Complete GLP-1 Dosing Guide February 2026 - Semaglutide & Tirzepatide

Understanding GLP-1 dosing is crucial for maximizing results while minimizing side effects. Whether you're starting semaglutide (Ozempic, Wegovy) or tirzepatide (Mounjaro, Zepbound), this comprehensive guide covers everything you need to know about dosing schedules, titration timelines, missed doses, and finding your ideal maintenance dose.

Why GLP-1 Dosing Requires Titration

GLP-1 medications are not one-size-fits-all. Starting at the full therapeutic dose would cause severe nausea and gastrointestinal distress for most people. Titration—gradually increasing the dose over time—allows your body to adjust while minimizing side effects.

The Science Behind Titration

GLP-1 receptor agonists slow gastric emptying, meaning food stays in your stomach longer. Your digestive system needs time to adapt to this change. Gradual dose increases give your body time to adjust, reducing the likelihood of nausea, vomiting, and other GI side effects.

Key Principle:

The goal is to find your minimum effective dose—the lowest dose that produces desired results with tolerable side effects. More is not always better.

Semaglutide Dosing Schedule (Ozempic & Wegovy)

Semaglutide is administered as a once-weekly subcutaneous injection. The standard titration schedule follows this pattern:

Standard Semaglutide Titration Schedule

Weeks 1-4: 0.25 mg weekly

Starting dose to assess tolerance. Minimal weight loss expected.

Weeks 5-8: 0.5 mg weekly

First therapeutic dose. Most people begin seeing weight loss.

Weeks 9-12: 1.0 mg weekly

Moderate therapeutic dose. Significant appetite suppression.

Weeks 13-16: 1.7 mg weekly (optional)

Higher dose if needed. Many people find maintenance here.

Week 17+: 2.4 mg weekly (maximum dose)

FDA-approved maximum for weight loss (Wegovy). Not everyone needs this dose.

Ozempic vs Wegovy Dosing Differences

While both contain semaglutide, Ozempic is approved for diabetes with a maximum dose of 2.0 mg weekly, while Wegovy is approved for weight loss with a maximum of 2.4 mg weekly. The medication is identical—only the FDA-approved indications and maximum doses differ.

Learn more about this confusing naming in our article on GLP-1 vs Wegovy vs Ozempic.

Tirzepatide Dosing Schedule (Mounjaro & Zepbound)

Tirzepatide is a dual GIP/GLP-1 receptor agonist administered once weekly. Its dosing schedule differs from semaglutide:

Standard Tirzepatide Titration Schedule

Weeks 1-4: 2.5 mg weekly

Starting dose to assess tolerance.

Weeks 5-8: 5 mg weekly

First therapeutic dose with noticeable effects.

Weeks 9-12: 7.5 mg weekly

Moderate dose. Many find maintenance here.

Weeks 13-16: 10 mg weekly

Higher therapeutic dose if needed.

Weeks 17-20: 12.5 mg weekly (optional)

Near-maximum dose for additional benefit.

Week 21+: 15 mg weekly (maximum dose)

FDA-approved maximum. Reserve for those needing highest dose.

Mounjaro vs Zepbound Dosing

Like semaglutide, tirzepatide has two brand names: Mounjaro for diabetes and Zepbound for weight loss. Both use identical medication and dosing schedules—the only difference is the FDA-approved indication.

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What to Do If You Miss a Dose

Life happens, and you might occasionally miss your scheduled injection. Here's what to do based on how late you are:

Missed Dose Guidelines

Less than 2 days late (within 48 hours):

Take your missed dose as soon as you remember, then continue with your regular schedule.

Example: If your injection day is Monday and you remember on Wednesday morning, take it right away.

More than 2 days late (48+ hours):

Skip the missed dose entirely and take your next dose on your regularly scheduled day.

Example: If your injection day is Monday and it's now Thursday, skip this week's dose and resume next Monday.

Important:

Never "double up" to make up for a missed dose. Taking two doses close together increases the risk of severe side effects.

Tips to Avoid Missing Doses

Set a recurring alarm on your phone for injection day
Choose an injection day that's convenient and consistent (many prefer Sunday evenings)
Keep your medication visible as a reminder
Pair your injection with a weekly routine (Sunday meal prep, Monday morning, etc.)
Use a medication tracking app to log doses
Prepare your injection supplies in advance

Microdosing vs Standard Dosing

Microdosing GLP-1 involves using lower-than-standard doses for metabolic benefits, maintenance, or to minimize side effects. This approach has gained popularity for long-term use and longevity purposes.

