Weight Loss Injection Dosage Guide: Dose Schedule, Strength, Maintenance

If you’re considering using a weight loss injection or just starting one, you may be wondering which dose is right for you.

In this weight loss injection dosage and maintenance guide, we’ll explore how dosages work.

Article Summary:

• Many types of weight management treatment follow a process called “titration”. This is where your dose gradually increases in strength over time.
• As your treatment progresses, your clinician may adjust your dosage based on how well you’re responding to treatment, and how your body is managing any side effects.
• Each weight loss journey is different, and you may never need to reach the maximum treatment dose.

What’s titration and how does it work?

In the context of medicine, “titration” is a gradual dosing plan. This means you begin treatment on a lower dose, which may increase in strength over time.

It's a common practice in medications which affect complex biological pathways, like antidepressants, where it’s particularly important to adjust dosing based on individual response to treatment. [1] And it's commonly applied to weight loss injections.

Why do I start weight loss injections on a lower dose?

Think of titration like strength training. In strength training, starting with a lighter weight helps your body to gently adjust to the changes in exertion, and minimizes your risk of injury. As your strength builds, you can gradually increase the weight of your equipment. The same principle applies to your weight management treatment. Starting low and going slow could help to minimize certain side effects like nausea, and support long-term success. [2]

Why does titration happen?

We practice titration with weight management treatment because there’s no single, standard dose that works for everyone.

During your weight management program, your clinician may adjust your dose based on factors like:

• How you’re responding to treatment
• Any side effects you experience during dose increases
• Your weight loss progress and general health

Some people may remain on a lower dose for longer, because they’re seeing positive results and there’s no need to increase their dose. In fact, data from a UK-based study suggests that people on lower doses of tirzepatide (the active ingredient in Zepbound) still lose clinically significant amounts of weight. [3] Your clinician may also keep you on a lower dose for longer, to help you manage any side effects you’re experiencing.

Meanwhile, others may benefit from regular, gradual adjustments to their treatment. We’ll explore what this may look like in the tables below.

Titration and weight loss injections

Your treatment plan will begin with a starting dose. As it progresses, your dose strength may gradually increase until you reach your "maintenance dose”. This is the dose that keeps your treatment at a safe, steady and effective level over time.

The following tables show the licensed dose escalations for Zepbound and Wegovy. Your treatment may escalate through these dosages before you reach your maintenance dose. However, every treatment plan is different and you may never need to reach the maximum dose to achieve your health goals.

Zepbound

[4]

Key takeaways:

• Zepound contains the active ingredient tirzepatide
• The recommended starting dose for Zepbound is 2.5mg
• After 4 weeks, you may be ready to increase your dose
• Each dose increase is in 2.5mg increments, after at least 4 weeks on your current dose
• The maximum dosage of Zebound is 15mg
• The recommended maintenance dosages of Zepbound are 5 mg, 10 mg or 15 mg. However, this will vary from person to person. [4]

Wegovy

[2]

Key takeaways:

• Wegovy contains the active ingredient semaglutide
• The recommended starting dose for Wegovy is 0.25mg
• After 4 weeks, you may be ready to increase your dose
• Each further dose increase takes place after at least 4 weeks on your current dose
• The maximum dosage of Wegovy is 2.4mg. If you find this strength difficult to tolerate, the dose may be temporarily decreased to 1.7 mg, for 2 to 4 weeks before re-escalating. [2]

When should I adjust my dosage?

Your treatment should be regularly reviewed by your clinician. They’ll be able to monitor your progress during each consultation.

You may be ready to increase your dose if:

• 'Food noise' has returned, and you're noticing increased cravings and thoughts about food.
• Your weight loss has stayed the same for several weeks, despite eating healthily and increasing your exercise. We call this a “weight loss plateau” and, while it’s perfectly normal, we understand that it may be frustrating: especially when you’re making positive lifestyle changes.
• You're experiencing little to no side effects. If you've passed the 4-week adjustment period and your side effects have eased, you may feel ready to increase your dose.

