Wegovy & Mounjaro dose titration explained

Medically reviewed by Muhammad A Jalil, Superintendent Pharmacist (GPhC Reg No: 2236161)

Published 2026-08-22 · Clinically reviewed 2026-08-22 · Updated 2026-08-23

Why Wegovy and Mounjaro start low and step up every four weeks, the full dose schedules, and what to do when side effects interrupt the climb.

Both of the main weight loss injections start deliberately low and step up at four-week intervals. Wegovy climbs through five levels — 0.25, 0.5, 1 and 1.7 mg before its 2.4 mg weekly maintenance dose — over about four months; Mounjaro starts at 2.5 mg for four weeks, moves to 5 mg, and can rise in 2.5 mg steps towards 15 mg if needed. The slow build is not bureaucratic caution: it is how your digestive system learns to tolerate the medicine, and hurrying it is the most common cause of miserable side effects. Just as importantly, the top dose is not the goal — the right maintenance dose is the one that keeps working at a level you tolerate comfortably.

Why the slow build-up exists

GLP-1 receptors sit throughout your gut as well as in your brain, and they need time to adapt. The starting doses are, by design, below the level that produces full appetite suppression — they exist to train tolerance, not to drive results. Dose-finding studies showed the same maintenance dose causes far less nausea when it is reached gradually, which is why every licensed schedule uses four-week blocks: long enough for the side-effect response to settle at each level while the therapeutic effect builds underneath.

The Wegovy schedule

Weeks 1–4: 0.25 mg once weekly — a training dose, not expected to drive much loss.
Weeks 5–8: 0.5 mg.
Weeks 9–12: 1 mg.
Weeks 13–16: 1.7 mg.
Week 17 onwards: 2.4 mg, the maintenance dose.

If the final step proves hard to tolerate, staying on 1.7 mg long term is an accepted fallback within the licence. And the month at each level is a minimum, not a metronome: prescribers routinely hold a step for eight weeks or longer when side effects ask for it.

The Mounjaro schedule

Weeks 1–4: 2.5 mg once weekly — again, a tolerability dose.
Week 5 onwards: 5 mg.
Optional further steps: 7.5 mg, 10 mg, 12.5 mg and 15 mg, each held for at least four weeks before the next.

Unlike Wegovy, Mounjaro has several recognised maintenance doses: 5 mg, 10 mg and 15 mg are all treated as places to settle, and many people stay in the middle of the range. The higher steps exist for those who tolerate the medicine well and want more effect from it.

When side effects interrupt the climb

Nausea, reflux or bowel changes that flare after a step and fade within a fortnight are the expected pattern. When they do not fade — or they are severe — the playbook has three moves: hold the current dose for another month, drop back one level, or slow the whole ladder down. None of these harms your long-term result, because the medicine is still working at every level above baseline. For day-to-day tactics, see our guide to managing nausea week by week.

Missed doses and changing your injection day

For Wegovy, take a missed dose as soon as you remember within five days; past that, skip it and resume on your usual day. For Mounjaro the window is four days. Never inject twice to catch up. You can also move your injection day for convenience — keep at least 48 hours between Wegovy doses, and at least three days for Mounjaro. After a break of more than two missed weeks, ask before restarting: your prescriber may want to resume at a lower step so your gut can re-adapt.

Do higher doses always mean more weight loss?

On trial averages, yes — the higher maintenance doses produced greater average loss. Individually, the spread is enormous: some people respond strongly at 5 mg or 1 mg and never need the top of the ladder, while others plateau until the next step unlocks progress. If your loss stalls, the answer is sometimes a dose step and sometimes habits — our plateau guide covers how to tell which.

Frequently asked questions

Can I skip steps to get results faster?

No — the schedules are the licensed minimums, and skipping steps mostly gets you nausea rather than speed. The medicines produce their loss over months at maintenance dose; arriving there a fortnight sooner changes almost nothing.

What if I have been on one dose longer than four weeks?

Nothing is lost. Four weeks is the minimum before stepping up, not an expiry date, and long holds are common — around holidays, side effects or simple preference. Step up when you and your prescriber are ready.

Do I have to reach 2.4 mg or 15 mg?

No. Wegovy's licence explicitly allows 1.7 mg as maintenance where 2.4 mg is not tolerated, and Mounjaro treats 5, 10 and 15 mg as maintenance options. The right dose balances results against comfort — for some people that is the top, for many it is not.

What happens if I switch between Wegovy and Mounjaro?

There is no direct milligram-for-milligram equivalence, because they are different molecules. Switching usually means starting the new medicine at a low-to-middle step chosen by your prescriber, not at the top of the previous ladder.

Titration is where good prescribing shows: the schedule should bend around your side effects, not the other way round. If you are considering treatment, you can check your eligibility for the weight loss programme — every plan includes a clinician review at each dose step.