Semaglutide starts at 0.25 mg once weekly and steps up roughly every four weeks toward a maintenance dose, a rhythm designed to build tolerance before the dose becomes therapeutically active. What most dosing pages skip is the part that confuses people day to day: compounded semaglutide is not drawn in milligrams, it is drawn in units on a syringe, and the number of units depends entirely on your vial concentration. This guide gives you both, in mg and in units, with the conversion worked out in plain language.
The standard titration schedule increases the dose every four weeks, giving your body time to adjust before the next step. This chart describes how a typical schedule is structured. It is reference, not instruction. Your own prescriber sets and adjusts your actual dose based on how you respond.
| Weeks | Dose (mg per week) | What is happening |
|---|---|---|
| 1 to 4 | 0.25 mg | Tolerability phase, not yet a therapeutic dose |
| 5 to 8 | 0.50 mg | Early appetite effects begin for most patients |
| 9 to 12 | 1.0 mg | Active phase for most patients |
| 13 to 16 | 1.7 mg | Continued escalation if well tolerated |
| Week 17 onward | 2.4 mg | Standard maintenance dose |
| Extended, eligible patients | Up to 7.2 mg | Approved March 2026 for patients who have tolerated 2.4 mg for at least four weeks. Requires physician evaluation. |
Providers can pause at any step if side effects need more time to settle, and not everyone needs to reach the highest dose. The goal is the lowest dose that produces steady results, not a specific number on a chart.
This is where most confusion happens, and it is specific to compounded semaglutide. Compounded semaglutide is not measured in milligrams at the syringe. It is measured in units on a U-100 insulin syringe, and how many units equal your prescribed dose depends entirely on the concentration of your specific vial.
The chart below is reference only, not instruction. Compounded dosing is not a labelled regimen, and compounded products are not FDA-approved. Always confirm your drawn volume with your provider before injecting. Never estimate.
The two most common compounded concentrations are 2.5 mg/mL and 5 mg/mL. Here is how the standard weekly doses convert to units for each, on a U-100 syringe where 1 unit equals 0.01 mL:
| Weekly dose (mg) | 2.5 mg/mL vial (units) | 5 mg/mL vial (units) |
|---|---|---|
| 0.25 mg | 10 units | 5 units |
| 0.50 mg | 20 units | 10 units |
| 1.0 mg | 40 units | 20 units |
| 1.7 mg | 68 units | 34 units |
| 2.4 mg | 96 units | 48 units |
Two worked examples, since this is how people actually search the question.
10 units of semaglutide is how many mg? It depends on your vial. On a 2.5 mg/mL vial, 10 units is 0.10 mL, which equals 0.25 mg. On a 5 mg/mL vial, that same 10 units equals 0.50 mg. Twice the medication in the same syringe volume.
20 units of semaglutide is how many mg? On a 2.5 mg/mL vial, 20 units is 0.20 mL, which equals 0.50 mg. On a 5 mg/mL vial, 20 units equals 1.0 mg.
That is the whole confusion in one example. The same number of units means a completely different dose depending on which vial is in front of you. Never assume. Always confirm the concentration on your specific vial before drawing.
Working out your own compounded schedule? A compounded semaglutide program includes provider-confirmed dosing for your specific vial concentration, so you are never guessing at the conversion yourself.
Compounded semaglutide is not FDA-approved as a finished product, even though it contains the same active ingredient. FDA guidance on compounding explains what that distinction means. It is prepared by a licensed compounding pharmacy according to a provider prescription, not manufactured and packaged the way an approved injection is.
Concentration changes how much liquid you draw, not how much medication you receive. A 0.25 mg dose is 0.25 mg whether it comes from a 2.5 mg/mL vial, drawn as 10 units, or a 5 mg/mL vial, drawn as 5 units. The dose is identical. Only the volume differs.
This matters practically because a higher concentration means a smaller injection volume for the same dose, which some patients find more comfortable, particularly at higher maintenance doses where the volume on a lower-concentration vial starts to add up. Neither concentration is inherently stronger. What matters is the milligram dose your provider prescribed, not which vial it came from.
The dose does not increase to chase a bigger effect. It increases to move from a tolerability phase into an active range without triggering the nausea and digestive discomfort that come from jumping too fast. Most patients notice appetite effects beginning somewhere between weeks four and eight, once the dose moves past the initial 0.25 mg step.
