GLP-1 titration chart

Find your product across the top of the first table if you inject, the second if you take tablets. Read down to your week or day and that cell is the dose the label permits. It is the EARLIEST permitted, never a dose you are behind on: every label here words its interval as "at least" four weeks or thirty days, and there is no upper bound on how long you stay where you are.

Greyed cells are rungs the label does not approve as somewhere to stay — an initiation dose it says is not effective, or a step the increment passes through. A cell that is not greyed is a dose the label names as a destination. Mounjaro has no greyed cells above the starting dose at all, because its label names no maintenance dosage and any rung can be where treatment settles.

Never read across the four injection columns as if they were the same scale. 1 mg of Wegovy is the third rung of five; 1 mg is not a Mounjaro dose at all. The labels state in terms that Rybelsus and Ozempic tablets "are not substitutable on a mg-to-mg basis", and no equivalence exists between an injection and a tablet either.

The fourth table is the half of the schedule that most printed charts drop: what each label says when a dose is not tolerated or two are missed. Only four of the seven labels say anything at all, and they do not say the same thing. Where a cell reads "the label is silent", that is a fact about the document, not a gap in this sheet.

Weekly injections — the escalation ladder by week

The earliest dose each label permits in each week, counting the first injection as week 1. Nothing here is a due date.

Wegovy injection is the only column here whose week numbers the label prints: Table 1 runs 1 through 4 at 0.25 mg, 5 through 8 at 0.5 mg, 9 through 12 at 1 mg, 13 through 16 at 1.7 mg and "17 and onward" at the maintenance dosage. Ozempic and Mounjaro gate every step above the first on "if additional glycemic control is needed", so most patients never reach the bottom of those columns. Zepbound escalates once to 5 mg unconditionally and then "in 2.5 mg increments, after at least 4 weeks on the current dose". Above the ladder, Wegovy injection permits one further step the label keeps out of its dosing table: 7.2 mg once weekly, for weight reduction in adults only, after tolerating 2.4 mg for at least 4 weeks, which makes week 21 the earliest it could begin. That week number is the sum of two figures the label prints, not one it prints itself.

Oral semaglutide — the escalation ladder by day

Tablets step every 30 days, not every 4 weeks. Counting the first tablet as day 1.

Thirty days is not four weeks. A tablet reaching its third step on day 61 is two days behind an injection reaching its third step in week 9, which is day 57, and after three steps the two calendars have drifted six days apart. Read each column on its own: the label states that Rybelsus and Ozempic tablets "are not substitutable on a mg-to-mg basis", which is why 7 mg of Rybelsus sits opposite 4 mg of Ozempic tablets and not opposite 7 mg. Rybelsus 3 mg and Ozempic tablets 1.5 mg are greyed because the label says of each, verbatim, "this dosage is not effective for glycemic control" — they exist to get a patient onto the drug. Wegovy tablets run four steps to a 25 mg maintenance dosage, the largest milligram figure of any semaglutide product and more than ten times Ozempic injection's 2 mg maximum, which is the clearest demonstration on this sheet that a milligram number alone tells you nothing without the brand.

Every labelled schedule at a glance

One row per product. Read down a row; the week column and the day column measure different things and must not be compared across.

Mounjaro's maintenance cell is empty because the word "maintenance" does not occur anywhere in that label — not in section 2, not once in the document. Its escalation happens only "if additional glycemic control is needed", so 2.5 mg once weekly can be where treatment settles, and that is why its earliest-maintenance cell reads Week 1. The paediatric Mounjaro row is the same label stopped at 10 mg, which is the only paediatric dosage difference in it; Zepbound has no paediatric dosage at all and therefore no row. Wegovy injection's 7.2 mg maximum is the conditional high dose rather than a rung of the ladder, reachable no earlier than week 21 and only for weight reduction in adults. No row exists for compounded semaglutide or compounded tirzepatide: neither has approved labelling, so neither has a labelled schedule to reproduce.

When the titration does not go to plan

What each label actually says about delaying a step, missing doses and not tolerating a maintenance dosage. Quoted, and blank where the label is blank.

