed dose entirely. Take your next scheduled dose on the regular day. Do not take two doses to make up for a missed one.

03

Changing Your Dose Day

You can change your injection day as long as there are at least 2 days (48 hours) between doses. Simply inject on the new preferred day.

Important: Never take a double dose to compensate for a missed injection. This can increase the risk of side effects including severe nausea, vomiting, and hypoglycaemia. If you have missed multiple consecutive doses, contact your healthcare provider before resuming treatment.

Storage Requirements

Proper storage is critical for semaglutide to remain effective. This is especially important in Nigeria's tropical climate, where ambient temperatures regularly exceed the medication's stability thresholds.

Condition	Requirement
Before first use	Refrigerate at 2-8°C (36-46°F). Do not freeze.
After first use (pen)	Refrigerate or store below 30°C (86°F) for up to 56 days.
Light exposure	Keep away from direct sunlight. Store with pen cap on.
Frozen medication	Do NOT use if frozen. Dispose of properly and obtain a replacement.
Expired medication	Check expiry date on pen. Do not use after expiry date.

Nigeria-Specific Storage Tips

Power outages: Keep medication in the coldest part of your refrigerator (back, lower shelf). During NEPA/PHCN outages, keep the fridge door closed to maintain temperature.
Travel: Use an insulated cool bag with ice packs when transporting. Avoid leaving in a hot vehicle.
Generator power: If using a generator, ensure the fridge stabilises at 2-8°C before relying on it for medication storage.
Visual inspection: Before each injection, check that the solution is clear and colourless. Discard if cloudy, discoloured, or contains particles.

Maximising Your Results

While semaglutide is highly effective on its own, combining it with lifestyle modifications can significantly enhance outcomes. Research published in peer-reviewed journals demonstrates that patients who combine GLP-1 therapy with structured lifestyle changes achieve greater and more sustained weight loss.

Nutrition

Prioritise protein at each meal (30g+ per meal)
Eat slowly and stop when comfortably full
Stay hydrated -- aim for 2-3 litres of water daily
Reduce refined carbohydrates and sugary drinks
Eat smaller, more frequent meals if experiencing nausea

Exercise

150+ minutes of moderate aerobic activity per week
Include resistance training 2-3 times per week
Walking is an excellent starting point
Gradually increase intensity as fitness improves
Resistance training helps preserve lean muscle mass

When to Contact Your Doctor

Regular check-ins with your healthcare provider are essential throughout semaglutide treatment. Contact your doctor promptly if you experience any of the following:

-- Persistent nausea or vomiting that prevents adequate food/fluid intake
-- Severe abdominal pain that does not resolve
-- Signs of an allergic reaction (rash, swelling, difficulty breathing)
-- Symptoms of low blood sugar (shakiness, sweating, confusion, rapid heartbeat)
-- Changes in vision
-- A lump or swelling in the neck

References

Novo Nordisk. Wegovy (semaglutide) Prescribing Information. Revised 2024.
Wilding JPH, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021;384(11):989-1002. PMID: 33567185
Wadden TA, et al. Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy. JAMA. 2021;325(14):1403-1413. PMID: 33625476
Rubino D, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance. JAMA. 2021;325(14):1414-1425. PMID: 33755728
Davies M, et al. Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes. Lancet. 2021;397(10278):971-984. PMID: 33667417
Garvey WT, et al. Two-year effects of semaglutide in adults with overweight or obesity. Nat Med. 2022;28(10):2083-2091. PMID: 36216945
Nauck MA, Meier JJ. Management of endocrine disease: Are all GLP-1 agonists equal? Eur J Endocrinol. 2019;181(6):R211-R234. PMID: 31600725
Blundell J, et al. Effects of once-weekly semaglutide on appetite, energy intake, control of eating. Diabetes Obes Metab. 2017;19(9):1242-1251. PMID: 28266779
Kushner RF, et al. Semaglutide 2.4 mg for the Treatment of Obesity: Key Element Results. Obesity. 2020;28(6):1050-1061. PMID: 32441473
WHO. Temperature sensitivity of vaccines. World Health Organization, 2006.

Medical Review

This article was reviewed by the Semaglutide.ng team for clinical accuracy. Content is based on published prescribing information and peer-reviewed research. It does not constitute medical advice. Always consult a qualified healthcare provider for personalised dosing guidance.

Last reviewed: February 2026

Semaglutide Dosing Guide