Ozempic dosage: what the label schedule says
Quick answer. The Ozempic injection label (Novo Nordisk, semaglutide) gives a starting dose of 0.25 mg once a week for 4 weeks, then 0.5 mg. Maintenance doses are 0.5 mg, 1 mg or 2 mg once a week, based on blood sugar control: 1 mg can follow at least 4 weeks on 0.5 mg, and 2 mg can follow at least 4 weeks on 1 mg, if more control is needed. The highest dose is 2 mg once a week. Ozempic is labeled for type 2 diabetes, not for weight loss. Ozempic is also the name of a daily tablet, which has its own schedule: 1.5 mg, then 4 mg, then 4 mg or 9 mg.
The Ozempic injection schedule in the label
This is the Ozempic injection label as revised in May 2026, which lists three uses: improving blood sugar control in adults with type 2 diabetes, lowering the risk of major cardiovascular events in adults with type 2 diabetes and established heart disease, and lowering the risk of kidney decline, kidney failure and cardiovascular death in adults with type 2 diabetes and chronic kidney disease. Weight loss is not a listed use. The weight-management counterpart is Wegovy, covered on the Wegovy dosage page. Both contain semaglutide.
| Label item | What the label says |
|---|---|
| Starting dose | 0.25 mg injected under the skin once a week for 4 weeks. |
| First step up | After 4 weeks on 0.25 mg, 0.5 mg once a week. |
| Maintenance doses | 0.5 mg, 1 mg or 2 mg once a week, based on blood sugar control. |
| Step from 0.5 mg to 1 mg | If more blood sugar control is needed after at least 4 weeks on 0.5 mg, the dose may be increased to 1 mg once a week. |
| Step from 1 mg to 2 mg | If more blood sugar control is needed after at least 4 weeks on 1 mg, the dose may be increased to 2 mg once a week. |
| Highest dose | 2 mg once a week. |
| Type 2 diabetes with chronic kidney disease | Increase to the maintenance dose of 1 mg once a week after at least 4 weeks on 0.5 mg. |
| How often, and when | Once a week, on the same day each week, at any time of day, with or without meals. |
The label gives no separate dose for the heart-protection use. The 1 mg and 2 mg steps are tied to needing more blood sugar control. The label for the weight-management product lists a different schedule.
The label schedule, step by step
The label sets a minimum of 4 weeks on each dose and no fixed calendar, so the table shows the earliest week each step could begin if every step took exactly 4 weeks. The weeks are arithmetic from the label rule. They are not a plan.
| Weekly dose | Earliest week it can begin | What the label says about it |
|---|---|---|
| 0.25 mg | Week 1 | Starting dose, for 4 weeks. |
| 0.5 mg | Week 5 | First step up. A listed maintenance dose. |
| 1 mg | Week 9 | After at least 4 weeks on 0.5 mg, if more blood sugar control is needed. A listed maintenance dose. |
| 2 mg | Week 13 | After at least 4 weeks on 1 mg, if more blood sugar control is needed. The highest dose. |
Ozempic pens and syringes
Ozempic pens hold several weekly doses and are used by one person. The label also lists single-dose prefilled syringes in its dosage forms section. Whether the syringes are on sale is not something the label says, and the Atlas has not confirmed it.
| Form | Dose per injection | What the label lists |
|---|---|---|
| Pen | 0.25 mg or 0.5 mg | 2 mg in 3 mL in total (0.68 mg per mL) |
| Pen | 1 mg | 4 mg in 3 mL in total (1.34 mg per mL) |
| Pen | 2 mg | 8 mg in 3 mL in total (2.68 mg per mL) |
| Single-dose prefilled syringe | 0.25 mg | 0.25 mg in 0.5 mL |
| Single-dose prefilled syringe | 0.5 mg | 0.5 mg in 0.5 mL |
| Single-dose prefilled syringe | 1 mg | 1 mg in 0.5 mL |
The label lists no 2 mg syringe. Pens are single-patient-use pens, meaning one person uses a pen over several weeks. The Atlas gives no steps for using a pen. See the maker's own instructions for use.
