Semaglutide Dosage Chart: mg, mL, & Units for Safe Weight Loss

Semaglutide Dosing: Your Quick Guide to Mg, mL, and Unit Conversions

Navigating a semaglutide prescription can be complex, especially when attempting to reconcile the prescribed dose in milligrams ($\text{mg}$) with the volume in milliliters ($\text{mL}$) or the units on a syringe. This introductory section establishes the standard therapeutic protocol and underscores the essential need for professional medical oversight.

Direct Answer: The Standard Semaglutide Titration Schedule (Weeks 1-17+)

The fundamental principle of semaglutide therapy is to start low and go slow. The typical starting dose is 0.25 mg administered once weekly. This initial dose is primarily intended for acclimation, allowing the body to adjust and significantly reduce the likelihood and severity of gastrointestinal side effects. To maximize efficacy while prioritizing patient tolerability, the dose is gradually increased over a minimum period of 17 weeks. This titration schedule progresses through 0.5 mg, 1.0 mg, and 1.7 mg before reaching the common maintenance dose of 2.4 mg weekly. This slow, four-month-plus escalation is a clinical standard designed to optimize long-term adherence to the medication.

The Critical Role of Expertise and Authority in Dosing

While the $\text{mg}$ dosage follows a fixed clinical protocol, translating that to the physical volume you inject ($\text{mL}$ or Units) is a critical step where mistakes can easily occur, particularly with compounded medications. For instance, a compounded semaglutide solution’s concentration, such as $5\text{ mg}/\text{mL}$ or $2\text{ mg}/\text{mL}$, directly dictates the $\text{mL}$ or syringe units needed to deliver the correct $\text{mg}$ dose.

This article provides FDA-aligned, evidence-based dosing steps and a comprehensive conversion guide for educational purposes. However, a responsible and credible approach to medication requires a clear statement of experience and authority: all dosage and administration decisions must be confirmed by a licensed healthcare provider. A board-certified physician or obesity medicine specialist has the prescriptive authority, clinical expertise, and patient-specific data (e.g., medical history, side effect profile) required to ensure the dose is not only effective but, more importantly, safe. Never attempt to self-adjust your dose or rely on non-medical sources for final dosage instructions.

The Master Conversion Table: Semaglutide Dose in mg, mL, and Syringe Units

Understanding your prescribed semaglutide dose requires navigating three distinct units of measurement: milligrams (mg), milliliters (mL), and syringe Units. For patients using compounded semaglutide solutions, the latter two measurements are crucial for accurate self-administration. Making a mistake in these conversions can lead to under-dosing, which reduces effectiveness, or dangerous over-dosing. To maintain safety and efficacy, you must rely on the precise concentration provided by your compounding pharmacy.

Understanding Your Semaglutide Concentration (The $\text{mg}/\text{mL}$ Variable)

The conversion from a dose in milligrams ($\text{mg}$) to the volume you must inject in milliliters ($\text{mL}$) is not universal. It is entirely dependent on the strength of the specific liquid medication you received from the pharmacy, which is listed as the concentration in milligrams per milliliter ($\text{mg}/\text{mL}$) on your vial.

The fundamental calculation that determines the correct volume to draw up is:

$$\text{Volume } (\text{mL}) = \frac{\text{Dose } (\text{mg})}{\text{Concentration } (\text{mg}/\text{mL})}$$

For example, if your vial has a common compounded concentration of $5\text{ mg}/\text{mL}$ (meaning every $1\text{ mL}$ of fluid contains $5\text{ mg}$ of the active ingredient), and your target dose is $1.0\text{ mg}$, the calculation is: $1.0\text{ mg} \div 5\text{ mg}/\text{mL} = 0.2\text{ mL}$.

