Semaglutide doses, as documented in the trials and label

The short version

This page documents the semaglutide dose and dosage exactly as published trials and the approved label describe them — in the third person, as a record, never as instructions for you. In plain terms: the shot version is started low and stepped up slowly over weeks so the stomach can adjust, ending at a weekly maintenance amount; the pill version uses different numbers and a strict empty-stomach routine because very little of it gets absorbed. The drug lasts a long time in the body — about a week — so it is dosed weekly as an injection, and it takes around five weeks to fully clear after the last dose. Nothing here tells anyone what to take; dosing decisions belong to a prescriber. The figures below are simply what the studies and labelling report.

Semaglutide dose: the subcutaneous titration

Across the trial and label record, subcutaneous semaglutide is started low and escalated to limit gastrointestinal effects. For chronic weight management, the documented schedule is 0.25 mg once weekly for weeks 1-4, then 0.5 mg for weeks 5-8, 1.0 mg for weeks 9-12, 1.7 mg for weeks 13-16, and 2.4 mg once weekly as maintenance ^[2]. For type 2 diabetes, the documented schedule initiates at 0.25 mg once weekly, escalating through 0.5 mg to a 1.0 mg maintenance dose, with up to 2.0 mg studied in the SUSTAIN FORTE program ^[3].

This stepwise titration is not arbitrary: the pooled STEP-program tolerability analysis found gastrointestinal adverse events were concentrated around dose escalation ^[20], which is the documented rationale for the gradual increase. An investigational high-dose obesity program, STEP UP, studied 7.2 mg once weekly subcutaneous. None of these figures is a recommendation; they are reported doses from published research and labelling.

Oral semaglutide dose and the semaglutide injection compared

Oral semaglutide uses entirely different numbers. The documented type 2 diabetes schedule is 3 mg daily for 30 days, then 7 mg, then 14 mg daily, taken on an empty stomach 30 minutes before the first food, drink, or other oral medication, with no more than about 120 mL of water ^[7]. PIONEER 1 established dose-dependent HbA1c and body-weight reductions across 3, 7, and 14 mg ^[29], and higher oral doses of 25 mg and 50 mg once daily were studied in the OASIS and PIONEER PLUS obesity and diabetes programs.

The strict fasted routine exists because oral bioavailability is only about 0.4-1%, even with the SNAC absorption enhancer ^[7]. Comparing the routes: a meta-analysis of once-daily oral semaglutide reported efficacy in glycemic control and weight with a cardiovascular profile consistent with the GLP-1 receptor agonist class ^[30], so the semaglutide injection and oral semaglutide engage the same mechanism — but the oral form's low, food-sensitive absorption makes administration accuracy consequential, a point documented as a caution on the Semaglutide effects page.

Half-life and pharmacokinetics

Semaglutide's elimination half-life is approximately one week, commonly cited as about 165-168 hours, for both subcutaneous and oral formulations, with effectively complete clearance roughly five weeks after the final dose. This long half-life is conferred by strong, reversible albumin binding via the C18 fatty di-acid side chain plus DPP-4 resistance from the Aib-8 substitution. A 2024 systematic review of semaglutide pharmacokinetics confirms a long elimination half-life supporting once-weekly subcutaneous administration and characterizes AUC, Cmax, time-to-Cmax, and clearance across formulations ^[8].

Drug-interaction pharmacokinetics are reassuring: a clinical study found no clinically relevant effect of semaglutide on the exposure of co-administered metformin, warfarin, atorvastatin, or digoxin, despite delayed gastric emptying ^[31]. On storage, pre-filled pens are typically refrigerated at 2-8 C before first use and may then be kept at room temperature (at or below 30 C) for a defined in-use period, commonly cited as up to 56 days, per the approved labelling; the oral tablet is co-formulated with SNAC and is not reconstituted. These are documented pharmacokinetic and handling facts, not dosing advice.