Ozempic tablets and Rybelsus tablets
Ozempic is also the name of a daily semaglutide tablet for type 2 diabetes. It shares one label with Rybelsus tablets, and the label says the two are not substitutable milligram for milligram. The Atlas's Ozempic tablets page and Rybelsus page explain the name change. The label is dated January 2026. Foundayo, which contains a different medicine and is labeled for weight management, is covered on the Foundayo dosage page.
- The label says not to switch between Rybelsus and Ozempic tablets during days 1 to 30. After 30 days it pairs Rybelsus 7 mg with Ozempic tablets 4 mg, and Rybelsus 14 mg with Ozempic tablets 9 mg, and says to start the other tablet the day after stopping the first.
- A person on the Ozempic injection can move to the tablets only from the 0.5 mg injection dose, according to the label. It says to start 7 mg or 14 mg Rybelsus, or 4 mg or 9 mg Ozempic tablets, one week after the last 0.5 mg injection.
- For a missed tablet, the label says to skip it and take the next dose the following day.
| Days | Ozempic tablets, once a day | Rybelsus tablets, once a day |
|---|---|---|
| 1 to 30 | 1.5 mg. The label says this dose is not effective for blood sugar control. | 3 mg. The label says this dose is not effective for blood sugar control. |
| 31 to 60 | 4 mg | 7 mg |
| 61 onward | Stay on 4 mg if no more blood sugar control is needed, or move to 9 mg if more is needed. | Stay on 7 mg if no more blood sugar control is needed, or move to 14 mg if more is needed. |
The label lists 9 mg (Ozempic tablets) and 14 mg (Rybelsus) as the highest steps and does not use the word maximum. How to take it, per the label: one tablet once a day on an empty stomach in the morning with up to 4 ounces of plain water, swallowed whole, then wait at least 30 minutes before eating, drinking or taking other oral medicines. Do not take more than one tablet a day.
What the label says about a missed injection
| Situation | What the label says |
|---|---|
| A dose is missed and 5 days or less have passed | Give the missed dose as soon as possible. The patient then goes back to the usual weekly schedule. |
| More than 5 days have passed | Skip the missed dose and give the next dose on the regularly scheduled day. |
| Changing the weekly injection day | The day can be changed if needed, as long as the time between two doses is at least 2 days (more than 48 hours). |
The Zepbound and Mounjaro labels give 4 days for a missed dose. The Ozempic label gives 5. This is label text for information, and what to do about a particular missed dose is a question for a prescriber or pharmacist.
What the Ozempic dose trials tested
Trial results are group averages from the study named, not promises for any one person. The last column names the analysis approach, because changes the numbers. These trials measured blood sugar first and weight second. Weight is not an approved use of Ozempic.
- In SUSTAIN FORTE, the 2 mg dose lowered HbA1c by about 0.2 points more than 1 mg. Digestive side effects were the most common events in both groups, at 34% on 2.0 mg and 31% on 1.0 mg.
- The weight-loss trials of semaglutide used the weight-management doses, up to 2.4 mg. They tested a different product with a different label. See the Wegovy dosage page for those trials.