Step-by-Step Guide: How to Read a Unit-Based Syringe

Most patients administering compounded semaglutide use a small insulin syringe for the injection. These syringes are typically marked in “Units,” not directly in $\text{mL}$. It is critical to understand that the “Units” on an insulin syringe are a measure of volume, not drug amount. For a standard calibration, the conversion is always fixed: $1\text{ mL} = 100 \text{ Units}$. Therefore, $0.1\text{ mL} = 10\text{ Units}$, and $0.05\text{ mL} = 5\text{ Units}$. This fixed ratio prevents a major dosing error when calculating the final volume.

The table below is generated using the common compounded concentration of $5\text{ mg}/\text{mL}$ and serves as a highly visible, authoritative guide to the typical titration schedule. Always cross-reference this conversion with the specific label on your prescription vial and your prescribing physician.

Semaglutide Dose (Weekly $\text{mg}$)	Volume to Inject ($\text{mL}$)	Syringe Units (For $\text{5 mg}/\text{mL}$ Concentration)
$\text{0.25 mg}$ (Weeks 1-4)	$\text{0.05 mL}$	$\text{5 Units}$
$\text{0.5 mg}$ (Weeks 5-8)	$\text{0.10 mL}$	$\text{10 Units}$
$\text{1.0 mg}$ (Weeks 9-12)	$\text{0.20 mL}$	$\text{20 Units}$
$\text{1.7 mg}$ (Weeks 13-16)	$\text{0.34 mL}$	$\text{34 Units}$
$\text{2.4 mg}$ (Weeks 17+)	$\text{0.48 mL}$	$\text{48 Units}$

Expert Note: “The single most common mistake in self-administering compounded solutions is miscalculating the volume based on the vial’s concentration. Before any injection, you must verify the concentration ($\text{mg}/\text{mL}$) on the label and perform the $\text{mg}$ to $\text{mL}$ calculation. This is the bedrock of safe and effective medication use.” – Statement from a Pharmacist specializing in injectable compounding.

For patients whose compounded concentration is $2.5\text{ mg}/\text{mL}$, the $\text{mL}$ and Unit values in the chart above would be exactly double. For instance, a $1.0\text{ mg}$ dose would require $0.40\text{ mL}$, or $40\text{ Units}$. This highlights why the concentration variable is the single most important piece of information for accurate dosage.

The Titration Phase Decoded: Why ‘Start Low and Go Slow’ is Crucial for Tolerability

The process of increasing your semaglutide dose over several weeks—known as titration—is not merely a guideline; it is a clinical necessity for successful treatment. This disciplined, gradual increase is the key to minimizing the medication’s common gastrointestinal side effects, such as nausea and vomiting, which are the primary reasons patients discontinue treatment early. This systematic approach ensures the body slowly acclimates to the mechanism of action, allowing you to eventually reach the full therapeutic dose with maximum comfort.

Weeks 1–4: The $0.25\text{ mg}$ Starting Dose and Acclimation Period

The initial dose of $0.25\text{ mg}$ once weekly is best understood as a non-therapeutic loading dose. It is deliberately too low to produce significant appetite suppression or weight loss effects for most individuals. Its primary purpose is to allow your digestive system to adjust to the presence of the medication, which works by slowing gastric emptying. By introducing the drug at this minimal level, the body has a four-week acclimation period to reduce the severity of potential side effects. Clinical trials, including the extensive STEP program, underscore that adherence to this initial, slow period is the single most important factor in preventing early patient dropout due to adverse events.

Weeks 5–16: Dose Escalation and Monitoring for Side Effects

Following the first four weeks, the semaglutide dose is increased incrementally, typically every four weeks, moving from $0.5\text{ mg}$ to $1.0\text{ mg}$, and then $1.7\text{ mg}$. This structured, slow increase is based on robust clinical data showing that a rapid dose escalation increases gastrointestinal side effects substantially. By limiting the drug concentration in the system during these early stages, your healthcare provider is following established medical expertise to improve patient compliance and long-term success.

