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[GLP-1 · Ozempic · FDA label guide]

Ozempic (semaglutide) dose schedule, titration chart and side effects

Novo Nordisk · Once weekly injection · Label reviewed as of

Short answer: Per the FDA label (2.2), Ozempic starts at 0.25 mg once weekly for 4 weeks, then 0.5 mg once weekly. If more glycemic control is needed, the label's schedule allows 1 mg after at least 4 weeks on 0.5 mg, then 2 mg after at least 4 weeks on 1 mg. The maximum recommended dosage is 2 mg once weekly.

Per label section 1, Ozempic is indicated in adults with type 2 diabetes as an adjunct to diet and exercise to improve glycemic control, to reduce the risk of major adverse cardiovascular events in those with established cardiovascular disease, and to reduce the risk of sustained eGFR decline, end-stage kidney disease, and cardiovascular death in those with chronic kidney disease. This page summarizes the current FDA prescribing information (revised 5/2026). It is not personalized medical advice; your prescriber sets your dose.

What is the Ozempic dose schedule?

The label's dosing schedule (label section 2.2):

Dosing schedule as written in the FDA label (label section 2.2).
PeriodDoseLabel note
Weeks 1–40.25 mg once weeklyInitiation dosage; the label says to follow the escalation to reduce the risk of gastrointestinal adverse reactions
Weeks 5–80.5 mg once weeklyIncrease after 4 weeks on 0.25 mg; 0.5 mg is also one of the label maintenance dosages
Weeks 9–12 (earliest)1 mg once weeklyOnly if additional glycemic control is needed, after at least 4 weeks on 0.5 mg; 1 mg is the label maintenance dosage for type 2 diabetes with chronic kidney disease
Week 13 onward (earliest)2 mg once weeklyOnly if additional glycemic control is needed, after at least 4 weeks on 1 mg; maximum recommended dosage

Maintenance: The label lists maintenance dosages of 0.5 mg, 1 mg, or 2 mg once weekly based on glycemic control, with a maximum recommended dosage of 2 mg once weekly. For type 2 diabetes with chronic kidney disease, the label maintenance dosage is 1 mg once weekly, reached after at least 4 weeks on 0.5 mg (2.2).

  • Each step up in the label (0.5 mg to 1 mg, 1 mg to 2 mg) comes after at least 4 weeks on the prior dosage and only if additional glycemic control is needed (2.2).
  • The label says the 0.25 mg start and stepwise escalation are meant to reduce the risk of gastrointestinal adverse reactions (2.2).
  • Per the label, steady-state exposure is reached after 4 to 5 weeks of once-weekly dosing (12.3).

What does the Ozempic titration calendar look like?

Below is the label schedule laid out week by week, using the earliest timing the label allows. The label lets prescribers stay at a step longer, so a real calendar is often slower. The blank columns are for your own record.

Ozempic titration calendar from the label schedule (label section 2.2). Not a personalized plan.
WeekLabel doseDateSite / timeWeightNotes
Week 10.25 mg once weekly
Week 20.25 mg once weekly
Week 30.25 mg once weekly
Week 40.25 mg once weekly
Week 50.5 mg once weekly
Week 60.5 mg once weekly
Week 70.5 mg once weekly
Week 80.5 mg once weekly
Week 91 mg once weekly
Week 101 mg once weekly
Week 111 mg once weekly
Week 121 mg once weekly
Week 132 mg once weekly
Week 142 mg once weekly
Week 152 mg once weekly
Week 162 mg once weekly
Week 172 mg once weekly
Week 182 mg once weekly
Week 192 mg once weekly
Week 202 mg once weekly

Printing this page prints the schedule and calendar without the site navigation.

What strengths does Ozempic come in, and how many doses are in each pen?

Ozempic pen presentations (label section 3; 16).
ProductDose per injectionDoses per pen / packContents
Single-patient-use pen0.25 mg or 0.5 mg4 doses of 0.25 mg and 2 doses of 0.5 mg, or 4 doses of 0.5 mg (carton: 1 pen, 6 NovoFine Plus needles)2 mg/3 mL (0.68 mg/mL)
Single-patient-use pen1 mg4 doses of 1 mg (carton: 1 pen, 4 NovoFine Plus needles)4 mg/3 mL (1.34 mg/mL)
Single-patient-use pen2 mg4 doses of 2 mg (carton: 1 pen, 4 NovoFine Plus needles)8 mg/3 mL (2.68 mg/mL)
Single-dose prefilled syringe0.25 mg1 dose per syringe (carton: 4 syringes)0.25 mg/0.5 mL
Single-dose prefilled syringe0.5 mg1 dose per syringe (carton: 4 syringes)0.5 mg/0.5 mL
Single-dose prefilled syringe1 mg1 dose per syringe (carton: 4 syringes)1 mg/0.5 mL
  • The pens are multi-dose, single-patient-use pens that deliver fixed doses; the label says a pen must never be shared between patients, even if the needle is changed (5.4; 16).
  • Per the label, after first use a pen can be stored for 56 days at 15°C to 30°C (59°F to 86°F) or refrigerated at 2°C to 8°C (36°F to 46°F); before first use it is kept refrigerated (16).
  • Per the label, prefilled syringes are stored refrigerated and may be kept at 8°C to 30°C (46°F to 86°F) for up to 28 days if needed (16).
  • There is no 2 mg single-dose prefilled syringe in the label; the 2 mg dose is listed only as a pen (3; 16).

What are the most common Ozempic side effects?

The label reports these rates from placebo-controlled trials (label section 6.1, Table 1). Percentages are the share of trial participants who reported each reaction.

