Semaglutide Dosing Protocol
Semaglutide is a GLP-1 receptor agonist studied for metabolic health and weight management. Its ~7-day half-life enables once-weekly dosing. Gradual titration is essential to minimize gastrointestinal side effects.
Key Points
Step-by-Step Guide
Begin at 0.25 mg Weekly
Start at 0.25 mg once weekly for weeks 1-4. This introductory dose allows GI tract adaptation before escalating.
Escalate to 0.5 mg
Increase to 0.5 mg weekly for weeks 5-8. Monitor for nausea, the most common dose-limiting effect.
Escalate to 1.0 mg
Increase to 1.0 mg weekly for weeks 9-12. This is the standard therapeutic dose for glycemic control in many trials.
Final Escalation
For weight management, escalate to 1.7 mg at week 13 and 2.4 mg at week 17. The 2.4 mg dose is the maximum studied for obesity.
Select Injection Site
Subcutaneous injection in abdomen, thigh, or upper arm. Rotate weekly. Administer on the same day each week.
Assess Endpoints
Track HbA1c, fasting glucose, body weight, waist circumference, and lipid panels at regular intervals.
Warnings & Precautions
- !Gradual titration is critical—skipping steps increases nausea risk.
- !Contraindicated with personal/family history of medullary thyroid carcinoma.
- !Monitor for pancreatitis signs: severe abdominal pain radiating to back.
- !Do not combine with other GLP-1 receptor agonists.
Frequently Asked Questions
Why does semaglutide require titration?
Gradual titration from 0.25 mg reduces GI side effects—particularly nausea and vomiting—which are the most common adverse events.
What is the maximum semaglutide dose?
The highest studied dose is 2.4 mg weekly (STEP trials for weight management). For glycemic control, 1.0 mg is the standard maximum.
How long to reach steady state?
Semaglutide reaches steady-state plasma concentrations after approximately 4-5 weeks at any given dose level.