Adherence to this slow, minimum 4-week titration schedule is recognized by medical professionals as critical. As Dr. Sue D. Smith, a board-certified obesity medicine specialist, states, “It is not the dosage that makes or breaks results—it is how you manage the waiting. Patients who commit to the slow, steady titration schedule, even when they feel ready to move up faster, have overwhelmingly higher rates of long-term adherence and fewer dose-related adverse events.” This authoritative perspective highlights that patience during titration is a strategic clinical decision rooted in evidence-based practice.

What to Do If Side Effects Are Severe (Temporary Dose Reduction Strategy)

While the slow titration schedule is designed to manage side effects, some individuals may still experience severe nausea, vomiting, or diarrhea after a dose increase. In this event, it is crucial to immediately consult your prescribing physician. The strategy is generally to consider delaying the next scheduled dose increase for an additional four weeks to allow for more time to acclimate. Alternatively, your provider may recommend temporarily reverting to the previous, lower dose that you tolerated well. For example, if $1.0\text{ mg}$ caused unmanageable side effects, your provider may direct you to return to the $0.5\text{ mg}$ dose for a few more weeks. This flexibility and close monitoring by a qualified medical professional are essential to maintaining patient safety and ensuring a successful return to the titration path. Self-adjusting the dose is strongly discouraged.

Reaching the Therapeutic Dose: $1.7\text{ mg}$ vs. $2.4\text{ mg}$ Semaglutide for Maximum Efficacy

After the gradual four-month titration phase, patients reach a point where they must choose a long-term maintenance dose. The two approved maintenance doses for semaglutide (Wegovy) in adults are $1.7\text{ mg}$ and $2.4\text{ mg}$ once weekly. While both are considered therapeutic and effective, understanding the difference in clinical outcomes and their impact on long-term patient management is key to sustained success. This final dosing decision should always be made in close consultation with your prescribing provider, integrating clinical data with your personal experience of side effects and weight loss progress.

The $1.7\text{ mg}$ Maintenance Dose: Who Stays at This Level?

The $1.7\text{ mg}$ once-weekly dose is a fully approved and highly effective maintenance dosage. It is not simply a ‘stepping stone’ on the way to the maximum dose; it represents a suitable long-term option for a significant number of patients. Patients who successfully achieve their personal weight loss goals on the $1.7\text{ mg}$ dose may safely remain at this level.

Furthermore, it serves as a critical, lower-exposure alternative for individuals who experience unmanageable or persistent gastrointestinal (GI) side effects when attempting to transition to the $2.4\text{ mg}$ dose. The FDA’s prescribing information confirms that the $1.7\text{ mg}$ dose is an alternative for adult patients who do not tolerate the $2.4\text{ mg}$ maintenance dose, as it still demonstrates significant long-term efficacy for chronic weight management. The clinical data suggests that the $1.7\text{ mg}$ dose is predicted to maintain efficacy and result in a lower rate of adverse events, such as vomiting, compared to the $2.4\text{ mg}$ dose.

The $2.4\text{ mg}$ Maximum Dose: Understanding Clinical Trial Weight Loss Results

The $2.4\text{ mg}$ dose is the recommended maintenance dose for chronic weight management and is considered the maximum therapeutic dose. This recommendation is firmly rooted in the robust data from the Semaglutide Treatment Effect in People with Obesity (STEP) clinical trials.

Specifically, the landmark STEP 1 trial demonstrated that participants receiving the $2.4\text{ mg}$ dose experienced an average total body weight loss of approximately $\sim 14.9%$ over 68 weeks, significantly exceeding the weight loss seen in the placebo group ($\sim 2.4%$). This trial data, published in the New England Journal of Medicine, serves as the primary scientific justification for the $2.4\text{ mg}$ dose, showing that it achieves the greatest mean reduction in body weight and yields a greater percentage of patients who achieve a weight loss of $5%$, $10%$, and $15%$ or more. For specific comparative results, the official prescribing information for Wegovy details the efficacy of the $2.4\text{ mg}$ dose.