Only four of the seven labels contain any of these instructions, and the two that contain a delay do not agree. Wegovy INJECTION, section 2.2, verbatim: "If patients do not tolerate a dose during dosage escalation, consider delaying dosage escalation for 4 weeks." Wegovy TABLETS, section 2.3, verbatim: "If patients do not tolerate a dose during dosage escalation, consider delaying dosage escalation." — the tablet sentence stops one clause short and never says by how much, so no number is printed in that cell. After missed doses, Wegovy injection section 2.4, verbatim: "If 2 or more consecutive doses of WEGOVY injection are missed, reinitiate dosage escalation at a lower dosage to reduce the risk of gastrointestinal adverse reactions". It does not say which lower dosage, and neither does this chart: from 1.7 mg the steps below are 0.25, 0.5 and 1 mg, and choosing between them is a prescriber's decision. Zepbound, section 2.1, verbatim: "If patients do not tolerate a maintenance dosage, consider a lower maintenance dosage." Delaying is not stopping: you stay on the dose you are already on for longer, so that window lengthens rather than a gap opening in the calendar.

Switches the labels actually authorise

The complete list. Any pairing not on it has no labelled equivalence, and none of these is a mg-for-mg conversion.

Six switches, and no seventh. Readers want a general milligram equivalence between an injection and a tablet, or between one tablet brand and another, and the label refuses to give one: "RYBELSUS and OZEMPIC tablets are not substitutable on a mg-to-mg basis." Note what the pairings imply rather than state — 0.5 mg of Ozempic injection maps to 7 mg or 14 mg of Rybelsus, a fourteen- to twenty-eight-fold difference in milligrams for the same molecule, because an oral tablet's bioavailability is nothing like an injection's. There is no authorised switch between a semaglutide product and a tirzepatide one in either direction; they are different molecules and the labels say nothing about moving between them. Both Wegovy switch rules are between the 2.4 mg injection and the 25 mg tablet only, and the tablet-to-injection direction offers 1.7 mg instead for a patient who did not tolerate 25 mg.

Frequently asked questions

How long do you stay on each GLP-1 dose?

At least four weeks for every injection here and at least thirty days for every tablet, and "at least" is the operative phrase. Ozempic escalates "after at least 4 weeks on the 0.5 mg dosage"; Mounjaro and Zepbound escalate "in 2.5 mg increments after at least 4 weeks on the current dose". No label sets an upper bound and none obliges anyone to keep climbing. Two labels name doses below the top of the ladder as maintenance in their own right — Wegovy at 1.7 mg and Zepbound at 5 mg and 10 mg — and Mounjaro names no maintenance dosage at all, so 2.5 mg once weekly can be the destination.

What week do you reach the maintenance dose on Wegovy?

Week 17 at the earliest. Wegovy injection Table 1 prints the windows: 0.25 mg in weeks 1 through 4, 0.5 mg in weeks 5 through 8, 1 mg in weeks 9 through 12, 1.7 mg in weeks 13 through 16, and "17 and onward" at the maintenance dosage, which is 2.4 mg recommended or 1.7 mg where 2.4 is not tolerated. One further step exists above that: 7.2 mg once weekly for weight reduction in adults, permitted only after tolerating 2.4 mg for at least four weeks, so week 21 is the earliest. The label gates that step on tolerance rather than putting it in Table 1, so week 21 is a sum of two figures the label prints, not a number it prints.

How long does it take to get to 15 mg of Zepbound or Mounjaro?

Twenty-one weeks at the fastest either label allows. The ladder is 2.5, 5, 7.5, 10, 12.5 and 15 mg, five escalations at four weeks each, so the earliest week at the top rung is week 21. Most people do not go there. Zepbound names 5 mg, 10 mg and 15 mg as maintenance dosages for weight reduction and 10 mg or 15 mg for obstructive sleep apnoea, which makes 7.5 and 12.5 mg rungs the increment passes through rather than destinations. Mounjaro names none of the six as maintenance. Mounjaro also caps paediatric patients aged 10 and over at 10 mg.

Can I delay a GLP-1 dose increase if I feel sick?

Wegovy injection is the only one of the seven whose label says how long: "If patients do not tolerate a dose during dosage escalation, consider delaying dosage escalation for 4 weeks." Wegovy tablets say to consider delaying and never say by how much, so this chart prints no figure for them. Ozempic, Rybelsus, Ozempic tablets, Mounjaro and Zepbound carry no delay instruction at all. What every label does say is that the escalation exists "to reduce the risk of gastrointestinal adverse reactions" — going slower is squarely within what the labels contemplate, and going faster is not. Delaying means staying on the dose you are on for four more weeks, not pausing the drug.

