Can I start Wegovy at 1.7 mg?
Can you start Wegovy at 1.7 mg? The answer is a hard no, and ignoring it risks severe side effects.
Key highlights
- You should not start Wegovy at 1.7 mg. Starting at a low dose allows your body to adjust to the medication and minimize the risk of serious side effects.
- The FDA suggests a gradual titration schedule, starting the medication with 0.25 mg once weekly for four weeks, until you reach the maintenance dose of 1.7 mg or 2.4 mg.
- Starting Wegovy at 1.7 mg can cause gastrointestinal side effects, such as vomiting and diarrhea, which lead to dehydration when left untreated. Prolonged dehydration can result in kidney damage, and sometimes patients may require dialysis.
- In case of medicine unavailability, talk to your doctor about free samples, pharmacies that may have 0.25 mg subcutaneous Wegovy injections, or alternatives to Wegovy.
- Always consult your healthcare provider before starting any weight loss medication, who will prescribe the drug and dosing strength best suited to your needs.
Wegovy (semaglutide) is a subcutaneous injection approved by the U.S. Food and Drug Administration (FDA) for weight loss in adults and children over 12 years of age for obesity (body mass index greater than 30). It is also prescribed to overweight adults (BMI greater than 27) with weight-related health conditions (e.g. type 2 diabetes, high blood pressure, or heart disease) for weight management with lifestyle changes. The medication comes in prefilled, single-dose pens of 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, and 2.4 mg.
When prescribed Wegovy for weight management, patients sometimes wonder, “If a higher dose is more effective, why not start there and get to my goal faster?”
Starting Wegovy at a dose of 1.7 mg is not recommended. The manufacturer, Novo Nordisk, suggests a starting dose of 0.25 mg, gradually increased to higher doses every 4 weeks.
The Wegovy dosing guide suggests dose initiation at 0.25 mg once weekly for four weeks, escalated to the next dose every four weeks through week five until week fifteen. It takes around 13 weeks to reach 1.7 mg, and the maintenance dose of 2.4 mg from week fifteen onward. If it does not suit you, your healthcare provider might recommend a maintenance dose of 1.7 mg. Patients usually start losing weight within the first month, even at the starting dose of 0.25 mg.
Patients taking Wegovy often report side effects, such as constipation, nausea, vomiting, heartburn, and diarrhea. While these side effects may be mild in most cases, some people may not tolerate them well. The side effects are typically less at low doses, which is why dose escalation or titration is suggested for weight loss medication. Once your body adjusts to the low dosage of Wegovy, you may not experience the side effects as the dose increases. However, in case you start with a higher dose, your body might react severely to these drugs.
In this article, we’ve shared all the important information on Wegovy dosing, including the official dosing schedule, risks of starting with a higher dose, and what to do when there’s a shortage of the low-dose Wegovy pens. We’ve also shared the safety and tolerability of semaglutide, what a 1.7 mg maintenance dose means, and how to handle accidental 1.7 mg starts when taking the medication.
Wegovy dosage schedule: A safe path to 2.4 mg
Wegovy (semaglutide) subcutaneous single-dose injections come in five strengths:
- 0.25 mg/0.5 mL
- 0.5 mg/0.5 mL
- 1 mg/0.5 mL
- 1.7 mg/0.75 mL
- 2.4 mg/0.75 mL
The FDA-approved titration schedule recommends starting Wegovy at the lowest available dose (0.25 mg once weekly).
Novo Nordisk, the manufacturer of Wegovy, provides a detailed schedule for Wegovy titration to avoid and reduce possible side effects:
| Treatment phase | Duration | Weekly dose |
|---|---|---|
| Initiation | Weeks 1-4 | 0.25 mg |
| Escalation | Weeks 5-8 | 0.5 mg |
| Weeks 9-12 | 1 mg | |
| Weeks 13-16 | 1.7 mg | |
| Maintenance | Week 17 onward | 2.4 mg or 1.7 mg |
The label recommends taking each dose for at least four weeks before escalating to a higher dose to allow your body time to adjust to the medication. Sometimes, your doctor might instruct you to take a dose for longer if the side effects are intolerable.
The Wegovy Quick Start Guide shares a few important details about the subcutaneous pen, including:
- The pen is one-time use only. Discard it after use.
- The dose is already set on your pen.
- You can inject the Wegovy pen into your upper arm, thigh, or abdomen.
- It is suggested to rotate the injection site to avoid pain, redness, or swelling.
