GLP-1 dose escalation schedules, four labels side by side
Every one of these labels starts a patient below the dose that does the work, and every one gives a different ladder to climb. The four schedules below are printed as four separate tables, each read from its own label’s dosage section, because they are not variants of one schedule and merging them would be the fastest way to attach a real number to the wrong drug.
Ellis Brandt built this site’s grading methodology and maintains it. Doses read from section 2 of each label. Last re-read September 2026.
Not medical advice. Semaglutide and tirzepatide are prescription-only medicines, and whether one is appropriate for you is a question for a licensed clinician who knows your history. This page reports what the FDA-approved prescribing information says and nothing else; it is not written or reviewed by a clinician. See the medical disclaimer.
Ozempic (semaglutide) injection
The Ozempic label sets an initiation dosage and then two optional increases, each gated on glycemic control rather than on the calendar alone: “If additional glycemic control is needed after at least 4 weeks” on the current dose.
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| Step | Dosage | What the label says about moving on |
|---|---|---|
| Initiation | 0.25 mg once weekly | For 4 weeks. The label calls this an initiation dosage. |
| After 4 weeks | 0.5 mg once weekly | A maintenance dosage. |
| Optional increase | 1 mg once weekly | After at least 4 weeks on 0.5 mg, if additional glycemic control is needed. |
| Optional increase | 2 mg once weekly | After at least 4 weeks on 1 mg. The maximum recommended dosage is 2 mg once weekly. |
The same label sets a separate rule for one population: in patients with type 2 diabetes and chronic kidney disease, increase to the 1 mg maintenance dosage after at least 4 weeks on 0.5 mg.
Wegovy (semaglutide)
Wegovy’s ladder is on the clock rather than on a response, and the label prints it as a table of week ranges. It is also the only one of the four whose label covers two dosage forms, so there are two schedules here and they are not related to each other.
Weeks 1 through 4
0.25 mg once weekly
Starting dosage
Weeks 5 through 8
0.5 mg once weekly
Dosage escalation
Weeks 9 through 12
1 mg once weekly
Dosage escalation
Weeks 13 through 16
1.7 mg once weekly
Dosage escalation
Week 17 and onward
1.7 mg or 2.4 mg once weekly, by indication
Maintenance dosage. The label states “See the indication below for the recommended maintenance dosage(s)” rather than a single figure.
Every step above is from the Wegovy prescribing information, section 2.2, Table 1 — one document. No step is carried across from another label, and no interval is inferred.
Wegovy prescribing information, label version 19, effective 2026-06-18, read September 2026. This is the injection schedule only; the tablet schedule in the same label is below and the two are not related.
For weight reduction in adults the recommended maintenance dosage is 2.4 mg once weekly, with 1.7 mg as the alternative. The label then adds a step above it: for patients who tolerate 2.4 mg for at least 4 weeks and for whom additional weight reduction is clinically indicated, “the dosage may be increased to a maximum dosage of 7.2 mg subcutaneously once weekly.” For cardiovascular risk reduction the maintenance dosage is 2.4 mg or 1.7 mg, and for noncirrhotic MASH with moderate to advanced fibrosis it is 2.4 mg, reducible to 1.7 mg if 2.4 mg is not tolerated.
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| Days | Once-daily tablet dosage | Stage |
|---|---|---|
| 1 through 30 | 1.5 mg | Starting dosage |
| 31 through 60 | 4 mg | Dosage escalation |
| 61 through 90 | 9 mg | Dosage escalation |
| 91 and onward | 25 mg | Maintenance dosage |
Mounjaro and Zepbound (tirzepatide)
Both tirzepatide labels start at 2.5 mg once weekly and both move in 2.5 mg increments after at least 4 weeks on the current dose. They differ in where they stop and in what they say about the starting dose.
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| Label | Starting dosage | Escalation | Maintenance dosages the label names | Maximum |
|---|---|---|---|---|
| Mounjaro | 2.5 mg once weekly | Increase in 2.5 mg increments after at least 4 weeks on the current dose, if additional glycemic control is needed | The label does not enumerate maintenance dosages separately | 15 mg once weekly in adults; 10 mg once weekly in patients aged 10 and older |
| Zepbound | 2.5 mg once weekly for 4 weeks. The label states that this dosage “is for treatment initiation and is not approved as a maintenance dosage” | After 4 weeks increase to 5 mg, then in 2.5 mg increments after at least 4 weeks on the current dose | Weight reduction and long-term maintenance: 5 mg, 10 mg or 15 mg. Obstructive sleep apnea: 10 mg or 15 mg | 15 mg once weekly, for all indications |
What the schedules do not cover
The four ladders above describe four FDA-approved products. Some telehealth providers supply compounded semaglutide or compounded tirzepatide instead, and a compounded preparation has no FDA-approved label — so there is no approved escalation schedule to read, no approved strength list, and nothing on this page that describes one. The FDA states plainly that “compounded drugs are not FDA approved” and that “the agency does not review compounded drugs for safety, effectiveness or quality before they are marketed.”