What happens if I miss two GLP-1 doses in a row?

For Wegovy injection the label is explicit: "If 2 or more consecutive doses of WEGOVY injection are missed, reinitiate dosage escalation at a lower dosage to reduce the risk of gastrointestinal adverse reactions". It does not say which lower dosage, and this chart will not choose one. None of the other six labels contains a reinitiation instruction. For a single missed dose the windows differ by product: Ozempic within 5 days, Mounjaro and Zepbound within 4 days (96 hours), Wegovy injection if the next scheduled dose is more than 2 days away, and all three tablets simply skip the dose and take the next one the following day.

Is there a titration chart for compounded semaglutide?

Not an authoritative one, and this sheet will not invent it. Compounded semaglutide and compounded tirzepatide are not FDA-approved and carry no approved labelling, so there is no labelled escalation schedule to reproduce, no approved concentration, and nothing to check a compounded titration against. All seven schedules here are transcribed from a current Structured Product Label on DailyMed, and each of those labels was checked for its marketing category before anything was quoted from it. If you have been handed a compounded titration plan, the doses and intervals in it came from whoever wrote it.

Why is my tablet schedule in days when my injection schedule is in weeks?

Because the labels are written that way, and the two units do not line up. Wegovy tablets step on days 1, 31, 61 and 91; Wegovy injection steps on weeks 1, 5, 9, 13 and 17, which are days 1, 29, 57, 85 and 113. A 30-day step is two days longer than a 28-day one, so after three steps the tablet calendar has drifted six days from the injection calendar. Converting one into the other, or either into months, is how a step lands on the wrong date.

Are the week numbers on this chart deadlines?

No, and that is the single most important thing on the sheet. Only Wegovy injection and Wegovy tablets escalate on a printed calendar; the other five products gate every step above the first on a condition — "if additional glycemic control is needed" for Ozempic, Rybelsus, Ozempic tablets and Mounjaro, and response and tolerability for Zepbound's maintenance selection. For those five, a week number here is the earliest a step could begin if it is taken at all. Every interval in every label is a minimum with no stated maximum, so a patient at 1 mg in week 20 is not behind.

Sources

1. [1]WEGOVY (semaglutide) injection and tablets — full US prescribing information, Novo Nordisk. Section 2.2 Table 1 (week windows), 2.3 Table 2 (day windows), 2.4 missed doses, 2.5 switching. Marketing category NDA, NDA215256. DailyMed set id ee06186f-2aa3-4990-a760-757579d8f77b
2. [2]OZEMPIC (semaglutide) injection — full US prescribing information, Novo Nordisk. Section 2.1 missed doses, 2.2 recommended dosage and escalation, 3 dosage forms and strengths. Marketing category NDA, NDA209637. DailyMed set id adec4fd2-6858-4c99-91d4-531f5f2a2d79
3. [3]RYBELSUS and OZEMPIC (oral semaglutide) tablets — full US prescribing information, Novo Nordisk. Section 2.2 starting, escalation and maintenance dosage, 2.3 switching between the two tablets, 2.4 switching from the injection. Marketing category NDA, NDA213051. DailyMed set id 27f15fac-7d98-4114-a2ec-92494a91da98
4. [4]MOUNJARO (tirzepatide) injection — full US prescribing information, Eli Lilly and Company. Section 2.1 recommended dosage and escalation, 2.2 administration, 8.4 paediatric use. DailyMed set id d2d7da5d-ad07-4228-955f-cf7e355c8cc0
5. [5]ZEPBOUND (tirzepatide) injection — full US prescribing information, Eli Lilly and Company. Section 2.1 recommended dose escalation schedule, 2.2 maintenance and maximum dosage, 2.3 missed dose. DailyMed set id 487cd7e7-434c-4925-99fa-aa80b1cc776b
6. [6]U.S. Food and Drug Administration — FDA’s Concerns with Unapproved GLP-1 Drugs Used for Weight Loss, including adverse events from doses beyond the approved label and accelerated titration schedules