# Semaglutide Dose and Dosage: What the Trials and Label Document > Semaglutide dose and dosage as documented in the trials and approved label — titration, the injection, the oral tablet, and half-life. Not dosing advice. The titration schedules, routes, and half-life reported in the clinical trials and the approved labeling — stated in the third person, never as advice. ## The short version This page describes the semaglutide dose and dosage figures recorded in the published trials and the approved label. It does not tell anyone what to take. Doses are stepped up slowly — "titrated" — to let the stomach adjust, because going up too fast worsens nausea. For the weekly shot used in weight management, trials started at 0.25 mg once weekly and worked up over about four months to a 2.4 mg maintenance dose [1]. The diabetes doses are lower. There is also a daily tablet that must be taken fasted. The drug clears slowly — its half-life is about a week — so it stays in the body for roughly five weeks after the last dose. Every figure below is reported as documented, and none of it is a recommendation. ## Semaglutide dose: the titration schedules Semaglutide is dose-escalated rather than started at the target amount, because the gastrointestinal effects are worst when the dose rises. The published schedules differ by indication. For chronic weight management (subcutaneous), the documented escalation is 0.25 mg once weekly for weeks 1-4, then 0.5 mg (weeks 5-8), 1.0 mg (weeks 9-12), 1.7 mg (weeks 13-16), and 2.4 mg as the maintenance dose once weekly. For type 2 diabetes (subcutaneous), the documented schedule starts at 0.25 mg once weekly for initiation, then 0.5 mg, then 1.0 mg maintenance, with up to 2.0 mg studied in a higher-dose trial. These are the schedules as recorded in the trial and label literature [1]; they are stated here as documentation, not as a protocol to follow. ## Semaglutide dosage: the maintenance figures by indication The maintenance dosage that carried each outcome differs by trial. The 2.4 mg once-weekly dose is the one studied in the weight-management and cardiovascular trials (STEP 1 weight change -14.9% [1]; SELECT cardiovascular HR 0.80 [3]). The kidney-outcomes trial, FLOW, used 1.0 mg once weekly (kidney composite HR 0.76) [6]. The diabetes cardiovascular trial, SUSTAIN-6, used 0.5 or 1.0 mg [2]. In other words, the dosage attached to a given benefit is the dosage that trial tested — the renal benefit comes from 1.0 mg in a CKD population, and the largest weight effect from 2.4 mg. These figures are reported as trial parameters; this site does not translate them into individual dosing. ## Semaglutide injection The subcutaneous injection is the once-weekly formulation and the route used in most of the outcome trials, including STEP 1 [1], SUSTAIN-6 [2], SELECT [3], and FLOW [6]. "Subcutaneous" means under the skin rather than into a vein or muscle. The once-weekly schedule is possible because of the molecule's pharmacokinetics: a fatty-acid side chain binds the blood protein albumin, slowing clearance, while a modification at position 8 blocks the DPP-4 enzyme that would otherwise degrade native GLP-1 within minutes [25]. The result is a half-life of about a week, discussed below. Reported injection-site reactions are covered, as anecdotal reports, on the [Semaglutide effects](/effects) page. ## Oral semaglutide Oral semaglutide is the once-daily tablet, co-formulated with an absorption enhancer called SNAC (sodium N-(8-[2-hydroxybenzoyl]amino)caprylate) that transiently raises local stomach pH to help the peptide cross the gut lining. Even so, oral bioavailability — the fraction that reaches the bloodstream — is low, about 0.4-1% [20]. That low and variable absorption is why the tablet must be taken on an empty stomach, 30 minutes before any food, drink, or other oral medicine, with no more than about 120 mL of water. The documented oral diabetes schedule is 3 mg daily for 30 days, then 7 mg, then 14 mg daily; higher oral doses (25 mg and 50 mg) were studied in obesity and diabetes programs [4]. A meta-analysis found oral semaglutide effective for glycemic control and weight, with a class-consistent cardiovascular profile [4]. ## Half-life and clearance Semaglutide has an elimination half-life of approximately one week — commonly cited as about 165-168 hours — for both the subcutaneous and oral forms, with effectively complete clearance roughly five weeks after the final dose. A systematic review of its pharmacokinetics confirmed a long half-life supporting once-weekly dosing and characterized exposure, peak concentration, and clearance across formulations [25]. The long half-life is the structural payoff of the molecule's design: strong, reversible albumin binding via the C18 fatty di-acid side chain, plus DPP-4 resistance from the position-8 substitution. The same slow clearance is why label guidance advises a multi-week washout before a planned pregnancy [9]. Semaglutide also showed a low drug-interaction profile, with no clinically relevant effect on the pharmacokinetics of co-administered metformin, warfarin, atorvastatin, or digoxin [26]. --- A regulatory reading desk on the semaglutide record — the trials, the labeling, and the kidney-outcomes evidence summarized and cited, with no clinic behind the desk, no legal counsel offered, and nothing here prescribed or sold.