Redose
The FDA approved Wegovy HD on March 19, 2026, a 7.2 mg once-weekly semaglutide shot that sits at three times the old 2.4 mg ceiling. In the 72-week STEP UP trial, it lifted average weight loss from 15.5% to 18.8%. That's a gap of 3.3 percentage points, which is real, but a lot smaller than the jump in dose.
So the new Wegovy max dose is less a fresh start than an extra gear for people who've already reached 2.4 mg. The numbers that follow come from the updated FDA prescribing information and Novo Nordisk's pricing pages. None of it is a reason to change a dose on your own; that call belongs to the prescriber who manages your treatment.
The Wegovy dosing chart now has a sixth step
The first 16 weeks haven't changed. The label still starts at 0.25 mg weekly and climbs every 4 weeks through 0.5 mg, 1 mg and 1.7 mg, reaching the 2.4 mg Wegovy maintenance dose at week 17. Those early steps are there to soften stomach side effects, and the label says a step can be held for 4 more weeks if a dose isn't tolerated.
| Weeks | Weekly dose | Pen strength |
|---|---|---|
| 1 to 4 | 0.25 mg | 0.25 mg in 0.5 mL |
| 5 to 8 | 0.5 mg | 0.5 mg in 0.5 mL |
| 9 to 12 | 1 mg | 1 mg in 0.5 mL |
| 13 to 16 | 1.7 mg | 1.7 mg in 0.75 mL |
| 17 onward | 2.4 mg | 2.4 mg in 0.75 mL |
| After 4+ weeks on 2.4 mg | 7.2 mg (HD) | 7.2 mg in 0.75 mL |
The new top step is optional. It's limited to adults with obesity who've tolerated 2.4 mg for at least 4 weeks and for whom more weight reduction is clinically indicated. For heart risk reduction, teens aged 12 and up, and MASH, the Wegovy dose schedule still tops out at 2.4 mg.
The soonest the label's schedule can reach 7.2 mg is week 21: sixteen weeks of titration, then at least four weeks on 2.4 mg.
There's no halfway pen between 2.4 mg and 7.2 mg
On the label, the Wegovy dose increase from 2.4 mg goes straight to 7.2 mg. The HD pen holds its full 7.2 mg in 0.75 mL, the same volume as the 2.4 mg pen, so the injection itself isn't bigger. In the trials, people were escalated over 20 weeks and then held on their dose for 52 weeks.
- Starter pens: 0.25 mg, 0.5 mg and 1 mg, each in 0.5 mL
- Step-up and maintenance pens: 1.7 mg and 2.4 mg, each in 0.75 mL
- Wegovy HD pen: 7.2 mg in 0.75 mL, single dose, once weekly
- FlexTouch option: one 2.4 mg pen holds 4 weekly doses (9.6 mg in 3 mL)
Oxford Online Pharmacy has a short walkthrough of the 7.2 mg pen. It was filmed for UK patients, so check every step against the instructions for use inside your own box.
What the STEP UP trials found at the highest dose of Wegovy
STEP UP randomized 1,407 adults with obesity and without diabetes, five to one to one, to 7.2 mg, 2.4 mg or placebo. Their average starting weight was 113 kg. After 72 weeks the 7.2 mg group had lost 18.8% of body weight, against 15.5% on 2.4 mg and 3.9% on placebo, according to the label's own tables.
A companion trial in 512 adults with type 2 diabetes told the same story at lower levels: 13.2% on 7.2 mg, 10.4% on 2.4 mg and 3.8% on placebo. The gap between the two doses stayed under 3 points. If you've been stuck for months on 2.4 mg, our piece on when the weight loss plateau usually hits explains why the curve flattens.
In STEP UP, 88.7% of people on 7.2 mg lost at least 5% of their weight, versus 86.6% on 2.4 mg. The higher dose barely changes who responds. It changes how far they go.
Why you'll see 20.7% quoted elsewhere
News reports often cite a 20.7% loss and say 31.2% of people on 7.2 mg lost a quarter of their weight. Those figures use an analysis that assumes everyone stayed on treatment. The label's 18.8% counts everyone who was randomized, including people who stopped, so it's the more conservative number and the one this piece leans on.
Side effects climb faster than the weight loss does
Stomach complaints rose only a little at 7.2 mg. The number that stands out is dysesthesia, a cluster of altered skin sensations such as burning, tingling or skin that hurts to touch. It was reported by 22% of people on 7.2 mg, compared with 6% on 2.4 mg and 0.3% on placebo.