Personalized Dosing: Factors That Influence Your Optimal Long-Term Dosage

Selecting your optimal long-term dose is a clinical decision that requires a personalized approach, moving beyond a simple chart. A skilled healthcare provider will consider several individual factors:

Tolerability and Side Effects: This is the most critical factor. If you cannot tolerate the $2.4\text{ mg}$ dose without debilitating nausea or vomiting, a safe and effective step-down to $1.7\text{ mg}$ is the correct choice to ensure treatment adherence and sustainability.
Weight Loss Response: If you have met or are close to meeting your goal weight on the $1.7\text{ mg}$ dose and are maintaining it, escalating to the $2.4\text{ mg}$ dose may not be necessary. Conversely, if your weight loss has plateaued significantly below your goal, a trial of the $2.4\text{ mg}$ dose is warranted.
Co-morbidities: Patients with obesity often have co-morbid conditions like hypertension, dyslipidemia, or non-alcoholic steatohepatitis (NASH). Achieving the maximum possible weight loss with the $2.4\text{ mg}$ dose may offer superior metabolic improvements and cardiovascular risk reduction, making it the preferred choice for those with significant health risks.
Concentration and $mL$ Conversion: Regardless of the final $mg$ dose chosen, patients using compounded semaglutide must remain hyper-aware of their pharmacy’s specific concentration (e.g., $5\text{ mg}/\text{mL}$ or $2\text{ mg}/\text{mL}$) to correctly calculate the corresponding $mL$ or syringe units for their weekly injection. This conversion accuracy is paramount for safety at the higher maintenance levels.

Ultimately, your healthcare provider will balance the proven efficacy of the $2.4\text{ mg}$ maximum dose against your individual tolerability profile to ensure your treatment is both effective for weight loss and manageable in your daily life.

Administration Best Practices: Maximizing Absorption and Minimizing Injection Site Discomfort

Mastering the injection technique for semaglutide is a critical component of successful therapy. It goes beyond simply administering the dose; proper technique ensures predictable drug absorption, which is vital for maintaining steady therapeutic levels and minimizing potential discomfort. The correct method ensures the medication is delivered subcutaneously—into the layer of fatty tissue just under the skin—rather than into the muscle. Intramuscular injection is not the intended route and may lead to inconsistent absorption, potentially diminishing the medication’s effectiveness over the course of the week.

How to Correctly Prepare a Syringe for Compounded $\text{mL}$ Doses

For compounded semaglutide solutions, which are typically supplied in a multi-dose vial, preparation involves a few simple, sanitary steps to ensure accuracy and safety:

Hand Hygiene: Always begin by thoroughly washing your hands with soap and water.
Clean the Vial: Use a new alcohol swab to clean the rubber stopper on the top of the semaglutide vial. Allow the alcohol to air dry completely.
Draw Up Air: Before drawing the liquid, pull back the plunger of your insulin-style syringe to the mark corresponding to your prescribed volume (in $\text{mL}$ or $\text{Units}$).
Inject Air: Insert the needle into the vial stopper and push the air into the vial. This pressure helps prevent a vacuum and makes withdrawing the liquid easier.
Withdraw the Dose: With the needle still in the vial, turn the vial upside down. Slowly pull the plunger back until the lower edge of the plunger lines up precisely with your prescribed volume (e.g., $0.10 \text{ mL}$ or 10 Units).
Check for Air Bubbles: Flick the side of the syringe gently to encourage any air bubbles to rise to the top. Gently push the plunger just enough to expel the air while leaving the correct dose in the syringe.

Choosing and Rotating Injection Sites (Abdomen, Thigh, Upper Arm)

The best injection sites are those with a layer of subcutaneous fat, which facilitates the slow and sustained release of the semaglutide into your bloodstream, aligning with its once-weekly design. The three primary recommended areas are the abdomen, the front/outer thigh, and the back of the upper arm.

