# Semaglutide Dose and Dosage: The Schedules Studied in the Trials > Semaglutide dose and dosage as documented in the trials and label: titration schedules, the semaglutide injection, oral semaglutide, half-life, and compounded semaglutide. Doses, titration and pharmacokinetics reported in the third person, exactly as documented — never as advice for any individual. ## Before the details This page describes the semaglutide dosage schedules used in published trials and stated on the approved label. It is a record, not a recommendation: nothing here tells any reader what to take. Dosing decisions belong to a prescriber who knows the individual. The pattern across uses is the same — start low, increase slowly. Semaglutide is started at a small dose and stepped up over weeks, because going slowly is what keeps the stomach side effects manageable. It comes two ways: a once-weekly injection under the skin, and a once-daily tablet that must be taken fasted. It also clears slowly, with a half-life of about a week, so the drug level stays steady between weekly doses and lingers for weeks after the last one. Each figure below is tied to a cited source. ## Semaglutide dose and semaglutide dosage: the titration schedules studied Across uses, the semaglutide dosage is built as a slow ramp. For chronic weight management, the subcutaneous schedule documented in the program steps upward over four-week intervals: 0.25 mg once weekly for weeks 1-4, then 0.5 mg, then 1.0 mg, then 1.7 mg, reaching a 2.4 mg once-weekly maintenance dose — the dose that produced the -14.9% mean weight change in STEP 1 [1]. The deliberate ramp exists to limit nausea, which clusters around each increase [16]. For type 2 diabetes, the subcutaneous schedule starts at 0.25 mg once weekly for initiation, then 0.5 mg, then 1.0 mg maintenance, with higher doses studied in dedicated trials. The cardiovascular and kidney outcomes were established at these diabetes doses: 0.5 or 1.0 mg in SUSTAIN-6 [2] and 1.0 mg in FLOW [6]. These are the doses the trials used; they are reported here as trial protocol, not as guidance. ## Semaglutide injection and oral semaglutide The semaglutide injection is given once weekly under the skin and is the formulation behind most of the outcome evidence — STEP, SUSTAIN, SELECT and FLOW all used the subcutaneous form [1][3][6]. Oral semaglutide is a once-daily tablet, and it comes with a strict rule. It is co-formulated with an absorption enhancer called SNAC, because on its own a peptide this size is barely absorbed from the gut — oral bioavailability is only about 0.4-1% [24]. The documented diabetes schedule is 3 mg daily for 30 days, then 7 mg, then 14 mg, taken on an empty stomach about 30 minutes before the first food, drink or other medication, with no more than roughly 120 mL of water [23]. Higher oral doses of 25 mg and 50 mg have been studied for diabetes and obesity in the PIONEER PLUS and related programs [13]. Because absorption is so fragile, taking the tablet incorrectly can substantially reduce the dose that actually reaches the body [24]. ## Half-life and how long it stays in the system Semaglutide has an elimination half-life of about one week — commonly cited as roughly 165-168 hours — for both the injection and the tablet, with effectively complete clearance around five weeks after the last dose [23]. That long half-life is the direct result of its design: strong, reversible binding to the blood protein albumin via the fatty-acid tail, plus resistance to the DPP-4 enzyme from the position-8 substitution [5]. The practical consequences are twofold. Drug levels stay steady from one weekly dose to the next, which is the whole point of once-weekly dosing. And the drug lingers: it does not leave the body quickly when stopped, which is why pregnancy guidance advises a washout of roughly two months before planned conception [23]. For research dosing context, investigational higher weekly doses (such as 7.2 mg in a high-dose obesity program) have also been studied. ## Compounded semaglutide Compounded semaglutide is semaglutide prepared by a compounding pharmacy rather than the approved, manufactured product. During the federally declared shortage from roughly 2022 to early 2025, compounding was permitted to fill the gap [2]. The compounded route sits outside the approved-product evidence base: regulators documented dosing errors, adverse events requiring hospitalization, and products containing unverified or non-pharmaceutical ingredients. After the shortage was declared resolved in early 2025, the compounding pathways were curtailed, leaving ongoing regulatory and telehealth uncertainty. The key point for a reader weighing the literature: the efficacy and safety figures throughout this digest come from trials of the manufactured product. They do not automatically transfer to a compounded preparation of uncertain identity, dose or purity. This is a quality-and-safety distinction, not an endorsement or a sales position — this site sells nothing. --- A calm reading room for the semaglutide literature — the brain's appetite circuitry, the STEP, SUSTAIN, SELECT and FLOW readouts, and the honest open questions, cited from the published record and prescribed by no one.