Adverse reactions reported in ≥5% of Ozempic-treated patients and more often than placebo, pool of 2 placebo-controlled trials in type 2 diabetes (label Table 1).
Adverse reactionPlacebo (N=262)Ozempic 0.5 mg (N=260)Ozempic 1 mg (N=261)
Nausea6.1%15.8%20.3%
Vomiting2.3%5%9.2%
Diarrhea1.9%8.5%8.8%
Abdominal pain4.6%7.3%5.7%
Constipation1.5%5%3.1%

When do they happen? Per the label, the majority of reports of nausea, vomiting, and/or diarrhea occurred during dose escalation. Gastrointestinal adverse reactions overall occurred in 15.3% (placebo), 32.7% (0.5 mg), and 36.4% (1 mg); in the 1 mg vs 2 mg trial they occurred in 30.8% (1 mg) and 34% (2 mg) (6.1).

The label also carries warnings that are not in this table (for example, a boxed warning or pancreatitis and gallbladder warnings where applicable). Read the full label linked under Sources, and report side effects to your prescriber.

What if you miss a dose of Ozempic?

Per the label, a missed dose is given as soon as possible within 5 days after the missed dose; if more than 5 days have passed, the missed dose is skipped and the next dose is given on the regularly scheduled day, after which the regular once-weekly schedule resumes. (label section 2.1) The full walk-through is on the Ozempic missed-dose page.

How is Ozempic taken?

The label describes once-weekly subcutaneous injection on the same day each week, at any time of day, with or without meals, in the abdomen, thigh, or upper arm, using a different injection site each week within the same region. The weekly day can be changed if at least 2 days (more than 48 hours) separate two doses. With insulin, the label describes separate, non-adjacent injections that are never mixed. (label section 2.1)

What should you track on Ozempic?

A simple log makes each titration step easier to talk through with your prescriber. These are the things worth writing down, and how Dose Track handles them:

  • Dose and date. Each injection with its amount, so the titration steps above line up with what you actually took. Dose Track keeps the full history of every dose change.
  • Injection site. The label lists the abdomen, thigh and upper arm. Dose Track records the site with each shot so rotation is easy to follow.
  • Weight. Logged by hand or synced from Apple Health or Android Health Connect, and charted alongside your dose changes.
  • Side effects. A note of what you felt and when, so you can see whether it settles after a dose step and bring the record to your prescriber.
  • Reminders. A notification on your injection day.

Your log stays on your phone. See GLP-1 tracking in Dose Track for the full feature list.

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Ozempic questions people ask

What's the highest dose of Ozempic?+
The label lists 2 mg once weekly as the maximum recommended dosage (2.2). In the label schedule, 2 mg is reached only if additional glycemic control is needed after at least 4 weeks on 1 mg. The 2 mg dose comes in a pen containing 8 mg/3 mL (2.68 mg/mL) that delivers 4 doses (3; 16). A 40-week trial compared Ozempic 2 mg with 1 mg once weekly (14.1).
How long does it take for Ozempic to work?+
The label does not give a single onset time. Per the label, peak semaglutide concentration occurs 1 to 3 days after a dose and steady-state exposure is reached after 4 to 5 weeks of once-weekly dosing (12.3). In the monotherapy trial, the primary HbA1c endpoint was measured at week 30, when HbA1c changed by -1.4% (0.5 mg) and -1.6% (1 mg) versus -0.1% with placebo (14.1, Table 3).
Can you skip the 0.25 mg starter dose of Ozempic?+
The label's schedule starts every patient at 0.25 mg once weekly for 4 weeks before moving to 0.5 mg, and says to follow this escalation to reduce the risk of gastrointestinal adverse reactions (2.2). The label does not describe starting at a higher dose. This is general label information, not personalized advice; any dosing change is a decision for the prescriber.
What time of day should you take Ozempic?+
The label says Ozempic is given once weekly on the same day each week, at any time of the day (2.1). It also allows the weekly day to be changed as long as at least 2 days (more than 48 hours) separate two doses (2.1). The label does not favor morning or evening.
Do you take Ozempic with food?+
Per the label, Ozempic is given with or without meals (2.1). Because it is a subcutaneous injection into the abdomen, thigh, or upper arm, the label has no food or water timing rules like those for semaglutide tablets (2.1). The label does note that semaglutide delays gastric emptying, which may affect absorption of other oral medicines (12.3; 5.10).
What happens if you miss a dose of Ozempic?+
Per the label, a missed dose is given as soon as possible within 5 days after it was due. If more than 5 days have passed, the label says to skip it and give the next dose on the regularly scheduled day, then continue the usual once-weekly schedule (2.1).
How many doses are in an Ozempic pen?+
Per the label, the 2 mg/3 mL pen holds 4 doses of 0.25 mg and 2 doses of 0.5 mg, or 4 doses of 0.5 mg; the 4 mg/3 mL pen holds 4 doses of 1 mg; and the 8 mg/3 mL pen holds 4 doses of 2 mg (3; 16). Single-dose prefilled syringes (0.25 mg, 0.5 mg, 1 mg) come 4 per carton (16).
How long does Ozempic stay in your system?+
Per the label, semaglutide has an elimination half-life of about 1 week and will be present in the circulation for about 5 weeks after the last dose (12.3). The label notes this long half-life when describing overdose management, where a prolonged period of observation and treatment may be necessary (10).

Sources

Reviewed as of . Section numbers above refer to the FDA prescribing information.

  1. Ozempic (semaglutide) injection — FDA label, DailyMed (revised 5/2026)
  2. Drugs@FDA (openFDA) — NDA 209637 original approval record

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