- Nausea: 39% on 7.2 mg, 35% on 2.4 mg, 13% on placebo
- Vomiting: 22% on 7.2 mg, 16% on 2.4 mg, 6% on placebo
- Constipation: 20% on 7.2 mg, 19% on 2.4 mg, 8% on placebo
- Hair loss: 6% on 7.2 mg, 3% on 2.4 mg, 1% on placebo
- Stopped for side effects: 5% on either dose, 2% on placebo
How the skin symptoms played out
Among 288 people who reported dysesthesia on 7.2 mg, 2% stopped the drug for good, 8% paused it and 23% had their dose lowered. Most of those whose dose was changed recovered, and they recovered faster than people whose dose stayed put. Of 38 who were later moved back up to 7.2 mg, 17 (45%) had the symptoms return.
Dysesthesia was nearly four times as common on 7.2 mg as on 2.4 mg. If a prescriber moves you up, it's the side effect most worth writing down.
Nausea on semaglutide tends to cluster in the first weeks after each step up. Our look at how long Ozempic nausea lasts covers that pattern in more detail.
What Wegovy HD costs, and what you get for it
The NovoCare self-pay price is $399 a month for the 7.2 mg dose, against $349 for any dose from 0.25 mg to 2.4 mg. That's $50 more a month, or $600 across a year of fills.
| Measure | 2.4 mg | 7.2 mg |
|---|---|---|
| Self-pay per month | $349 | $399 |
| Self-pay per year | $4,188 | $4,788 |
| Average loss at 72 weeks | 15.5% | 18.8% |
| Loss from a 113 kg start | About 17.5 kg | About 21.2 kg |
Put against the trial, that $600 a year bought about 3.3 extra points of weight loss. On STEP UP's 113 kg average starting weight, that's roughly 3.7 kg more, set against a much higher chance of skin symptoms. Whether the trade is worth it is a question to price out with your prescriber, not on a forum.
Insured patients may pay as little as $25 a month through Novo's savings offer, which caps savings at $100 a month. New self-pay patients can get two 0.25 mg or 0.5 mg fills at $199 each through December 31, 2026, but the HD dose isn't part of that offer. Our Wegovy savings card breakdown walks through the rest.
Tracking a dose of Wegovy once you move past 2.4 mg
A sixth step means one more pen strength to keep straight, and the 2.4 mg and 7.2 mg pens share the same 0.75 mL volume. Logging the strength on every injection day, along with any skin or stomach symptoms, gives your prescriber a clean record for judging whether the higher dose is earning its place. Redose is built for that kind of tracking and record-keeping only, and it never makes dosing decisions.
- Pen strength and date for every weekly injection you take
- Injection site, rotated between abdomen, thigh and upper arm
- Skin symptoms like burning or tingling, with a 0 to 10 rating
- Nausea, vomiting or constipation days after each new step
- Weekly weight on the same scale at the same time of day
Your wegovy injection doses are fixed by the pen, so there's no unit math for branded pens. If you also log a compounded or vial-based medication, the Redose calculators turn milligrams into syringe units for the exact concentration on your label.
What the label says about a Wegovy missed dose
If one injection is missed and the next is more than 2 days away, the label says to take it as soon as possible. If the next one is less than 2 days away, skip it and go back to your usual day. Our missed dose guide compares that with Ozempic's 5-day window.
Questions people ask about the Wegovy max dose
What is the highest dose of Wegovy?
It's 7.2 mg once weekly, sold as Wegovy HD. The label limits it to adults with obesity who've been on 2.4 mg for at least 4 weeks and need more weight reduction. For every other approved use, 2.4 mg is still the ceiling.
Can you start Wegovy at 7.2 mg?
No. Every patient starts at 0.25 mg and climbs in 4-week steps, reaching 2.4 mg at week 17 at the earliest. With the 4-week minimum on 2.4 mg, the soonest anyone reaches 7.2 mg on the label's schedule is week 21.
Is the Wegovy dosage chart different for teens?
The first 16 weeks are the same for patients 12 and older. After that, maintenance stays at 2.4 mg or 1.7 mg, and the label doesn't allow the 0.25 mg, 0.5 mg or 1 mg steps as long-term doses. The 7.2 mg step is an adult-only option.
Does Wegovy HD come as a pill?
No. Wegovy HD is an injection only. The Wegovy tablet has its own schedule that climbs every 30 days to a 25 mg once-daily maintenance dose, and it isn't interchangeable with the 7.2 mg pen milligram for milligram.
Track every step of your Wegovy dosing chart with confidence. Download Redose for gentle injection reminders, site rotation on a body map, side effect notes you can show your prescriber, and a complete private log of your protocol. Get the app here: iOS.