Providers typically advance the dose when one of three things is true: side effects at the current dose have become manageable, progress has slowed below where the patient and provider expect, or enough time has passed on the current dose to step up safely. That decision belongs to the prescriber, not to a fixed calendar the patient follows alone. Increasing faster than prescribed does not accelerate results. It mainly increases the odds of significant digestive side effects.
Once a patient reaches and stabilizes on a maintenance dose, typically 2.4 mg weekly under the standard schedule, the focus shifts from escalation to consistency. Some patients and providers agree to stay at a lower dose, such as 1.0 mg or 1.7 mg, if that is already producing steady results with a better side-effect profile. That is a clinically reasonable outcome, not a failure to reach the real dose.
What changed in 2026. On 19 March 2026 the FDA approved an extended higher dose of 7.2 mg weekly. Per the manufacturer approval announcement, it is for adults who have tolerated the 2.4 mg dosage for at least 4 weeks and where additional weight reduction is clinically indicated. This is not a default starting point and not something most patients need.
The same announcement notes a real tradeoff. In clinical trials, dysesthesia, a tingling or burning skin sensation, was reported at a higher rate at the higher dose than at 2.4 mg or placebo. The supporting trial, STEP UP, was published in The Lancet Diabetes and Endocrinology. That tradeoff is exactly why the higher dose requires physician evaluation rather than being offered by default.
For the large majority of patients, reaching and maintaining 2.4 mg remains the typical path, with the extended dose reserved for specific cases a provider identifies.
Microdosing semaglutide, meaning doses well below the standard 0.25 mg starting step, has become a visible trend online, and it is worth addressing honestly rather than ignoring.
The straightforward version: microdosing is not a labelled regimen. It was not the protocol studied in the clinical trials that led to approval, and no manufacturer or regulator has defined a standardized microdose schedule. People describe using it for reasons ranging from cost management to a belief that smaller, more frequent effects suit them better, but the evidence base for the practice is thin next to the standard titration schedule.
What a supervised program does instead is start at the established 0.25 mg tolerability dose and adjust the pace of escalation rather than the structure, based on how an individual responds. That is a meaningfully different thing from an undefined microdose regimen, and it is worth understanding the difference before assuming start lower and microdose mean the same thing.
Patients considering a switch usually want a conversion chart, and the honest answer is that one does not exist. There is no published equivalence table between the two medications, because they are not dosed on the same scale and do not act on the same combination of receptors. Tirzepatide activates an additional receptor pathway that semaglutide does not.
The decision point that actually matters: switching is a prescriber decision based on your history with the current medication, not a milligram conversion you or an online chart can calculate. If semaglutide is not producing the results you expected at an appropriate dose and duration, or side effects have been difficult to manage, that is the conversation to have with your provider rather than a switch attempted from an unofficial chart. InjectCo offers a tirzepatide treatment program alongside semaglutide, so that conversation can happen in one place.
Titration exists specifically to manage tolerability, so side effects at any given step are information rather than a sign something has gone wrong. Nausea, mild digestive discomfort, and reduced appetite are common in the first days after any dose increase and typically ease within a week or two as the body adjusts.
A few practical points help at almost every step. Smaller, lower-fat meals reduce digestive symptoms for many patients. Staying hydrated matters more than it sounds like it should. Symptoms that are present but manageable do not necessarily mean the dose needs to change.
What does warrant a call to your provider: side effects that are worsening rather than settling, symptoms severe enough to affect daily function, or any sign of a more serious reaction. Your provider can also slow the titration schedule itself, extending a step to six or eight weeks instead of four, which is a normal adjustment rather than a departure from the plan.
The oral tablet approved for weight management is dosed on a completely different ladder from the injection, and the two schedules are not interchangeable. Per the FDA-approved prescribing information, the tablet starts at 1.5 mg once daily and escalates every 30 days:
| Days | Once-daily tablet dosage |
|---|---|
| 1 through 30 | 1.5 mg (starting dosage) |
| 31 through 60 | 4 mg |
| 61 through 90 | 9 mg |
| 91 and onward | 25 mg (maintenance dosage) |
A note worth flagging, because it is a common mix-up: the 3 mg, 7 mg and 14 mg oral tablet schedule many people have seen belongs to the oral semaglutide product indicated for type 2 diabetes, not to the tablet indicated for weight management. If you are searching oral dosing for weight management, the ladder above is the relevant one.
