Semaglutide Titration Chart & Dose Calculator Companion
Semaglutide (Ozempic®, Wegovy®) requires gradual titration to balance clinical efficacy with tolerability. Use this chart with the Peptide Calculator to translate each weekly dose into syringe units based on your vial strength and reconstitution volume.
Evidence-Based Titration Timeline
| Timeframe | Dose | Clinical Notes |
|---|---|---|
| Weeks 1-4 | 0.25 mg | Initiation dose to assess tolerance; not intended for glycemic control. |
| Weeks 5-8 | 0.5 mg | Escalate if nausea is controlled; monitor GI symptoms closely. |
| Weeks 9-12 | 1.0 mg | Standard maintenance for most patients; reassess weight and glucose response. |
| Weeks 13-16 | 1.7 mg | Optional intermediate step for Wegovy® patients who need gradual escalation. |
| Week 17+ | 2.4 mg (max) | Maximum FDA-approved dose for chronic weight management when tolerated. |
Always confirm the indication-specific labeling before escalating doses. Slow titration and shared decision-making reduce discontinuations.1
Converting Milligrams to Syringe Units
Reconstituted pens or vials may vary (e.g., 2.0 mg in 2 mL vs. 5 mg in 2 mL). To avoid arithmetic errors, enter your vial strength and selected dose into the Peptide Calculator and select the insulin syringe size you are using. The tool outputs the exact units to draw for each weekly dose.
Example Calculation
A 5 mg vial diluted with 2 mL bacteriostatic water yields 2.5 mg/mL. Enter 5 mg, 2 mL, and a 0.5 mg target dose into the calculator to receive a draw volume of 0.20 mL (20 insulin units on a 1 mL syringe).
Managing Side Effects During Titration
- Pair escalations with dietary adjustments focusing on low-fat meals to reduce nausea.2
- Encourage slow eating and limiting carbonated beverages the week after each increase.
- Delay the next titration step if vomiting, persistent emesis, or severe abdominal pain occurs.
- Monitor glucose trends in individuals with type 2 diabetes to adjust concomitant insulin or sulfonylureas.1
When to Pause Dose Escalation
Clinicians often pause progression when patients report significant GI intolerance or dehydration. Maintain the prior tolerated dose for 2-4 additional weeks before reassessing. If symptoms persist, consider reverting to the last well-tolerated dose or discontinuing therapy per ADA standards.2
Linking Lifestyle Data With Your Protocol
The Peptide Calculator syncs with our iOS app for tracking weight, waist circumference, and glucose snapshots alongside weekly doses. Recording context helps correlate titration phases with clinical outcomes and adverse events.
References
- Novo Nordisk, 2024: Novo Nordisk. Ozempic® (semaglutide) injection prescribing information. Revised 2024. Source
- ADA, 2024: American Diabetes Association. Standards of Medical Care in Diabetes—2024. Diabetes Care 47 (Supplement 1): S1–S291. Source
- Wilding et al., 2021: Wilding, J.P.H. et al. "Once-Weekly Semaglutide in Adults with Overweight or Obesity." New England Journal of Medicine 384, no. 11 (2021): 989-1002. Source