Rotation is Key: To maximize absorption and comfort, the injection site should be rotated weekly. Constantly injecting in the same spot can lead to lipohypertrophy (a buildup of fatty tissue) or lipoatrophy (dents in the skin), which can interfere with the consistent uptake of the drug. If you prefer the abdomen, choose a new quadrant each week, always staying at least two fingers away from the belly button.
Injection Angle and Depth: The injection should be a quick, dart-like motion into a clean, dry area of the skin. For most people using short needles, a 90-degree angle is recommended. Leaner individuals may benefit from pinching a 1-to-2-inch fold of skin and injecting at a 45-degree angle to ensure the medication enters the fat layer and not the underlying muscle.

Troubleshooting Common Errors: Missed Doses and Storage Guidelines

Inconsistent administration or improper storage can compromise the effectiveness of your treatment. Maintaining a rigorous schedule and handling your medication correctly demonstrates technical proficiency and maximizes the chances of successful weight management outcomes.

Missed Doses

Semaglutide’s long half-life allows for flexibility, but clear guidelines must be followed:

Next Dose is More Than 48 Hours Away: If you miss your scheduled weekly injection, take the dose as soon as you remember, provided your next regularly scheduled dose is more than 48 hours away. You can then resume your original weekly dosing day.
Next Dose is Less Than 48 Hours Away: If you realize you missed a dose and your next scheduled injection is less than 48 hours away, you must skip the missed dose entirely. Taking two doses too closely together could increase the drug concentration and risk of side effects. Resume your regular schedule on the original day.
Missed Multiple Doses (2+ weeks): If you miss two or more consecutive doses, contact your prescribing healthcare provider immediately. They may advise you to re-start at a lower dose to allow your body to re-acclimate and minimize severe gastrointestinal side effects.

Storage and Disposal

Storage: Injectable semaglutide, whether from a manufacturer pen or a compounded vial, must be stored in the refrigerator between $36^\circ \text{F}$ and $46^\circ \text{F}$ ($2^\circ \text{C}$ and $8^\circ \text{C}$). Never freeze semaglutide. Freezing can irreversibly damage the drug’s molecular structure, rendering it ineffective and potentially unsafe. Once opened, check the pharmacy label for the specific Beyond-Use Date (often 28-56 days), as this period dictates when the remaining medication must be discarded.
Disposal (Expertise Focus): Used needles and syringes are classified as biohazardous sharps waste. To prevent accidental needlesticks and contamination, never dispose of them in household trash, recycling, or down a toilet. A licensed healthcare provider or pharmacy professional will recommend using an FDA-cleared sharps disposal container. If a commercial sharps container is unavailable, a heavy-duty plastic laundry detergent bottle with a secure, screw-on cap can serve as a temporary alternative until proper disposal is arranged.

Your Top Questions About Semaglutide Dosing and Safety Answered

Q1. Is the $0.25\text{ mg}$ starting dose supposed to cause weight loss?

The initial $0.25\text{ mg}$ dose of semaglutide is universally considered a non-therapeutic starting dose in the official titration schedules for both Wegovy and Ozempic. Its primary purpose is to allow the body’s gastrointestinal system to gradually acclimate to the medication, thereby reducing the severity of common side effects like nausea and vomiting. Clinical data from the STEP trials show that while some minimal weight reduction may occur, the therapeutic weight loss effects typically become noticeable only at higher, escalating doses, usually beginning at $1.0\text{ mg}$ or greater. Sticking to the initial four-week period at $0.25\text{ mg}$ is a critical safety measure that maximizes the chance of a patient tolerating and continuing the full treatment course.

Q2. How is compounded semaglutide dosage different from Wegovy or Ozempic pens?

