GLP-1 titration tracker
Where you are, and where the results came from
At week 6 you are still climbing. Wegovy’s label says 0.5 mg is not a treatment dose — it is there to let your gut adapt.
You reach the first dose the label calls treatment (1.7 mg) in 7 weeks, and the top of the ladder in 11 weeks. Judging the medication now is judging a dose it was not designed to work at.
The ladder, from the label
- Weeks 1–40.25 mgNot a treatment dose
- Weeks 5–80.5 mgNot a treatment doseYou are here
- Weeks 9–121 mgNot a treatment dose
- Weeks 13–161.7 mg
- Week 17+1.7 mg or 2.4 mg
Weekly injection · approved for chronic weight management. Maximum 2.4 mg once weekly.
What the label lets you do
If patients do not tolerate a dose during dosage escalation, consider delaying dosage escalation for 4 weeks.
If one dose is missed and the next scheduled dose is more than 2 days (48 hours) away, take it as soon as possible. If the next dose is less than 2 days away, skip it. If 2 or more consecutive doses are missed, dosing may be resumed as scheduled or the escalation schedule restarted.
This rule is specific to Wegovy. Every product on this page has a different one, and the two semaglutide injections do not match each other.
The number you are comparing yourself to
The headline figure for Wegovy is −14.9% mean body weight, intention-to-treat — measured in STEP 1, at 2.4 mg, over 68 weeks.
That is 16 weeks of climbing followed by roughly 52 weeks at the top dose. If you are at week 6, you are 62 weeks short of it. See the full spread of outcomes on the weight loss calculator — the mean is not what most people got.
Schedule, delay rule and missed-dose rule read from WEGOVY (semaglutide) injection — Prescribing Information, section 2.3 — U.S. Food & Drug Administration.
Direct answer
What you need to know
Evidence strength: StrongFor the first 12 weeks on Wegovy, you are not on a dose the label calls treatment. Its own words: 0.25 mg, 0.5 mg and 1 mg “are initiation and escalation dosages and are not approved as maintenance dosages for chronic weight management”. Zepbound says the same of its 2.5 mg start. So the most common question asked at week six — why isn’t this working — usually has a dull answer: it hasn’t started.
Key takeaways
- Wegovy reaches a maintenance dose at week 17; Zepbound reaches 15 mg at week 21.
- The published results were measured at the top dose over 68–72 weeks — roughly a year after the climb ends.
- Every label permits staying longer at a dose. Wegovy’s says to consider delaying escalation by 4 weeks.
- Every product has a different missed-dose rule, and Ozempic and Wegovy do not match despite being the same molecule.
Important limitation: This is the label schedule, not your schedule. Prescribers vary it deliberately, and the labels expect them to. Nothing here tells you what dose you should be on, whether to increase, or whether a side effect warrants staying put — and the labels do not publish side-effect incidence per escalation step, so we cannot tell you how rough any particular increase is likely to be.
Next action: Find your week on the tracker above, then check your own product’s missed-dose rule rather than the one you remember. If you are judging progress, the weight loss calculator shows what the trials actually found, and at which dose.
Primary sources: FDA — Wegovy label, FDA — Zepbound label
General education, not medical advice. Never change a dose without your prescriber, and follow the schedule they gave you over anything on this page.
The sentence nobody quotes
Search for a dosing schedule and you will find the same five-row table everywhere. It is accurate. It is also a transcription, and it leaves out the line immediately above it.
The 0.25 mg, 0.5 mg, and 1 mg once-weekly dosages are initiation and escalation dosages and are not approved as maintenance dosages for chronic weight management.
That is Wegovy’s label, section 2.3, verbatim. It means the first 12 weeks are a tolerance ramp rather than a course of treatment. Zepbound puts it slightly differently — 2.5 mg “is for treatment initiation and is not intended for chronic weight management” — and Rybelsus is blunter still, saying its 3 mg starting dose “is not effective for glycemic control”.
None of that is hidden. It is simply upstream of the table everyone copies, and it changes what the table means.
It is also the honest answer to the question people usually arrive with, which is why it does not feel like anything is happening yet. No approved label states a time until the medication starts working — what the labels do and do not say about timing is worth reading before comparing yourself to a trial result, because the ramp above is usually the real explanation.
Why the arithmetic matters
The figure people measure themselves against — roughly 15% on semaglutide, roughly 21% on tirzepatide — comes from trials that ran 68 and 72 weeks. Set that against the ladder:
| Product | Weeks climbing | Trial length | Weeks at the top dose |
|---|---|---|---|
| Wegovy | 16 | 68 | 52 |
| Zepbound | 20 | 72 | 52 |
| Foundayo | 22 | 72 | 50 |
A reader at week eight comparing themselves to a 68-week result is roughly a seventh of the way through, and still below the dose that produced it. That is not encouragement — some people genuinely do not respond, and our calculator shows how many. It is a point about when the question can first be answered.