Administration is strict, and it is the part that most affects whether the dose works. Take one tablet once daily on an empty stomach in the morning with water, up to 4 ounces, and no other liquid. Swallow it whole rather than splitting, crushing or chewing it. Then wait at least 30 minutes before eating food, drinking other beverages, or taking any other oral medication. Do not take more than one tablet a day. If a dose is missed, the label says to skip it and take the next dose the following day.
The reason the empty-stomach rule matters so much is absorption. Oral bioavailability sits at roughly 1 to 2 percent, against 89 percent for the injection, so anything that interferes with absorption has an outsized effect on how much medication actually reaches you.
The two forms are not dose-equivalent, so how many mg of the tablet equals my injection dose does not have a clean answer. The label handles switching with specific instructions rather than a conversion: one week after stopping the 2.4 mg weekly injection, a patient may start 25 mg tablets daily, and the day after stopping 25 mg tablets they may start the 2.4 mg weekly injection. Either direction is a prescriber decision.
Prefer to avoid both needles and daily tablets? InjectCo also offers sublingual semaglutide drops, worth asking about at your evaluation if self-injection is not the right fit.
Eligibility is a clinical decision a provider makes, not a self-assessment. Generally, candidates have a BMI of 30 or higher, or 27 or higher with a weight-related condition such as elevated blood sugar or high blood pressure, along with a history of limited success through diet and exercise alone.
Certain conditions rule candidacy out, including a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2, active pancreatitis, and pregnancy. A full medical history review happens before anything is prescribed, and titration only ever starts after that evaluation.
The chart numbers in this guide are reference points describing what a typical schedule looks like. They are not a prescription for your situation. What determines your dose is how your body responds, tracked by a provider who can adjust the pace when side effects need more time or when progress calls for a step up.
You can see what the program costs before you book anything.
The standard injectable starting dose is 0.25 mg once weekly for the first four weeks. That step is a tolerability phase rather than a therapeutic dose, meant to let the body adjust before the dose increases.
The standard maintenance ceiling is 2.4 mg weekly. As of 19 March 2026, an extended dose of 7.2 mg weekly is FDA-approved for adults who have already tolerated 2.4 mg for at least four weeks and where a provider determines additional weight reduction is clinically indicated.
Under the standard four-week-per-step schedule, most patients reach the 2.4 mg maintenance dose around week 17. Providers may extend any step if side effects need more time to settle, which is a normal adjustment rather than a setback.
Compounded semaglutide is measured in units on a U-100 syringe rather than in milligrams, and the unit count depends on your vial concentration. A 2.5 mg/mL vial needs 10 units for a 0.25 mg dose. A 5 mg/mL vial needs only 5 units for that same dose. Compounded products are not FDA-approved.
It depends entirely on your vial. On a 2.5 mg/mL vial, 10 units is 0.10 mL and equals 0.25 mg. On a 5 mg/mL vial, the same 10 units equals 0.50 mg. Always confirm the concentration printed on your own vial before drawing.
Not automatically. Reaching an active dose range matters more than chasing the highest number, and many patients do well below the maximum dose. The right dose is the one your provider determines is working for you, not the largest one available.
Contact your provider for guidance specific to your schedule rather than guessing, and do not double the next dose to make up for a missed one. For the oral tablet, the label instruction is to skip the missed dose and take the next one the following day.
No. The oral tablet for weight management runs 1.5 mg, then 4 mg, then 9 mg, reaching a 25 mg once-daily maintenance dose, escalating every 30 days. The injection runs on a weekly milligram scale entirely. The two are not dose-equivalent, and the label sets out specific switching instructions rather than a conversion. Note also that the 3 mg, 7 mg and 14 mg oral schedule belongs to the diabetes product, not the weight management tablet.
A provider reviews exactly where you are in titration and whether the next step up is right for you yet, based on your own response rather than a generic schedule.
Dr. Allen earned his Doctor of Osteopathic Medicine at Lake Erie College of Osteopathic Medicine and completed his emergency medicine residency with Texas A&M. As Medical Director, he reviews InjectCo treatments, protocols, and patient education content for accuracy and safety across all nine Texas locations.
Sources opened and verified on 16 September 2026. Every chart on this page is reference material describing what published schedules look like. It is not a prescription and does not replace the dose your own prescriber sets. Compounded semaglutide is not FDA-approved and compounded dosing is not a labelled regimen. This page is general education, not medical advice. Individual results vary.
