GLP-1 dose escalation schedules: Wegovy and Zepbound
The escalation schedules on the FDA labels for Wegovy (semaglutide) and Zepbound (tirzepatide), at their fastest pace: one step every four weeks to a maintenance dose. Both labels allow more than one maintenance dose.
Both drugs start low and step up in four-week intervals. The slow start is there for tolerability: gastrointestinal side effects are most common while the dose is rising. Zepbound’s label steps up by 2.5 mg after at least four weeks at each dose, so four weeks is the fastest pace, not a fixed one.
Wegovy reaches its 2.4 mg maintenance dose after 16 weeks, and its label allows 1.7 mg as maintenance for people who do not tolerate 2.4 mg. Zepbound reaches 15 mg after 20 weeks; its label lists 5, 10 and 15 mg as maintenance doses.
Wegovy’s label says to consider delaying the next step by four weeks if a dose is not tolerated; Zepbound’s says to weigh response and tolerability when choosing the maintenance dose. These are the labels’ schedules, shown for reference, not a prescription.
| Drug | Dose | When |
|---|---|---|
| Wegovy (semaglutide) | 0.25 mg | Weeks 1 to 4 |
| Wegovy (semaglutide) | 0.5 mg | Weeks 5 to 8 |
| Wegovy (semaglutide) | 1 mg | Weeks 9 to 12 |
| Wegovy (semaglutide) | 1.7 mg | Weeks 13 to 16 |
| Wegovy (semaglutide) | 2.4 mg | Week 17 onward |
| Zepbound (tirzepatide) | 2.5 mg | Weeks 1 to 4 |
| Zepbound (tirzepatide) | 5 mg | Weeks 5 to 8 |
| Zepbound (tirzepatide) | 7.5 mg | Weeks 9 to 12 |
| Zepbound (tirzepatide) | 10 mg | Weeks 13 to 16 |
| Zepbound (tirzepatide) | 12.5 mg | Weeks 17 to 20 |
| Zepbound (tirzepatide) | 15 mg | Week 21 onward |
Sources
Use this figure
Free to use in articles, course material and reports under CC BY 4.0. Credit “Klarovel” with a link to this page. The credit line is already printed on the image.
Related: Semaglutide and tirzepatide calculators
Klarovel does not sell, supply or ship peptides. Nothing on this page is medical advice or a dose recommendation.