Protocol Reference — Semaglutide

Titration Start

0.25 mg SC weekly for 4 weeks

GI tolerance adaptation period. Do not skip.

Step 2

0.5 mg SC weekly for 4 weeks

Assess GI tolerability before proceeding.

Step 3

1.0 mg SC weekly for 4 weeks

Maintenance dose for type 2 diabetes. Weight management continues titrating.

Step 4 (weight)

1.7 mg SC weekly for 4 weeks

Intermediate step. Monitor for dose-limiting GI effects.

Step 5 (weight)

2.4 mg SC weekly (maintenance)

Target maintenance dose for weight management (Wegovy). Slow titration reduces GI discontinuation from 5-10% to 2-3%.

Oral alternative

3 mg daily x30d, then 7 mg x30d, then 14 mg daily

Rybelsus. 14 mg oral daily is roughly equivalent to 1 mg SC weekly in systemic exposure.