| Trial | People and length | Doses tested | Result | Analysis approach |
|---|---|---|---|---|
| SUSTAIN 1 | 387 adults with type 2 diabetes treated with diet and exercise alone, who received at least one dose. 30 weeks. | 0.5 mg and 1.0 mg once a week, against placebo | HbA1c (a blood sugar marker) fell 1.45 and 1.55 percentage points, against 0.02 on placebo. Weight fell 3.73 kg and 4.53 kg, against 0.98 kg. | Modified intention to treat: everyone who received at least one dose. |
| SUSTAIN FORTE | 961 adults with type 2 diabetes on metformin, with or without a sulfonylurea. 40 weeks. | 2.0 mg against 1.0 mg once a week | On the trial-product approach, HbA1c fell 2.2 points on 2.0 mg and 1.9 on 1.0 mg, and weight fell 6.9 kg and 6.0 kg. On the treatment-policy approach, HbA1c fell 2.1 and 1.9 points and weight fell 6.4 kg and 5.6 kg. | Two approaches reported: trial product (no discontinuation or rescue medicine) and treatment policy (regardless of discontinuation or rescue). |
| SURPASS-2 | 1,879 adults with type 2 diabetes. 40 weeks. Open label, run by the maker of tirzepatide. | Semaglutide 1 mg once a week, against tirzepatide 5 mg, 10 mg and 15 mg | HbA1c fell 1.86 points on semaglutide 1 mg. The tirzepatide arms fell 2.01, 2.24 and 2.30 points. | The abstract does not name the approach. |
| PIONEER 1 | 703 adults with type 2 diabetes managed with diet and exercise. 26 weeks. | Tablet doses of 3 mg, 7 mg and 14 mg once a day, against placebo | Differences from placebo in HbA1c on the treatment-policy approach were -0.6, -0.9 and -1.1 points. On the trial-product approach they were -0.7, -1.2 and -1.4 points. | Two approaches reported: treatment policy and trial product. |
Sources: SUSTAIN 1 (2017), SUSTAIN FORTE (2021), SURPASS-2 (2021) and PIONEER 1 (2019). The Atlas read the published abstracts. Novo Nordisk funded SUSTAIN 1 and SUSTAIN FORTE, and Eli Lilly funded SURPASS-2. Several PIONEER 1 authors work for Novo Nordisk. The tablets tested in PIONEER 1 were the 3 mg, 7 mg and 14 mg strengths, which are the Rybelsus strengths, so the trial does not directly test the 1.5 mg, 4 mg and 9 mg Ozempic tablet strengths.
What is listed for the cash price
The Atlas has one price entry for Ozempic: TrumpRx listed $199 a month when the Atlas read it in October 2026. The site did not say which doses the price covers, and the Atlas could not confirm how TrumpRx fills orders. The Atlas has no price data for the Ozempic tablets. See paying for GLP-1 medicines for the sources and the limits of that entry.
Using Ozempic for weight loss
A prescriber who uses a diabetes-labeled product to treat weight is prescribing off-label, and the Atlas does not advise on that. The dose ladder for weight reduction is the Wegovy label's. The Ozempic injection and Wegovy injection are separate products with separate labels, and the Atlas gives no conversion between them. Ozempic vs Wegovy compares the two, and the microdosing page covers what is known about doses below the label ladder.
Quick answers
- What is the Ozempic dosage?
- The label starts at 0.25 mg once a week for 4 weeks, then 0.5 mg. Maintenance doses are 0.5 mg, 1 mg or 2 mg once a week, based on blood sugar control. The highest dose is 2 mg once a week. A prescriber sets the plan.
- How long does the label say to stay on 0.25 mg?
- Four weeks. The label calls 0.25 mg the starting dose, then moves to 0.5 mg.
- When can the Ozempic dose go from 0.5 mg to 1 mg?
- The label says the dose may be increased to 1 mg if more blood sugar control is needed after at least 4 weeks on 0.5 mg.
- What is the highest Ozempic dose?
- 2 mg once a week, which the label allows if more blood sugar control is needed after at least 4 weeks on 1 mg.
- What are the Ozempic pen strengths?
- The label lists a pen delivering 0.25 mg or 0.5 mg per injection (2 mg in 3 mL), a 1 mg pen (4 mg in 3 mL) and a 2 mg pen (8 mg in 3 mL). It also lists single-dose syringes of 0.25 mg, 0.5 mg and 1 mg.
- What does the label say if an Ozempic dose is missed?