Finding my right dose

The most effective dose for you is the one where you see steady progress (losing around 1-2lbs, or 0.5-1kg a week) and your side effects are manageable. [5] This may mean following the dosage pathways shown in the tables above, but it could also mean taking a more personalized approach.

There’s never any pressure to increase your dose: if you’re happy with your progress, you may wish to stay at your current strength. And, if you increase your dose and experience particularly uncomfortable digestive side effects, you may wish to decrease your dose (“down-titration”) for a short period. Your clinician can help you manage a plan that feels right for you.

Can I skip to a higher dosage?

No, you can’t skip ahead to a higher dosage of weight management treatment.

It’s really important to follow your prescribed titration schedule. This is to keep your treatment safe and effective. Skipping to a higher dosage, or increasing your dosage strength too quickly, may increase your risk of uncomfortable side effects, like nausea or dehydration due to vomiting and diarrhea. [2, 4]

Weight loss injections like Zepbound and Wegovy have been clinically proven to support weight loss, when paired with positive lifestyle changes like a balanced diet and increased daily movement. [6, 7] Studies have also shown that gradual weight loss is more sustainable in the long term. [8]

A slow and steady approach to weight management and a healthier lifestyle is the best foundation for success.

What should I do if I miss a dose?

If you miss a dose of your medication, it’s important you follow the exact instructions in your patient medical information (PMI) sheet. This will be provided with your medication.

Zepbound

• Within 4 days (96 hours): Take the missed dose as soon as possible within 4 days after the missed dose.
• After 4 days (96 hours): Skip the missed dose completely and take your next dose on your regular scheduled day.

In both cases, you can then resume your regular once-weekly dosing schedule.

Important: never take an extra dose (or double dose) to make up for a missed injection of Zepbound. [4]

Wegovy

• At least 2 days (48 hours) until your next dose: If you miss a dose and your next scheduled dose is at least 2 days away, take your missed dose as soon as possible.
• Less than 2 days (48 hours) until your next dose: If you miss a dose and your next scheduled dose is less than 2 days away, skip the missed dose completely and take your next once-weekly dose on your regular scheduled day.

You can then resume your regular once-weekly dosing schedule.

Important: never take an extra dose (or double dose) to make up for a missed injection of Wegovy. [2]

If you miss more than one weekly dose of your treatment with MedExpress, contact Customer Care. A clinician will review your account to decide if it’s safe to resume treatment at your current dose, or if you need to re-titrate from a lower dose. This may be necessary to avoid severe digestive side effects.

Can I switch medication during treatment?

Yes, you can switch medication during treatment, as long as you're clinically suitable and the treatment is available.

There are several reasons why you might want to switch treatments. These include:

• Cost: If the cost of your current treatment is a concern, you may be able to switch to a more affordable alternative.
• Side effects: If you’re finding the side effects of your current medication difficult to manage, switching to a medication with a different active ingredient may be more comfortable for you. [9]

Switching between Zepbound and Wegovy

Switching between Zepbound and Wegovy means changing the active ingredients in your treatment (tirzepatide and semaglutide, respectively). This may mean starting at a specific dose, subject to approval from your clinician.

Switching between semaglutide treatments

Because Wegovy and generic semaglutide contain the same active ingredient (semaglutide), you may be able to switch between them at equivalent strengths. For example, if you’re currently taking Wegovy at 1.7mg strength and want to switch to generic semaglutide, you may be able to transition directly to generic semaglutide at 1.5mg strength without the need to re-titrate at a lower dose.

How safe are weight loss injections for long-term use?

Zepbound and Wegovy have been clinically proven to support meaningful results with long-term use (a year or longer). [6, 7, 10]

There’s no set amount of time that you should remain on treatment. Some people choose to stay on it for longer because they find it supports ongoing weight management, while others may feel comfortable completing treatment once they’ve reached their health goals. What matters is that your treatment remains safe and effective.

