Drug facts
A missed semaglutide dose
Quick answer
Count forward to your next scheduled dose, not back to the one you missed. If the next dose is more than 2 days away, take the missed dose as soon as possible. If it is less than 2 days away, skip it and carry on with your regular weekly day.
The rule1
The label states it as two cases. If one dose is missed and the next scheduled dose is more than two days away, administer it as soon as possible. If the next scheduled dose is less than two days away, do not administer the missed dose — resume dosing on the regularly scheduled day of the week.
Either way the weekly day does not move. The missed dose is either taken or abandoned; the schedule underneath it stays where it was.
Why it is measured to the next dose1
Because what the rule is protecting against is two doses landing close together. Semaglutide is dosed once weekly precisely because it stays in the body a long time, and a missed dose taken the day before the next one would stack them. Measuring the gap forward answers that question directly; measuring backward from the missed dose does not.
This is worth saying plainly because the equivalent rule for tirzepatide is written the other way — a fixed window from the missed dose. Somebody moving between the two drugs, or reading a page about the other one, can carry the wrong arithmetic across.
Two or more in a row1
The label treats this as a different situation, not a bigger version of the same one. If two or more consecutive doses are missed, it says to reinitiate dosage escalation at a lower dose, to reduce the risk of gastrointestinal adverse reactions.
In other words, tolerance to the dose you were on is not assumed to survive the gap. Restarting where you left off is the thing the label specifically does not say to do, and stepping back down is a decision for your prescriber rather than something to work out from the schedule alone.
What this means for a compounded vial2
On the label — Wegovy / Ozempic
A fixed-strength device. Resuming means taking the next pen on the usual day, with nothing to recalculate.
In a compounded vial
Concentration is set by the pharmacy, so a dose is a mark on a syringe rather than a device — and if a break means stepping back to a lower dose, that is a different mark. See units, milligrams and milliliters.
What this page is not
This is what the approved label says, not advice about your own dose. If you have missed more than one, or you are not sure how long it has been, that is a question for the prescriber who wrote it.