Five products, five different missed-dose rules
This is the other thing the tracker exists for. The rules are not variations on a theme — they are structurally different, and two products containing the same molecule do not share one.
| Product | Molecule | If you miss a dose |
|---|---|---|
| Wegovy | Semaglutide | If one dose is missed and the next scheduled dose is more than 2 days (48 hours) away, take it as soon as possible. If the next dose is less than 2 days away, skip it. If 2 or more consecutive doses are missed, dosing may be resumed as scheduled or the escalation schedule restarted. |
| Zepbound | Tirzepatide | Take it as soon as possible within 4 days (96 hours) of the missed dose. After 4 days, skip it and take the next dose on the regular day. The day of the week can be changed as long as doses are at least 3 days (72 hours) apart. |
| Foundayo | Orforglipron | Take it as soon as possible and do not double up. If 7 or more consecutive doses are missed, the label says to reinitiate escalation at a lower dose. |
| Ozempic | Semaglutide | Take it within 5 days of the missed dose. |
| Mounjaro | Tirzepatide | Take it as soon as possible within 4 days (96 hours). After 4 days, skip it. The day of the week can be changed as long as doses are at least 3 days apart. |
| Rybelsus | Semaglutide (oral) | Skip the missed dose and take the next dose the following day. |
The Ozempic and Wegovy rows are the ones worth reading twice. Same molecule, same manufacturer, and two different rules: five days for one, and for the other a question about how far away your next dose is. Remembering the wrong one is an easy mistake and the label is the only thing that settles it.
What this tool will not do
- It will not tell you to increase. That is a prescriber decision, made on tolerability and response, and the labels are written that way deliberately.
- It will not estimate side effects per step. The labels report overall incidence, not incidence by escalation step. We would have to invent that breakdown, so we do not show one.
- It does not cover compounded products. A compounded preparation follows whatever protocol its prescriber sets, not an approved label — see compounded semaglutide.
- It is not your schedule. If your prescriber gave you something different, theirs is the one to follow.
Common questions
Why am I not losing weight on a GLP-1 yet?
If you are in the first weeks, the most likely answer is that you are not yet on a dose intended to do anything. Wegovy's label states that 0.25 mg, 0.5 mg and 1 mg 'are initiation and escalation dosages and are not approved as maintenance dosages for chronic weight management' — that is 12 weeks before you reach a dose the label counts as treatment. Zepbound says its 2.5 mg starting dose 'is for treatment initiation and is not intended for chronic weight management'. The published results were measured at the top dose after 68 or 72 weeks.
How long does it take to reach the full dose?
On the label schedule with no delays: Wegovy reaches its 2.4 mg maintenance dose at week 17, and Zepbound reaches 15 mg at week 21. Foundayo escalates in 30-day steps and reaches 17.2 mg at around week 23. Those assume every step goes smoothly — the labels explicitly allow staying longer at a dose, and doing so is not a setback.
Can I stay on a lower dose for longer?
Yes, and every label says so in its own words. Wegovy's tells prescribers to 'consider delaying dosage escalation for 4 weeks' if a dose is not tolerated. Zepbound's frames 4 weeks as a minimum before increasing, not a schedule to keep. For the type 2 diabetes products, increases happen only if additional glycaemic control is needed — staying put is a normal outcome, not a stalled escalation. This is a prescriber decision, but it is a normal one.
What happens if I miss a dose?
It depends entirely on which product you take, and the rules genuinely differ. Ozempic allows 5 days. Zepbound and Mounjaro allow 4 days (96 hours). Wegovy is different in kind — it asks whether your next scheduled dose is more than 2 days away. Rybelsus is a daily tablet, so you skip and take the next one tomorrow. Foundayo says take it as soon as possible without doubling up, and restart escalation at a lower dose if you miss 7 or more in a row. Applying a rule you remember from a different product is a common error.
Do Ozempic and Wegovy have the same missed-dose rule?
No, and this surprises people. They are the same molecule from the same manufacturer, but Ozempic's label allows a missed dose to be taken within 5 days, while Wegovy's asks whether the next scheduled dose is more than 48 hours away and says to skip it if not. Wegovy also says that missing 2 or more consecutive doses may mean restarting the escalation schedule. Check the label for the product you actually hold.
Do side effects get worse at each dose increase?
The escalation exists precisely because gastrointestinal side effects are dose-related — that is the stated reason on every one of these labels. What the labels do not publish is incidence broken down by escalation step, so we cannot tell you how much worse a given increase is likely to be, and we will not estimate it. What they do give you is the remedy: if a dose is not tolerated, escalation can be delayed.
Sources
Each source below supports specific statements on this page. We cite the strongest available authority and verify against the current version before publishing.
- WEGOVY (semaglutide) injection — Prescribing Information, section 2.3U.S. Food & Drug AdministrationSupports: Wegovy's escalation table, the statement that 0.25 mg, 0.5 mg and 1 mg are not approved as maintenance dosages, the 4-week delay allowance, and the missed-dose rule.
- ZEPBOUND (tirzepatide) injection — Prescribing Information, section 2.2U.S. Food & Drug AdministrationSupports: Zepbound's 2.5 mg increments, the statement that 2.5 mg is for initiation and not intended for chronic weight management, and the 4-day missed-dose window.
- OZEMPIC (semaglutide) injection — Prescribing Information, section 2.1Novo Nordisk, via DailyMed (U.S. National Library of Medicine)Supports: Ozempic's escalation and its 5-day missed-dose rule — the one that differs from Wegovy despite the same molecule.
- FOUNDAYO (orforglipron) tablets — Prescribing Information, section 2.1Eli Lilly, via DailyMed (U.S. National Library of Medicine)Supports: Foundayo's 30-day steps and the instruction to reinitiate escalation at a lower dose after 7 or more consecutive missed doses.
- RYBELSUS (semaglutide) tablets — Prescribing Information, section 2.2Novo Nordisk, via DailyMed (U.S. National Library of Medicine)Supports: Rybelsus's schedule and the statement that its 3 mg starting dose is not effective for glycaemic control.
- FDA-approved prescribing information (drug labels)DailyMed, U.S. National Library of MedicineSupports: The current prescribing information for each product, which is the authority over this page.
This page is general education, not medical advice. Talk to your own healthcare provider about your situation before starting, stopping, or changing any medication.