- Give it as soon as possible within 5 days of the missed dose. If more than 5 days have passed, skip it and give the next dose on the regular day. The weekly day can be changed if doses are at least 2 days (more than 48 hours) apart.
- What is the Ozempic tablet dosage?
- One tablet a day: 1.5 mg for days 1 to 30, 4 mg for days 31 to 60, then 4 mg or 9 mg from day 61 depending on whether more blood sugar control is needed. The 1.5 mg dose is not effective for blood sugar control, per the label.
- Is Rybelsus the same as Ozempic tablets?
- They share one label but are not substitutable milligram for milligram. Rybelsus is 3 mg, 7 mg and 14 mg. Ozempic tablets are 1.5 mg, 4 mg and 9 mg.
- Is Ozempic dosed for weight loss?
- No. Ozempic is labeled for type 2 diabetes and its dose steps are tied to blood sugar control. The weight-management product is Wegovy, which has its own schedule.
Questions to ask
- Which Ozempic dose is the goal for my blood sugar, and how will we decide whether to step up?
- If I miss a dose, who do I call, and what does your office want me to do?
- Which form will I get (pen or tablet), and who will teach me to use it?
- What will each dose cost me, with my coverage?
- What is the plan if I cannot tolerate a step?
What is still unknown
- The label sets a minimum of 4 weeks per dose and no fixed calendar, so how long a person stays at each step is a prescriber decision.
- The Atlas read the injection label revised May 2026 (and its June 2026 copy on DailyMed) and the tablet label revised January 2026. It read the dosing and dosage-forms sections only.
- The label lists single-dose syringes, but the Atlas has not confirmed they are on sale.
- The Atlas read the published abstracts of the trials, not the full papers. SURPASS-2's abstract does not name its analysis approach, and no trial in the table tested the 1.5 mg, 4 mg or 9 mg Ozempic tablet strengths directly.
- The Atlas has no price data for Ozempic tablets or for the Ozempic pen beyond one listing, and prices change often.
Sources
- Ozempic (semaglutide) injection: FDA-hosted prescribing information, 5/2026 Novo Nordisk, on Drugs@FDA (U.S. Food and Drug Administration). Supplement 038. Regulator
- Ozempic (semaglutide) injection: prescribing information Novo Nordisk, on DailyMed (U.S. National Library of Medicine). Label version 5/2026. Official FDA label on DailyMed
- Ozempic and Rybelsus (semaglutide) tablets: FDA-hosted prescribing information, 1/2026 Novo Nordisk, on Drugs@FDA (U.S. Food and Drug Administration). Supplement 030. Regulator
- Ozempic and Rybelsus (semaglutide) tablets: prescribing information Novo Nordisk, on DailyMed (U.S. National Library of Medicine). Label version 1/2026. Official FDA label on DailyMed
- Efficacy and safety of once-weekly semaglutide monotherapy versus placebo in patients with type 2 diabetes (SUSTAIN 1) Sorli C, et al. Lancet Diabetes Endocrinol. 2017;5(4):251-260. PMID 28110911. Funding: Novo Nordisk. Journal article
- Efficacy and safety of once-weekly semaglutide 2.0 mg versus 1.0 mg in patients with type 2 diabetes (SUSTAIN FORTE) Frias JP, et al. Lancet Diabetes Endocrinol. 2021;9(9):563-574. PMID 34293304. Funding: Novo Nordisk. Journal article
- Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes (SURPASS-2) Frias JP, et al. N Engl J Med. 2021;385(6):503-515. PMID 34170647. Funding: Eli Lilly. Journal article
- PIONEER 1: randomized clinical trial of the efficacy and safety of oral semaglutide monotherapy in comparison with placebo in patients with type 2 diabetes Aroda VR, et al. Diabetes Care. 2019;42(9):1724-1732. PMID 31186300. Funding: Novo Nordisk (several authors are company employees). Journal article