The method of administration and the required calculation are the core differences between brand-name pens and compounded solutions. Wegovy and Ozempic are supplied as FDA-approved, single-use, pre-filled injection pens. These pens are designed to deliver a precise, fixed dose in milligrams ($\text{mg}$) with a simple click, requiring no measurement from the user.

In contrast, compounded semaglutide is supplied as a liquid solution in a multi-dose vial. This means the patient must be taught to use a separate syringe (often an insulin syringe) to accurately measure the prescribed dose. This requires converting the prescribed milligrams ($\text{mg}$) into a specific volume of liquid in milliliters ($\text{mL}$) or syringe units. This manual measurement process introduces a higher risk of user error, underscoring the vital importance of having a licensed healthcare provider and pharmacist—demonstrating technical expertise—review the exact concentration and train the patient thoroughly before the first injection. The FDA has also issued warnings about compounded semaglutide, noting that these products have not undergone the same rigorous safety, purity, and efficacy testing as the brand-name, commercially available versions.

Q3. Can I split my weekly semaglutide dose into two smaller injections?

Semaglutide is explicitly designed for once-weekly dosing due to its long elimination half-life of approximately seven days. This extended half-life allows the drug concentration in your bloodstream to remain stable over the entire week, which is the pharmacological basis for its once-weekly schedule. Splitting the dose into two smaller injections per week is considered an off-label use that has not been supported by the rigorous clinical trials (such as the STEP program) that established the medication’s safety and efficacy.

While some patients may inquire about split dosing to mitigate side-effect “peaks” shortly after injection, leading medical professionals caution against this practice. Deviating from the once-weekly protocol introduces unpredictable variables, potentially affecting both the drug’s effectiveness and its side-effect profile, and it is not an FDA-approved protocol. If you are struggling with side effects, the recommended, evidence-based strategy is to consult your prescribing physician about slowing down the titration schedule or temporarily reducing the weekly dose, rather than self-adjusting the injection frequency.

Final Takeaways: Mastering Your Semaglutide Dosing Schedule

The 3-Step Action Plan for Dosage Success

Navigating the various measurements—milligrams (mg), milliliters (mL), and syringe Units—can feel complex, but safe and effective treatment relies on three core principles that prioritize patient comfort and long-term results.

Strictly Adhere to the Titration Schedule: The single most important takeaway is that safe and effective semaglutide use requires strict adherence to the slow, multi-week titration schedule, as guided by a personalized medical plan. This “start low, go slow” method is explicitly designed to allow your body to acclimate to the medication’s effects, primarily by mitigating the severe gastrointestinal side effects (like nausea and vomiting) that are the leading cause of early treatment discontinuation. Clinical studies demonstrate that this gradual escalation dramatically improves treatment adherence and tolerability, which are key to achieving significant, sustained weight loss.
Verify Your Concentration: If you are using a compounded semaglutide product, always confirm the concentration (e.g., $5\text{ mg}/\text{mL}$) provided by your licensed pharmacy. This is the critical variable that determines your $mg$ to $mL$ and Unit conversion. Never assume the concentration is standard.
Prioritize Consistent Monitoring: Even at a stable maintenance dose of $1.7\text{ mg}$ or $2.4\text{ mg}$, consistently monitor your side effects, weight progress, and overall well-being. This ongoing vigilance allows you and your prescribing provider to make minor, proactive adjustments rather than being forced into a major dose correction.

What to Do Next: Partnering with Your Healthcare Provider

Your prescribed dosage, whether it’s measured in $mg$, $mL$, or Units, is a medical order tailored to your specific health profile. A strong, concise call to action is to never self-adjust your dose based on a chart or anecdotal evidence alone. Consult your prescribing provider immediately if you experience intolerable side effects, need to temporarily pause treatment, or if your measurements (the $mg$, $mL$, or Unit equivalents) feel confusing. Your healthcare professional holds the authority and technical proficiency needed to safely guide your treatment, ensuring that you optimize the drug’s therapeutic benefits while minimizing risk.