The same FDA page records what has gone wrong when a dose schedule is written outside an approved label: reports of adverse events, “some requiring hospitalization, that may be related to dosing errors associated with compounded injectable semaglutide products”, and further reports involving patients “prescribed compounded semaglutide or tirzepatide products in doses beyond what is in the FDA-approved drug label” — including “increasing the amount more quickly (titration schedule).”
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| Question | Why the labels do not answer it | Status here |
|---|---|---|
| The escalation schedule for a compounded semaglutide or tirzepatide preparation | A compounded drug is not FDA-approved and is not reviewed by the FDA for safety, effectiveness or quality before it is sold, so it has no prescribing information to read. | [needs citation] |
Nothing closes that marker by argument. What a reader on a compounded product has instead is the schedule their own prescriber wrote, and it is worth asking that prescriber which approved schedule, if any, it was modelled on. Related: what each label says about a missed dose.
Sources
Drag the table sideways to read the remaining columns.
| Label | Applicant on the label | SPL version | Label effective date | Where it was read |
|---|---|---|---|---|
| Ozempic (semaglutide) | Novo Nordisk Pharmaceutical Industries, LP | 20 | 2026-06-01 | DailyMed, set id adec4fd2-6858-4c99-91d4-531f5f2a2d79 |
| Wegovy (semaglutide) | Novo Nordisk Pharmaceutical Industries, LP | 19 | 2026-06-18 | DailyMed, set id ee06186f-2aa3-4990-a760-757579d8f77b |
| Mounjaro (tirzepatide) | Eli Lilly and Company | 40 | 2026-08-27 | DailyMed, set id d2d7da5d-ad07-4228-955f-cf7e355c8cc0 |
| Zepbound (tirzepatide) | Eli Lilly and Company | 40 | 2026-08-28 | DailyMed, set id 487cd7e7-434c-4925-99fa-aa80b1cc776b |
Each capture was checked against its own document title before anything was quoted from it, and a nonsense set id was fetched through the identical method in the same session as a control — it returned 404 with an empty body, so a document that returns is a document that exists.
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| Page | Publisher | Content current as of | Address |
|---|---|---|---|
| FDA’s Concerns with Unapproved GLP-1 Drugs Used for Weight Loss | U.S. Food and Drug Administration | 2026-09-01 | fda.gov |
Read with a browser user agent rather than an automated fetcher, and a nonsense fda.gov path was requested through the identical method in the same session as a control — it returned 404, so the pages above returned because they exist.
See the providers
Once you know the schedule, the boards list the providers who sell each drug on it and what each one publishes.
- Semaglutide providersprovider board
Readers who have settled on semaglutide and are choosing who to buy it from.
- Tirzepatide providersprovider board
Readers who have settled on tirzepatide and are choosing who to buy it from.
More, read from the same labels
- Semaglutide vs tirzepatidereading the label
What the four FDA-approved labels say each molecule is, what each is approved to treat, and where the two differ.
- Side effect ratesreading the label
What each label reports for nausea, vomiting, diarrhea and constipation — and the sentence every label prints above those numbers.
- Missed dose rulesreading the label
The window each label gives for a late dose, and the minimum gap it requires when the injection day changes.
- Drug interactionsreading the label
Insulin and sulfonylureas, oral medications, and the oral-contraceptive precaution that appears on two of these four labels and not the other two.
- Buying one onlinereading the label
The agency's own warning signs for a telehealth GLP-1 seller, its 28-day vial rule, and what it says about drugs that arrive warm.
- Who should not take onereading the label
The boxed warning every one of these labels carries, the two contraindications, and which warnings appear on which product.
The one thing all four agree on
Each label ties escalation to gastrointestinal tolerance, in almost identical words: follow the escalation “to reduce the risk of gastrointestinal adverse reactions”. The ladder is not a formality; it is the label’s stated mitigation.
Four labels, read September 2026. Versions and effective dates at the foot of this page.