Drug facts

Compounded semaglutide dosage chart

By David Chen·Editor·Reviewed September 2026

If you have a vial in front of you and want the mark on the syringe, work it out here — it needs the concentration printed on your own label, because a compounded vial’s strength is set by the pharmacy that made it.

The schedule¹

1. Weeks 1–40.25 mgStarting dose. Intended to reduce gastrointestinal side effects, not for weight reduction.
2. Weeks 5–80.5 mg
3. Weeks 9–121 mg
4. Weeks 13–161.7 mg
5. Week 17 onward2.4 mgUsual maintenance dose. The label also allows 1.7 mg as maintenance, and — for weight reduction, after at least four weeks at 2.4 mg — an increase to a maximum of 7.2 mg once weekly.

Compounded semaglutide has no dosing label of its own, so this is the schedule a prescriber works from for a compounded vial too: Wegovy’s. What changes with a vial is not the dose but how you measure it.

The steps are not evenly spaced, and that catches people out. From 0.25 mg the dose doubles, doubles again, then rises by 0.7 mg and by 0.7 mg again. There is no “next 0.25 mg” — the rungs are the four the label names and nothing in between, which is worth knowing before reading a seller’s dose list.

The starting dose¹

0.25 mg once weekly, for weeks 1 to 4 — for every approved indication. The label’s own table calls that row the “Starting Dosage” and the next three the “Dosage Escalation”; maintenance does not begin until week 17. The early rungs exist to let the gastrointestinal side effects settle, which is why a month at 0.25 mg with little change is not the drug failing — see does compounded semaglutide work?

The maintenance dose¹

For weight reduction in adults the label names either 1.7 mg or 2.4 mg once weekly, with 2.4 mg recommended. A dose that is working and tolerated is a dose to stay on. The label’s other indications — cardiovascular risk reduction, weight reduction in children 12 and older, and MASH — also maintain at 2.4 mg or 1.7 mg.

The highest dose¹

7.2 mg once weekly, and only in one situation: an adult using Wegovy for weight reduction who has tolerated 2.4 mg for at least four weeks, where more weight reduction is clinically indicated. For every other indication the ceiling is 2.4 mg. The diabetes product, Ozempic, stops lower still, at 2 mg — its schedule is on compounded semaglutide vs Ozempic.

If a seller’s plan appears to go higher than any of these, check what the number refers to: a vial’s total milligrams, or a month’s worth of doses, is not the weekly dose.

Why the steps are four weeks apart¹

Each increase is permitted only after at least four weeks at the current dose. Moving faster is the most common way people run into nausea and vomiting severe enough to stop treatment altogether, and the schedule is built around that rather than around reaching 2.4 mg quickly. The label goes further: if a dose is not tolerated during escalation, it says to consider delaying the next step by four weeks.

What this means for a compounded vial¹

The ladder in units, and mixing a vial¹

Drawn from a vial, these milligram steps turn into very small syringe marks. At 5 mg/mL the starting 0.25 mg is 5 units and 2.4 mg is 48; at 2.5 mg/mL they are 10 and 96. The 7.2 mg maximum is 1.44 mL even at 5 mg/mL, more than a 1 mL syringe holds.

The first rows are where a misread line costs the most, which is why FDA’s alert on compounded semaglutide dosing errors is worth knowing before a first dose. If your vial comes as a powder, the volume of water your pharmacy specifies sets the strength: 5 mg in 2 mL is 2.5 mg/mL, and in 1 mL it is 5 mg/mL, halving every mark. The reconstitution calculator does that sum, and semaglutide dosage in units has the full chart and the FDA alert.

What each dose costs²

Sellers price these doses differently. Some charge the same at every dose; others raise the price as the dose rises, which means the figure quoted at 0.25 mg is not what a maintenance dose costs.