The maintenance dose
The maintenance dose is the ongoing dose of a medication after the dose adjustment or titration phase. It is typically decided by a healthcare professional considering the patient’s tolerance to the prescribed dose. Most patients take Wegovy 2.4 mg as the maintenance dose, which is the highest available dose. If the patient does not tolerate the side effects at 2.4 mg, the doctor might prescribe 1.7 mg once weekly as the maintenance dose.
Choosing between Wegovy 1.7 mg and 2.4 mg maintenance dose
According to the FDA, 2.4 mg is the recommended maintenance dose of Wegovy for weight loss in obese and overweight individuals with weight-related medical conditions, such as hypertension, cardiovascular disease, hyperlipidemia, or obstructive sleep apnea.
Clinical trials show that adults taking Wegovy 2.4 mg for 68 weeks lost 14.9% (15.3 kg on average) of their body weight. Results concluded that 86.4% participants lost 5% or more of their body weight, followed by 69.1% losing 10% or more, and 50.5% losing 15% or more of their total body weight before starting the weight loss medication. Patients taking semaglutide also reported improvements with respect to cardiometabolic risk factors. Participants in the study were administered semaglutide at a starting dose of 0.25 mg, eventually increasing it over 16 weeks, along with a reduced-calorie diet and physical activity.
Patients taking semaglutide for the first time might want to start the treatment with a higher dose because of better efficacy. While higher doses may help you achieve your weight loss goals faster in the first few weeks, your body may not tolerate the side effects.
It has been reported that the highest dose of Wegovy, 2.4 mg, gives the best weight loss results. SUSTAIN 1 to 5 trials showed a weight loss of 3.5 to 4.3 kg in patients taking 0.5 mg and 4.5 to 6.4 kg in patients taking 1 mg, compared to 15.3 kg in patients taking 2.4 mg of Wegovy once weekly. However, the adverse effects are also more common with higher doses compared to lower doses. A study analyzing the gastrointestinal tolerability of once‐weekly semaglutide concluded that adverse events were more frequent with semaglutide 2.4 mg. Results demonstrated that 87.6% of the participants on semaglutide 2.4 mg experienced adverse events, compared to 81.8% among those on semaglutide 1.0 mg.
Doctors suggest taking 2.4 mg as the maintenance dose when well-tolerated by patients, and 1.7 mg as the maintenance dose when the patient cannot tolerate the side effects of a higher dose.
Why the Wegovy titration schedule matters
Titration refers to changes in medication doses to achieve the best clinical response. The dose may be up-titrated to offer the best relief to the patient or down-titrated to lessen side effects. It allows your body to adjust to the new dose slowly.
Patients taking Wegovy report adverse effects, including gastrointestinal side effects, such as vomiting, nausea, constipation, diarrhea, and abdominal pain. GI tolerance is a limiting factor in Wegovy dosing, as prolonged gastrointestinal issues, such as vomiting and diarrhea, may cause dehydration, which can lead to kidney damage.
When starting weight loss drugs like Wegovy, doctors recommend up-titration over weeks until the patients reach the maximum dose for the most optimal weight loss results. In case the patient does not tolerate the maximum dose (2.4 mg), the dose may be down-titrated to 1.7 mg to offer a balance between efficient weight loss and tolerable side effects.
The active ingredient in Wegovy, semaglutide, is a glucagon-like peptide-1(GLP-1) receptor agonist that delays gastric emptying and signals the brain to reduce hunger. If you take a high dose of the medication too soon, your body may go into shock, leading to severe GI distress and side effects.
Can you start at Wegovy 1.7 mg?
You cannot start Wegovy at 1.7 mg. The FDA has approved Wegovy 0.25 mg as the starting dose.
It is important to follow the approved titration schedule to avoid adverse gastrointestinal effects at higher doses. Typically, your doctor will suggest starting the treatment with 0.25 mg once weekly and increasing the dosing to 0.5 mg per week after 4 weeks of treatment. Similarly, after taking 0.5 mg for four weeks, they will up-titrate the weekly dose to 1 mg, followed by 1.7 mg, and 2.4 mg every four weeks. Sometimes, they might suggest staying on a specific dose for longer if your body does not tolerate the side effects.
In some cases, a healthcare professional may suggest a different dosing regimen depending on your specific condition. For example, they might up-titrate the dose in case you do not lose weight on a lower dose. Patients taking semaglutide in a different form or a different brand name previously might not need to start Wegovy at 0.25 mg. However, the doctor would not start treatment at a 1.7 mg dose in all cases.