Every weight loss journey is different. Some people may find side effects more difficult to manage, while others may see the results they’re looking for while still on a lower dosage strength. That’s why it’s important to work with expert, licensed clinicians who can guide you along your treatment pathway, and make sure your treatment remains right for you.

Find out which treatment may be suitable for you with MedExpress.

References

1. Caffrey AR, Borrelli EP. The art and science of drug titration. Therapeutic Advances in Drug Safety. 2020 Jan;11(11):204209862095891. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7967860/
2. Wegovy ® (semaglutide injection) Product Monograph Unclassified / Non classifié Product Monograph Including Patient Medication Information PR WEGOVY ® semaglutide injection Solution for Subcutaneous Injection in a pre-filled pen Produced by recombinant DNA technology in Saccharomyces cerevisiae [Internet]. [cited 2026 Oct 7]. Available from: https://pdf.hres.ca/dpd_pm/00082777.PDF
3. Rosenior‐Patten O, Lees Z, Rowe R, Hussain S, Ahmad E, Brooke E, et al. Real‐World Effectiveness and Treatment Patterns of Tirzepatide in a Large UK Digital Health Cohort. Diabetes, Obesity and Metabolism. 2026 Aug 6;. Available from: https://pubmed.ncbi.nlm.nih.gov/42560020/
4. Eli Lilly Canada Inc. ZEPBOUND (tirzepatide injection) Patient Medication Information and Product Monograph [Internet]. Toronto, Ontario: Eli Lilly Canada Inc.; 2026 June [cited 2026 Oct 7]. Available from: https://pdf.hres.ca/dpd_pm/00084997.PDF
5. Maintaining a healthy weight [Internet]. Heart and Stroke Foundation of Canada. [cited 2026 Oct 7]. Available from: https://www.heartandstroke.ca/healthy-living/healthy-weight/maintaining-a-healthy-weight
6. Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, et al. Tirzepatide Once Weekly for the Treatment of Obesity. New England Journal of Medicine [Internet]. 2022 June 4 [cited 2026 Oct 7];387(3):205–16. Available from: https://www.nejm.org/doi/full/10.1056/NEJMoa2206038
7. Wilding JPH, Batterham RL, Calanna S. Once-Weekly Semaglutide in Adults with Overweight or Obesity. The New England Journal of Medicine [Internet]. 2021 Feb 10 [cited 2026 Oct 7];384(11):989–1002. Available from: https://www.nejm.org/doi/full/10.1056/NEJMoa2032183
8. Eldor R, Avraham N, Rosenberg O, Shpigelman M, Golan-Cohen A, Cukierman-Yaffe T, et al. Gradual Titration of Semaglutide Results in Better Treatment Adherence and Fewer Adverse Events: A Randomized Controlled Open-Label Pilot Study Examining a 16-Week Flexible Titration Regimen Versus Label-Recommended 8-Week Semaglutide Titration Regimen. Diabetes Care. 2025 July 17;48(9):1607–11. Available from: https://diabetesjournals.org/care/article-abstract/48/9/1607/162990/Gradual-Titration-of-Semaglutide-Results-in-Better?redirectedFrom=fulltext
9. Jain AB, Ali A, Gorgojo Martínez JJ, Hramiak I, Kavia K, Madsbad S, et al. Switching between GLP‐1 receptor agonists in clinical practice: Expert consensus and practical guidance. International Journal of Clinical Practice. 2020 Nov 3;75(2). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7900946/
10. Shah MY, Mohammad A, Bashir Ahmed Samejo R, Rana S, Singla S, Aurangzeb RI, et al. Weight Loss That Lasts: Reviewing the Long-Term Impact of GLP-1 Receptor Agonists. Cureus. 2025 July 19;. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12361690/