Short answer: The label says to start Ozempic at 0.25 mg once weekly for 4 weeks, then increase to 0.5 mg once weekly. The 0.25 mg start is meant to lower the risk of stomach side effects. If more blood sugar control is needed after at least 4 weeks, it may go to 1 mg, then 2 mg after at least 4 more weeks. The maximum is 2 mg once weekly.
This is what the FDA label says. Follow your prescriber. Your prescriber may use a different dose or pace than the label's standard schedule.
What Ozempic is approved for: The label says Ozempic is approved, along with diet and exercise, to improve blood sugar control in adults with type 2 diabetes. It is also approved to lower the risk of major heart events in adults with type 2 diabetes and known heart disease, and to lower the risk of kidney decline, kidney failure and death from heart causes in adults with type 2 diabetes and chronic kidney disease.
Source
OZEMPIC (semaglutide) injection, for subcutaneous use, prescribing information and Medication Guide. Novo Nordisk. DailyMed, version published June 10, 2026. DailyMed setid adec4fd2-6858-4c99-91d4-531f5f2a2d79
Ozempic is injected under the skin of the abdomen, thigh or upper arm once a week, on the same day each week, at any time of day, with or without meals.
The label says to use a different injection site each week when using the same body area, and to check that the liquid is clear and colorless before use.
If used with insulin, the two are given as separate injections and never mixed. They may go in the same body area, but not right next to each other.
The table below is the label's schedule, from the Dosage and Administration section. Numbers are copied exactly; the section is in brackets.
| Step | Weekly dose | When |
|---|---|---|
| Start | 0.25 mg | Weeks 1 to 4 |
| First maintenance dose | 0.5 mg | After 4 weeks on 0.25 mg |
| Optional increase | 1 mg | After at least 4 weeks on 0.5 mg, if more glycemic control is needed |
| Optional increase (maximum) | 2 mg | After at least 4 weeks on 1 mg, if more glycemic control is needed |
The 0.25 mg starting dose is for starting treatment, to reduce the risk of stomach and gut side effects.
The recommended maintenance dose is 0.5 mg, 1 mg or 2 mg once weekly, based on blood sugar control.
The maximum recommended dose is 2 mg once weekly.
For adults with type 2 diabetes and chronic kidney disease, the label gives a maintenance dose of 1 mg once weekly, reached after at least 4 weeks on 0.5 mg.
The weekly injection day can be changed if needed, as long as there are at least 2 days (more than 48 hours) between two doses.
No dose adjustment is recommended for people with kidney impairment or (section 8.7) liver impairment.
The label says to stop Ozempic at least 2 months before a planned pregnancy because semaglutide takes a long time to clear the body.
When Ozempic is used with insulin or a sulfonylurea, the label says a lower dose of those medicines may reduce the risk of low blood sugar.
If a dose is missed, take it as soon as possible within 5 days after the missed dose. If more than 5 days have passed, skip the missed dose and take the next dose on the regularly scheduled day. Then resume the regular once-weekly schedule.
More on this: missed a dose of Ozempic.
In Dose Track you set up Ozempic as a protocol with the dose and schedule your prescriber gave you. A protocol can hold dose steps, each with its own dose and length in days or weeks, so a step-up plan like the one on the label can be entered once and the app moves to the next step on its own. Reminders follow the schedule, and every dose is logged with the date and time, so you can see which step you are on and when your last dose was. The app follows what you enter; it does not choose or change a dose.
This page is what the FDA label says, in plain words. It is not medical advice. Follow your prescriber, and ask them or your pharmacist about anything here.