If a patient cannot tolerate dose escalation at any stage, the FDA allows staying on the prior tolerated dose and delaying escalation instead of discontinuing therapy. The label does not endorse a different starting dose for any patient.
Potential side effects of starting at Wegovy 1.7 mg
The incidence of GI-related side effects of Wegovy is higher at higher doses of Wegovy. Starting the medication at low doses helps your body adjust to the side effects. Gastrointestinal side effects of Wegovy may cause fluid loss and dehydration, leading to kidney injury. The risk of kidney damage is higher if the patient is directly administered 1.7 mg or 2.4 mg because of the strength of the active ingredient. You might even need to stop the medication before gaining benefits from it.
Gastrointestinal distress
Gastrointestinal side effects are common with all doses of Wegovy, though they may vary in intensity from person to person.
Here are some anecdotal comments from users on Reddit:
A patient who jumped to 1.7 mg from 0.5 mg experienced severe nausea, vomiting, diarrhea, and sulfur burps, and decided to stay on the same dose to avoid the risk of further serious side effects.
Another patient who moved to 1.7 mg from 0.5 mg experienced uncomfortably higher heart rate, diarrhea, and extreme fatigue.
A patient who started the medication at 1.7 mg because of a shortage of lower doses mentioned that they thought they were going to die and felt like their stomach was eating itself.
Another user who accidentally took 2.4 mg as their first Wegovy dose experienced extreme pain, shaking, sweating, fever, nausea, headache, and projectile vomiting every 45 hours for 24 hours. It took them almost three days to recover.
Risk of dehydration and other complications
Prolonged vomiting and diarrhea can lead to fluid depletion that can cause dehydration in patients taking Wegovy for weight loss. When left untreated, dehydration can also damage the kidneys, resulting in acute kidney injury, especially in patients with underlying kidney disease. The Wegovy FDA label mentions acute kidney injury and worsening of chronic renal failure in patients taking GLP-1 receptor agonists, even sometimes requiring hemodialysis. Kidney damage is more prevalent in patients who experience dehydration due to diarrhea, nausea, or vomiting. These side effects are reported more frequently among those taking higher doses. Severe dehydration and loss of electrolytes from the body due to gastrointestinal side effects at 1.7 mg or higher may require immediate medical attention or an emergency room visit.
Psychological impact and treatment abandonment
Wegovy has helped patients lose a notable amount of weight when taken consistently over months. However, the side effects can sometimes be intolerable for patients, leading to treatment abandonment. In the SELECT trial, 16.60% of participants taking Wegovy withdrew from the trial because of adverse events (AEs). At the same time, 5.9% of participants in the STEP 5 trial (2-year maintenance) stopped Wegovy treatment because of adverse events.
Prolonged use of Wegovy is also associated with depression and suicidal thoughts in patients. A patient reported on Reddit extreme cramping and anxiety attacks after accidentally taking a double dose of Wegovy while they were already taking antidepressants.
You must pay attention to sudden changes in behavior, thoughts, mood, or feelings and discuss them with your healthcare provider. Sometimes, the adverse effects, at higher doses especially, may be traumatic and too much to handle for some people, causing them to quit Wegovy and hinder their chance for long-term success.
The risks of skipping doses
You might have heard about the effectiveness of Wegovy 1.7 mg and how it helped many patients lose more weight than any of the previous doses. However, titrating weight loss medications, such as semaglutide, is necessary to ensure that your body adjusts to the new medication.
When starting Wegovy, your doctor will start you at a low dose to avoid or minimize common side effects like nausea, vomiting, and diarrhea. Starting at a higher dose can cause more severe side effects that may make the treatment intolerable.
Think of it as trying a HIIT (high-intensity interval training) workout to burn fat and lose weight faster when you have never exercised previously. While it may have faster results, intense training will strain your heart and increase your chances of injury being an amateur. In contrast, if you start with moderate weight training and workout, and eventually build your stamina for HIIT, your body will adapt to the strenuous exercise more efficiently. Similarly, titration prepares your body for the side effects you may experience more severely at higher doses.
Why can’t my doctor just let me start higher?
Even if you emphasize starting with a higher dose, your doctor will not prescribe you 1.7 mg or 2.4 mg of Wegovy right away. The FDA guidelines for Wegovy recommend starting the medication at 0.25 mg once weekly for four weeks and increasing the dose to 0.5 mg once weekly for the next four weeks before increasing to 1 mg once weekly for four weeks, then 1.7 mg once weekly for 4 weeks, and then 2.4 mg once weekly. This is to ensure the efficacy and safety of the medication and to avoid serious side effects. Clinical studies do not provide any data on the use of 1.7 mg as the starting dose, making it a risky choice.