Common Microdosing Protocols

Semaglutide Microdosing:

0.125 mg to 0.25 mg weekly for maintenance
0.3 mg to 0.5 mg weekly for gentle weight management
Typically 25-50% of standard therapeutic doses

Tirzepatide Microdosing:

1.25 mg to 2.5 mg weekly for maintenance
3 mg to 4 mg weekly for metabolic benefits
Lower than the standard 5 mg starting dose

Who Should Consider Microdosing?

Maintenance phase: Those who've reached their goal weight
Metabolic health: People focused on blood sugar control and longevity
Side effect sensitivity: Those who experience discomfort at higher doses
Cost considerations: Lower doses extend medication supply
Prevention: People with pre-diabetes or metabolic syndrome

For more on this approach, read our comprehensive guide on Microdosing GLP-1 for Longevity.

Maintenance Doses and Long-Term Use

Once you've reached your weight loss goal, you'll need to determine your maintenance dose. This is highly individual and depends on several factors.

Finding Your Maintenance Dose

Your maintenance dose should:

Keep your weight stable (±3-5 lbs variation is normal)
Provide manageable appetite control without excessive suppression
Produce minimal or no side effects
Support your ability to maintain healthy eating habits
Be sustainable financially and practically long-term

Maintenance Dose Strategies

There are several approaches to maintenance dosing:

Strategy 1: Stay at Maximum Effective Dose

Continue the dose that got you to goal weight. Provides strongest appetite control but highest cost and side effect risk.

Strategy 2: Step Down to Maintenance

Gradually reduce to the lowest effective dose. More economical and often better tolerated long-term.

Strategy 3: Cyclic Dosing

Alternate between higher and lower doses, or take periodic breaks. Experimental approach, discuss with your provider.

Strategy 4: Transition to Microdosing

Move to very low doses for metabolic maintenance without active weight loss. Cost-effective for long-term use.

Managing Side Effects During Titration

Even with proper titration, you may experience side effects—especially during the first few days after each dose increase. Here's how to manage them:

Common Side Effects and Solutions

Nausea:

Eat smaller, more frequent meals
Avoid fatty, greasy, or spicy foods
Stay hydrated with small sips of water
Consider ginger tea or anti-nausea medication
Don't lie down immediately after eating

Constipation:

Increase fiber intake gradually
Drink plenty of water (64+ oz daily)
Stay physically active
Consider a stool softener or magnesium supplement

Diarrhea:

Avoid high-fat foods
Reduce artificial sweeteners and sugar alcohols
Stay hydrated with electrolytes
Eat bland, easy-to-digest foods

Fatigue:

Ensure you're eating enough calories and protein
Check for nutrient deficiencies (B12, iron, vitamin D)
Prioritize sleep quality
Stay moderately active to boost energy

When to Contact Your Provider:

Severe or persistent vomiting
Signs of dehydration (dark urine, dizziness, rapid heartbeat)
Severe abdominal pain
Vision changes
Signs of pancreatitis (severe upper abdominal pain radiating to back)
Any side effect that significantly impacts your quality of life

Working with Your Provider on Dosing

Your dosing journey should be collaborative. A good GLP-1 provider will work with you to customize your titration schedule based on your response, tolerance, and goals.

Questions to Ask Your Provider

Can we slow down the titration if I'm experiencing side effects?
What's the minimum effective dose I should try before increasing?
How long should I stay at each dose level?
What should I do if side effects don't improve after a week?
Can I try microdosing instead of the standard protocol?
What's my maintenance plan once I reach my goal?
How often will we reassess my dose?

Signs Your Dose Might Need Adjustment

Consider increasing your dose if:

Weight loss has stalled for 4+ weeks despite healthy habits
Appetite control is insufficient
You have no side effects and tolerate current dose well
You haven't reached therapeutic dose range yet

Consider decreasing your dose if:

Side effects are interfering with daily life
You're losing weight too rapidly (>2-3 lbs per week consistently)
You can't eat enough to meet nutritional needs
You've reached goal weight and need maintenance dosing

Consider staying at current dose if:

You're losing 1-2 lbs per week consistently
Side effects are minimal or manageable
You feel good and can maintain healthy eating
You haven't been at this dose for at least 4 weeks

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The Bottom Line

GLP-1 dosing is both an art and a science. While standard titration schedules provide a framework, your optimal dose depends on your individual response, tolerance, goals, and preferences.

Don't rush the process. Slower titration often means better tolerance and more sustainable results. Work closely with your provider to find the minimum effective dose that produces results without excessive side effects.

Remember: the goal isn't to reach the maximum dose—it's to find YOUR optimal dose. Some people achieve excellent results at lower doses, while others benefit from higher doses. There's no one-size-fits-all approach.

Whether you follow standard protocols or explore microdosing, the key is finding a sustainable approach that supports your long-term health and weight management goals.

Complete GLP-1 Dosing Guide: Semaglutide & Tirzepatide