Standard schedules balance efficacy against tolerability. Most patients follow standard titration; some need to slow it. Skipping steps significantly increases discontinuation risk.
Semaglutide for weight (Wegovy)
| Week | Dose | Notes |
|---|---|---|
| 1–4 | 0.25 mg/wk | Initiation |
| 5–8 | 0.5 mg/wk | Modest weight effect begins |
| 9–12 | 1.0 mg/wk | Meaningful appetite reduction |
| 13–16 | 1.7 mg/wk | Approaching maintenance |
| 17+ | 2.4 mg/wk | Maintenance |
Tirzepatide for weight (Zepbound)
| Week | Dose | Notes |
|---|---|---|
| 1–4 | 2.5 mg/wk | Initiation |
| 5–8 | 5 mg/wk | First effective dose |
| 9–12 | 7.5 mg/wk | Continue if tolerated |
| 13–16 | 10 mg/wk | Common maintenance |
| 17+ | 12.5 → 15 mg/wk | Maximum (not all reach this) |
When to deviate
- Slow if a dose step produces intolerable symptoms — hold 4 more weeks, then re-attempt.
- Hold at sub-maximum if weight goals are met.
- Re-escalate after a break at the dose you were at, not the next step.
Flat-rate pricing connection
Dose-step pricing creates a financial incentive to stay at sub-optimal doses. Flat-rate programs (NexLife) remove that — titration becomes a clinical decision, not a budget decision.