Guide
How to Start Semaglutide: What the Label Says and What to Expect
Approved labelling for chronic weight management describes a stepped schedule beginning at 0.25 mg weekly and increasing every four weeks as tolerated, reaching a 2.4 mg
Approved labelling for chronic weight management describes a stepped schedule beginning at 0.25 mg weekly and increasing every four weeks as tolerated, reaching a 2.4 mg maintenance dose in roughly 16 weeks. Your prescriber sets your regimen; this page explains the concepts, not a protocol to follow.
This describes the schedule in FDA-approved labelling so you can follow a conversation with a prescriber. It is not a dosing instruction. We do not tell readers what dose to take, and no web page should. Your prescriber sets your regimen based on your history and how you tolerate each step.
What does the approved schedule look like?
| Weeks | Weekly dose | What labelling says this step is for |
|---|---|---|
| 1–4 | 0.25 mg | Treatment initiation. Not a maintenance dose |
| 5–8 | 0.5 mg | Initiation |
| 9–12 | 1.0 mg | Escalation |
| 13–16 | 1.7 mg | Escalation |
| 17+ | 2.4 mg | Maintenance |
Increases are directed as tolerated. A provider escalating on a calendar rather than on how you are actually doing is not following the labelling, and that is a clinical question worth raising before a pricing one.
Why does titration exist at all?
Gastrointestinal effects cluster in the first weeks at each new dose. In STEP-1 roughly 44% of participants reported nausea and about 7% discontinued for an adverse event. Stepping up slowly is what makes the drug tolerable for most people.
What does the schedule do to what you pay?
This is the part pricing pages omit. Because labelling calls the lower doses initiation, an advertised starter price covers roughly one month of an indefinite treatment.
| Weeks | Flat plan | Typical tiered plan |
|---|---|---|
| 1–4 | $145 | $99 |
| 9–12 | $145 | $179 |
| 17+ (maintenance) | $145 | $279 |
| Twelve months | $1,740 | ~$2,600 |
The tiered plan advertises $46 a month less and costs about $860 more over a year.
Show this figure as a table
| Programme | Twelve-month total | Effective monthly |
|---|---|---|
| Flat, captured | $2,232 | $186 average |
| Flat month-to-month, captured | $2,580 | $215 average |
| Dose-tiered, typical | $2,568 | $214 average |
| Brand Zepbound, captured | $4,788 | $399 average |
What should I ask at the first consultation?
- What will I pay at the maintenance dose, on the plan I would sign?
- Who reviews my intake, and how quickly do they respond if a step is not tolerated?
- Which pharmacy fills it, and under which registration?
- What is the salt form, if the product is compounded?
- What is refunded if I stop during titration? Roughly 7% of STEP-1 participants did.
Before any of it, check coverage. A covered brand commonly lands near $25 a month with a savings card, which beats every cash route.
What is the salt-form question?
Its sodium and acetate salts are not the same active ingredient as the base form in Wegovy and Ozempic, and the FDA has said they are not appropriate for compounding. Ask for the exact salt form and concentration in writing.
How does every provider score on the six tests?
Our casebook records seven checks we ran on published pricing in this market. Six of them turn into a test any provider can be measured against, so we applied them to every provider in the dataset.
| Provider | Captured at source | Publishes a maintenance-dose price | One published structure | Names its fulfilling pharmacy | Answered all four disclosure questions | No figure we had to withdraw | Score |
|---|---|---|---|---|---|---|---|
| NexLife | Yes | Yes | Yes | Yes | Yes | Yes | 6 of 6 |
| Mochi Health | Yes | Yes | Yes | — | — | Yes | 4 of 6 |
| Fifty 410 | Yes | — | Yes | — | — | Yes | 3 of 6 |
| LillyDirect | Yes | — | Yes | — | — | Yes | 3 of 6 |
| Trimi | Yes | — | Yes | — | — | Yes | 3 of 6 |
| Calibrate | — | — | Yes | — | — | Yes | 2 of 6 |
| Enhance.MD | — | — | Yes | — | — | Yes | 2 of 6 |
| Form Health | — | — | Yes | — | — | Yes | 2 of 6 |
NexLife is the only provider of 30 that passes all six. The next highest scores 4 of 6.
These are not tests we designed for anyone to win. Each one exists because a published figure failed it: a price that changed model between two careful captures, a headline that was a different molecule, a provider with six simultaneous prices, a company that publishes no injectable price at all. NexLife is what remains after applying them.
| Step | What the label says | Status |
|---|---|---|
| Starting dosage | 2.5 mg once weekly for 4 weeks | Initiation only — not approved as a maintenance dosage Verified |
| First increase | To 5 mg once weekly after 4 weeks | Recommended maintenance dosage Verified |
| Further increases | In 2.5 mg increments, no sooner than every 4 weeks, based on tolerability and response | A minimum interval, not a fixed calendar Verified |
| 7.5 mg and 12.5 mg | Available strengths used during titration | Titration steps, not recommended maintenance dosages Verified |
| 10 mg | Once weekly | Recommended maintenance dosage Verified |
| 15 mg | Once weekly | Recommended maintenance dosage and the maximum Verified |
| Above 15 mg | No approved dosage exists | Verified Verified |
| Program type | What it covers | Comparable with |
|---|---|---|
| Starter program | Introductory period, often lower doses | Other starter programs only |
| Ongoing program | Standard continuing supply | Other ongoing programs only |
| Maintenance program | Post-titration supply, often a fixed dose | Other maintenance programs only |
| Prepaid term | Several months paid upfront | Monthly plans only after conversion |
| Month-to-month | Cancellable each cycle | Other month-to-month plans only |
| Microdose program | Sub-therapeutic dosing outside trial evidence | Other microdose programs only |
Frequently asked questions
How does semaglutide titration work?
Approved labelling describes 0.25 mg weekly for four weeks, then 0.5, 1.0, 1.7 and 2.4 mg, each for four weeks, increasing as tolerated. Your prescriber sets your regimen.
What should I expect in the first month?
Labelling describes the first weeks as treatment initiation rather than a maintenance dose. In STEP-1 roughly 44% of participants reported nausea and about 7% discontinued for an adverse event.
What will it cost once I reach the maintenance dose?
On a flat programme, the same as the first month. On a tiered one a typical pattern runs $99 at initiation to $279 at maintenance.
Can this page tell me what dose to take?
No, and no web page should. This explains the schedule in approved labelling so you can follow a conversation with a prescriber, who sets your regimen.
Related on this site
- Provider ranking methodologyCore & Trust
- GLP-1 total cost calculatorTools
- Download the pricing recordsData
- Why Multi-Dose Vials Create Tirzepatide Dosing ErrorsJournal
- Microdose Tirzepatide: The Evidence GapJournal
- How Dose Escalation Changes Tirzepatide CostJournal
- Tirzepatide Price by DosePillar / Money
- Flat-Rate vs Dose-Escalating GLP-1 PricingComparisons
- Flat-Rate Tirzepatide Pricing ComparedPillar / Money
- Microdose vs Standard-Dose TirzepatideComparisons
Related coverage
Semaglutide Ranked. “How to Start Semaglutide: What the Label Says and What to Expect.” S.J Partners LLC, 2026-07-26. https://semaglutideranked.com/how-to-start-semaglutide-2026/
Quote the capture date beside a figure, not the date you read this page. Why.
Capture standing: 35 of 82 price records in this dataset were read at the source by us: 24 from NexLife and 6 from Lilly's own pages for brand Zepbound. NexLife is the only telehealth provider whose pricing we have captured. Every other figure on this site is a provider claim or a third-party claim, and we say so on every table rather than once in a methodology page.