Physicians follow the Prescribing Information (label) from Novo Nordisk as a guideline to ensure patient safety and optimal results, and typically do not deviate from the standard protocol for fast results.
What to do if you can’t find the starting doses during shortages
GLP-1 receptor agonist drugs have become extremely popular since their FDA approval for weight loss, type 2 diabetes, heart disease prevention, and other health conditions. This often leads to a shortage of Wegovy injections, especially the 0.25 mg and 0.5 mg doses. Here’s what you can do when you cannot find the starting dose of Wegovy during shortages.
Talk to your pharmacist
Shortage of a specific dose of the drug you want can be frustrating, but it is quite common. The best is to keep in touch with your pharmacist and request that they inform you whenever the drug is available. You can also inquire about other locations that stock Wegovy injections.
Contact your doctor immediately
When you cannot find the desired dose, do not take a higher dose of the medication. Talk to your doctor, and they may:
- Prescribe a different GLP-1 drug, such as Saxenda (liraglutide) or Zepbound (tirzepatide), to get you started on your weight loss journey. If it does not suit you or you wish to try Wegovy, you can switch to it when available.
- Suggest you wait for the drug to be available in the starting dose and provide guidance on diet and exercise in the meantime.
- Offer Wegovy samples or inform you of other pharmacies that stock Wegovy 0.25 mg.
The danger of “dose splitting”
Sometimes, a healthcare professional or an acquaintance might suggest you take a pen with a higher dose and split the dose per week by counting the number of clicks for accurate dosing. It might seem like a good idea, but it can be quite dangerous. Pre-filled subcutaneous Wegovy pens are intended for single use and must be discarded after taking the dose. Reusing the injection increases the risk of contamination and may pose a safety risk due to inaccurate dosing.
What to do if you accidentally start at 1.7 mg
If you accidentally start Wegovy at 1.7 mg and experience severe vomiting, nausea, diarrhea, or any other side effects, stay hydrated and talk to your healthcare provider right away. Your doctor might recommend delaying further escalation or adjusting the dose to a lower one. Do not change the dose on your own without consulting your healthcare provider.
A patient reported on Reddit that they had to go to the emergency room after accidentally starting Wegovy at 1.7 mg as they experienced migraine, nausea, diarrhea, and severe vomiting. They could not even drink water, making it hard to stay hydrated.
In case over-the-counter (OTC) medications and drinking water are not enough, visit the ER immediately to get your fluids replenished and avoid serious dehydration.
Managing common side effects during titration
Patients experiencing nausea and vomiting are advised to eat bland meals and avoid fatty/ spicy foods. It is also recommended to eat frequent meals and smaller portions to avoid unease. You can try chewing on ginger for immediate relief and ask your doctor about antiemetics if the symptoms do not subside with home remedies.
Diarrhea and constipation are quite common with Wegovy use, and you can manage them by adding more fiber to your diet. Add probiotics suggested by your healthcare provider to your diet, and make sure to stay hydrated.
Semaglutide (Ozempic) is widely used for lowering blood sugar levels, and Wegovy, with the same active ingredient, may also cause hypoglycemia in patients with diabetes. Make sure to inform your doctor if you have type 2 diabetes or take blood glucose-lowering medications, to avoid low blood sugar.
In case you experience persistent vomiting, dehydration, fainting, severe abdominal pain, or notable changes in mood and behavior (including suicidal thoughts) when taking Wegovy, report these adverse events to the doctor immediately for adequate medical advice.
FAQs about Wegovy dosing
Can I go from 0.5 mg to 1.7 mg?
No, you cannot go from 0.5 mg to 1.7 mg directly. A comment on Reddit by a patient jumping to 1.7 mg from 0.5 mg reported diarrhea, fatigue, and sulfur burps, while another had an uncomfortably high heart rate. Doctors suggest gradually increasing the dosage every 4 weeks to help minimize the risk of side effects and avoid serious gastric and psychological distress.
Is the 1.7 mg dose strong?
Though 1.7 mg is not the highest dose of Wegovy, it is one of the standard maintenance doses. It is highly effective, and patients report losing 7.4 lbs in their first month of use. Yet, many users mention experiencing the worst side effects on 1.7 mg, even compared to 2.4 mg.
