Wegovy dosage and how to use the pen

The Wegovy dosing schedule week by week

According to the Farmacotherapeutisch Kompas of Zorginstituut Nederland (the Dutch National Health Care Institute), the Wegovy dosing schedule moves to the maintenance dose in four steps of 4 weeks. The schedule below is the usual course; your doctor can extend a step if you have side effects.

If you do not tolerate 2.4 mg well, the doctor may decide to keep you on 1.7 mg. The schedule is a guideline, not a race: if you need more time at a step, you get it.

Why you build up slowly and when a step waits

You build up Wegovy slowly to limit gastrointestinal complaints. That is why the European Medicines Agency (EMA) prescribes a build-up over 16 weeks. Semaglutide slows gastric emptying and suppresses appetite; if you go up too quickly, you are more likely to get nausea, vomiting and diarrhoea, and to stop sooner as a result.

A step waits if the side effects have not eased after 4 weeks, if you have lost a lot of weight on the current step, or if nausea means you are eating and drinking too little. In those cases, in consultation with your doctor, you stay on the same dose for another 4 weeks. Never increase the dose yourself, not even if you "don't notice anything": for most people, the effect on appetite starts from 0.5 to 1 mg.

The most common side effects, and when to call the doctor, are covered in our article on Wegovy side effects.

The maintenance dose: do you always need to reach 2.4 mg?

No, not everyone ends up on 2.4 mg. The maintenance dose of 2.4 mg is the dose with which the research results were achieved: in the STEP 1 trial, published in The New England Journal of Medicine, adults with overweight or obesity lost an average of 14.9% of their body weight over 68 weeks on 2.4 mg, compared with 2.4% on placebo, alongside lifestyle support. That is an average; the result varies from person to person.

If you do not tolerate 2.4 mg, the product information allows you to stay on 1.7 mg. The doctor then looks at how your weight develops on that dose. At every check-up, the doctor assesses not just the scales, but also your eating pattern, your side effects and your energy.

With us, that kind of support is part of the medical weight loss with injections programme. We do not prescribe Wegovy; the doctor assesses in the consultation which medication suits your situation.

Want to know which medication and which schedule suit you? In a few minutes you will know whether medical weight loss could be right for you; the doctor then assesses your application. Eligibility check →

How to use the Wegovy pen: instructions, injection site and storage

The Wegovy pen in the Netherlands is a FlexTouch pen with four doses of the same strength. You inject once a week under the skin, on a fixed day, at any time of day and with or without food. According to apotheek.nl, the patient information website of the Dutch pharmacists' organisation KNMP, you inject into your abdomen, thigh or upper arm and choose a different injection site each week.

An injection takes five steps:

1. Check the pen. Take the pen out of the fridge, check the strength on the label and check that the liquid is clear and colourless.
2. Attach a new needle and remove both needle caps. Use a new needle for every injection.
3. Check the flow with a new pen: turn the dose selector to the flow check symbol and press until a drop appears.
4. Set the dose. Turn the dose selector until the dose counter shows the strength of your pen. You cannot set more than that.
5. Inject. Insert the needle into the skin, press the button until the counter shows 0 and count slowly to 6. Remove the needle and put it in a sharps container.

Storage: before first use, in the fridge at 2 to 8 °C, not in the freezer. After first use, the pen can be kept for 6 weeks below 30 °C or in the fridge, with the cap on and without a needle. After that, you throw the pen away, even if there is still liquid in it.

Wegovy is a prescription medicine that you can only get through a doctor and a registered pharmacy. How that route works is explained in our article on how to buy Wegovy.

How long does one pen last?

One Wegovy pen lasts 4 weeks. Each FlexTouch pen contains four doses of the same strength, one per week. During the build-up phase you therefore use exactly one pen per 4-week step, and after that one pen every 4 weeks on the maintenance dose.

This also means that at the end of each build-up step you need a pen of the next strength. Arrange your repeat prescription in good time, preferably a week before your current pen runs out.

Counting clicks with Wegovy: why the pen gives a fixed dose

Counting clicks is not part of using the Wegovy pen. Each pen is made for one strength, and the dose counter only lets you set that dose. A "click table" or "click schedule" for Wegovy does not exist in the official instructions for use.

The question comes from the practice with Ozempic pens, where some users try to create an in-between dose by turning fewer clicks than the pen indicates. This is advised against: the dose becomes inaccurate, the pen runs out sooner and the doctor no longer knows what you are using. If you need an in-between dose, discuss it with the doctor; with Wegovy, that is what the 1 mg and 1.7 mg strengths are for.

Forgot a dose or injected late: what should you do?

If you have forgotten a dose, inject it as soon as possible if there are still at least 2 days until your next scheduled injection. This matches the advice in the Farmacotherapeutisch Kompas: take it within 5 days of the missed moment; after that, skip it and carry on with your usual day. Never inject two doses at once to catch up.

If you have missed several doses in a row, for example due to illness or holidays, talk to your doctor. Often you then restart on a lower step to prevent side effects. If you want to move your regular injection day, you can, as long as there are at least 3 days between two injections.

Is Wegovy 1 mg the same as Ozempic 1 mg?

Yes, 1 mg of Wegovy and 1 mg of Ozempic contain the same amount of the same active substance, semaglutide. The difference lies in the registration, the available strengths and the pen. Ozempic is registered for type 2 diabetes and goes up to a maximum of 2 mg; Wegovy is registered for weight management and goes up to 2.4 mg.

In practice, this means that a course of semaglutide via Ozempic tops out at 2 mg, and via Wegovy at 2.4 mg. Which version the doctor chooses depends on your situation and on availability. The full comparison is in our article Wegovy vs Ozempic; the dosing schedule of the other pen is in the article on Ozempic dosage.

Prefer to lose weight with your own doctor who tailors the schedule to you? The doctor assesses whether medical weight loss suits you and supports you at every step. Medical weight loss with injections →

Frequently asked questions about Wegovy dosage

What is the dosing schedule for Wegovy?

Weeks 1 to 4: 0.25 mg per week; weeks 5 to 8: 0.5 mg; weeks 9 to 12: 1 mg; weeks 13 to 16: 1.7 mg; from week 17: 2.4 mg as the maintenance dose. If you have side effects, the doctor can extend a step by 4 weeks or keep you on 1.7 mg.

How quickly does Wegovy start to work?

Most people notice less appetite in the first weeks, often more clearly from 0.5 to 1 mg. Measurable weight loss usually follows after 4 to 8 weeks; the full effect comes on the maintenance dose, after a few months. The pace varies from person to person.

What does Wegovy cost at the pharmacy?

The pharmacy price varies by strength and by pharmacy; when you use Wegovy to lose weight, you pay for it yourself in most cases. Current prices and the reimbursement rules are in our article on the Wegovy price. You can also read whether Wegovy is covered by insurance.

Is Wegovy a weight loss pill?

No, in the Netherlands Wegovy is a weekly injection. A tablet form of semaglutide for weight management is in development; you can read the current status in our article on the Wegovy pill.

Can children use Wegovy?

Wegovy is registered for young people aged 12 and over with obesity and a body weight above 60 kilos, with the same dosing schedule as adults. The doctor stops the treatment if, after 12 weeks on the highest tolerated dose, BMI has not fallen by at least 5%.

What are the side effects of Wegovy 1 mg?

At every step, including 1 mg, the main side effects are nausea, diarrhoea, constipation and a full feeling, usually strongest in the first week after the increase. In the STEP trials, just over 4 in 10 participants had nausea at some point during the 68 weeks. The complaints usually ease as your body adjusts.

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