GLP-1 Dosage Guide: Semaglutide & Tirzepatide Dose Schedules Explained
Complete GLP-1 dosage guide with titration schedules, target doses, missed dose rules, and tips for maximum results.
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Why GLP-1 dosing matters
Getting the dose right is one of the most important factors in your GLP-1 journey. Too low, and you may not see meaningful weight loss. Too high too fast, and side effects like nausea and vomiting can become unmanageable. The key is titration: starting low and increasing gradually to let your body adjust.
Semaglutide (Wegovy) dosing schedule
Wegovy is the FDA-approved brand of semaglutide for weight loss. The standard titration schedule is:
| Weeks | Dose | Purpose |
|---|---|---|
| 1 to 4 | 0.25 mg weekly | Initial titration |
| 5 to 8 | 0.5 mg weekly | Step 2 titration |
| 9 to 12 | 1.0 mg weekly | Step 3 titration |
| 13 to 16 | 1.7 mg weekly | Step 4 titration |
| 17+ | 2.4 mg weekly | Target maintenance dose |
Some providers may adjust this schedule based on your tolerance. If side effects are severe at a given dose, your provider may keep you at a lower dose longer before increasing.
Tirzepatide (Zepbound) dosing schedule
Zepbound is the FDA-approved brand of tirzepatide for weight loss. The titration schedule is:
| Weeks | Dose | Purpose |
|---|---|---|
| 1 to 4 | 2.5 mg weekly | Initial titration |
| 5 to 8 | 5 mg weekly | Step 2 titration |
| 9 to 12 | 7.5 mg weekly | Step 3 titration |
| 13 to 16 | 10 mg weekly | Step 4 titration |
| 17 to 20 | 12.5 mg weekly | Step 5 titration |
| 21+ | 15 mg weekly | Target maintenance dose |
Compounded semaglutide and tirzepatide dosing
Compounded versions of GLP-1 medications are widely available through telehealth providers. The dosing schedules typically mirror the brand-name titration, but the concentration and delivery may differ. Always follow the specific instructions provided by your telehealth provider and pharmacy.
What to do if you miss a dose
- Semaglutide: If you miss a dose and it has been less than 2 days (48 hours), take it as soon as you remember. If more than 2 days have passed, skip it and take your next dose on the regular day.
- Tirzepatide: If you miss a dose and it has been less than 4 days (96 hours), take it as soon as you remember. If more than 4 days have passed, skip it and resume on your regular schedule.
- Never take two doses at once to make up for a missed one.
- If you miss doses for more than 2 weeks, contact your provider. You may need to restart at a lower dose.
How dosing affects weight loss
Clinical trials consistently show that higher doses produce more weight loss, but the relationship is not linear. The biggest jumps in weight loss typically occur when moving from the starting dose to the first therapeutic dose. After that, each increase produces diminishing returns but may still improve results.
- Semaglutide 0.25 mg: Minimal weight loss (titration phase)
- Semaglutide 1.0 mg: ~8 to 10% body weight loss
- Semaglutide 2.4 mg: ~15% body weight loss (target dose)
- Tirzepatide 5 mg: ~10 to 12% body weight loss
- Tirzepatide 10 mg: ~15 to 18% body weight loss
- Tirzepatide 15 mg: ~20% body weight loss (target dose)
Tips for managing dose increases
- Expect some nausea or digestive changes after each increase; this is normal
- Eat smaller, blander meals for the first few days after a dose increase
- Stay hydrated and avoid alcohol
- If side effects are severe or do not improve after a week, contact your provider
- Do not skip doses to avoid side effects; this disrupts the titration process
- Track your side effects and weight in a journal or app to share with your provider
Frequently asked questions
What is the starting dose for semaglutide?
The standard starting dose for semaglutide (Wegovy) is 0.25 mg once weekly for 4 weeks. This is a titration dose, not a therapeutic dose, and is designed to minimize side effects.
What is the maximum dose of tirzepatide for weight loss?
The maximum approved dose of tirzepatide (Zepbound) for weight loss is 15 mg once weekly. Most patients reach this dose after about 20 weeks of titration.
What happens if I miss a GLP-1 dose?
If you miss a dose and it has been less than 5 days (tirzepatide) or less than 2 days (semaglutide), take it as soon as you remember. If more time has passed, skip it and take your next dose on the regular schedule. Do not double up.
Can I increase my GLP-1 dose faster to lose weight quicker?
No. Rapid dose escalation increases the risk of nausea, vomiting, and other side effects. Follow your provider's titration schedule. Faster titration does not necessarily produce faster weight loss.
Conclusion
GLP-1 dosing is a carefully designed process. Start low, titrate gradually, and communicate with your provider about side effects and progress. The target doses of 2.4 mg for semaglutide and 15 mg for tirzepatide produce the best weight loss results in clinical trials, but getting there safely is the priority. Follow your schedule, manage side effects proactively, and stay consistent for the best outcomes.
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