What if I’ve been on Ozempic® before?
If you have been taking Ozempic, you can switch to the same dosage of Wegovy because it contains the same active ingredient, semaglutide. However, it is not recommended to select the dose of the new drug yourself. Starting Wegovy at 1.7 mg may result in serious gastrointestinal side effects along with fatigue, cramps, and anxiety. Your doctor might not prescribe you the smallest dose, but suggest a more suitable dose of Wegovy, considering your previous use of Ozempic.
Do I lose weight at the lower doses?
Yes, patients start losing weight even with the starting dose of 0.25 mg. The weight loss and side effects may vary from person to person, making it important to stay consistent. Most patients taking Wegovy mention losing significant weight when they reach 1.7 mg and 2.4 mg after 13 weeks of the treatment plan.
Can I move up a dose faster than 4 weeks if I have no side effects?
Novo Nordisk provides a titration schedule that suggests increasing the Wegovy dose every four weeks. Sometimes, patients with serious side effects may be asked to continue a specific dose for more than four weeks.
If you do not have any side effects, it is strongly recommended to follow the recommended titration schedule instead of self-escalating the dose.
How long until I reach 1.7 mg?
Typically, patients taking Wegovy reach the 1.7 mg dose in weeks 13-16 (3-4 months).
If I can’t tolerate 2.4 mg, can I stay at 1.7 mg permanently?
Yes, 1.7 mg is a common and approved maintenance dose if your body does not tolerate 2.4 mg and the side effects worsen. You can keep taking 1.7 mg of Wegovy for as long as your doctor recommends.
Can adolescents start at 1.7 mg?
A study on semaglutide for the Management of Obesity in Adolescents mentions that adolescents can receive semaglutide for weight loss, but the dosing regimen is the same as adults. Adolescents will follow the same titration schedule, instead of starting at a higher dose. The dose may be reduced for tolerability, if needed. According to the manufacturer, the starting dose of Wegovy for adolescents is 0.25 mg weekly, increased every four weeks until a maintenance dose of 1.7 mg or 2.4 mg once weekly is reached.
What if I miss a dose?
If you miss your scheduled Wegovy dose, and it has been less than five days since the scheduled day, you can take it. In case it has been more than five days after the scheduled day, skip the missed dose and take your next scheduled dose on the designated day to avoid overdosing.
I’ve been on Mounjaro or Zepbound. Can I start Wegovy at 1.7 mg?
Starting Wegovy at 1.7 mg when you have been taking Mounjaro or Zepbound depends on your healthcare professional. They can evaluate your current medical condition and side effects to suggest the alternative dose of Wegovy accordingly. Always talk to your doctor before starting a new dose of weight loss medication.
How long does it take for Wegovy to work for weight loss?
Some patients start experiencing weight loss within the first few weeks, whereas others do not feel any notable difference in their body weight until they reach the maintenance dose. Everyone’s experience may differ. Lower doses are typically for adjustment to the side effects, and you’ll be able to notice significant weight loss at higher doses.
Conclusion: Patience is key to success
The significant weight loss reported by patients on Wegovy 1.7 mg and 2.4 mg doses might make you think of starting the medication at a higher dose for fast results. However, you must consider the gastrointestinal side effects, including nausea, vomiting, diarrhea, and constipation, associated with Wegovy use, especially at higher doses.
The Wegovy prescribing information recommends starting your weight loss treatment with the 0.25 subcutaneous injection once weekly for four weeks to allow your body to adjust to the medication. Many people start losing weight on the starting dose within a few weeks. The dosage is then increased to 0.5 mg, 1 mg, 1.7 mg, and 2.4 mg gradually. Most patients take 1.7 mg or 2.4 mg as the maintenance dose.
Skipping the titration regimen and starting Wegovy with the 1.7 mg dose may cause severe GI side effects, and prolonged vomiting and diarrhea can lead to dehydration. The FDA guidelines mention that loss of fluid and electrolytes can result in worsening of existing renal disease and cause acute renal injury. Wegovy has been clinically tested for safety and efficacy when following the FDA-approved dose titration. There are no safety studies on taking 1.7 mg as the starting dose.
If you plan to start Wegovy or are unable to find the lowest dose, always consult your healthcare professional for the best solution. They might offer you samples, help you find the injection at other pharmacies, or suggest an alternative. Do not use Wegovy or any other weight loss injection without your doctor’s prescription. Always consult your healthcare provider if you cannot find Wegovy injections or are unable to tolerate the side effects at any dose.
