Weight Management Protocol
SemaglutideComplete Dosing & Administration Guide
The revolutionary once-weekly GLP-1 medication that helps your body feel full faster and longer, leading to significant weight loss while also protecting your heart—FDA approved and backed by some of the largest clinical trials in obesity medicine history.
Dose Range
0.25-2.4mg
Frequency
Once weekly
Route
Subcutaneous injection
Cycle Length
Ongoing/indefinite
Dosing
How much
do I take?
Starting Dose
0.25 mg
This starting dose is designed to let your body adjust to the medication and minimize nausea. You probably won't see much weight loss yet—that's normal. This phase is all about getting your GI system used to the medication.
Standard Dose
0.5-1.0 mg
After 4 weeks at 0.25mg, increase to 0.5mg. After another 4 weeks, move to 1.0mg. This gradual approach significantly reduces nausea and vomiting. Most people start seeing meaningful weight loss at the 0.5-1.0mg doses.
Advanced Dose
1.7-2.4 mg
The 2.4mg dose (Wegovy) is the FDA-approved dose for chronic weight management. Continue increasing by 0.5mg increments every 4 weeks until reaching 2.4mg. This is where the most significant weight loss occurs—averaging 15% or more of body weight in trials.
Timing
Best time to take
Choose any day of the week that works for your schedule and stick with it. Many people prefer Sunday or Monday to make it easy to remember. Take it at roughly the same time each week, though the exact hour doesn't matter much due to the long half-life.
With food?
Semaglutide injections can be taken with or without food—it doesn't affect absorption. However, because the medication slows stomach emptying, eating smaller meals will help reduce nausea. The oral version (Rybelsus) MUST be taken on an empty stomach with a small amount of water.
If stacking
Semaglutide is typically used as a standalone weight management therapy. If using with other diabetes medications, especially insulin or sulfonylureas, doses of those medications may need to be reduced to prevent low blood sugar. Always coordinate with your healthcare provider.
Adjusting Your Dose
Increase if
- +You've tolerated the current dose for 4+ weeks without significant GI issues
- +Weight loss has plateaued and you haven't reached target dose
- +Blood sugar targets aren't being met (for diabetes patients)
- +Your healthcare provider recommends progression based on your response
Decrease if
- -Nausea, vomiting, or diarrhea are severe and persistent
- -You're unable to eat enough to maintain basic nutrition
- -You experience signs of dehydration from GI symptoms
- -Side effects significantly impact your quality of life
Signs of right dose
- ✓Steady weight loss of 1-2 pounds per week
- ✓Feeling satisfied with smaller portions
- ✓Reduced food cravings and thoughts about food
- ✓Manageable or no GI side effects
Dosing Calculator
Calculate Your Exact Dose
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Administration
How do I
use it?
Reconstitution
What you need
- •Pre-filled semaglutide pen (Ozempic or Wegovy)—no mixing required
- •Pen needles (usually provided or prescribed separately)
- •Alcohol swabs for injection site cleaning
- •Sharps container for safe needle disposal
Injection
Route
Subcutaneous injection (into the fatty tissue just under the skin)—quick, relatively painless, and can be self-administered at home
Best sites
- •Abdomen (stomach area)—at least 2 inches from belly button, most popular site
- •Front of thighs—middle section works best
- •Upper arm—outer area, may need assistance
Technique
- 1.Remove pen cap and attach a new needle—never reuse needles
- 2.Clean injection site with alcohol swab and let it air dry
- 3.If using a new pen, prime it according to package instructions
- 4.Dial your prescribed dose on the pen
- 5.Pinch skin at injection site and insert needle straight in (90-degree angle)
- 6.Press and hold the dose button until the dose counter shows 0
- 7.Keep the button pressed and count slowly to 6 before removing needle
- 8.Remove needle, dispose in sharps container, and replace pen cap
Storage
Signs of degradation
Sample Daily Schedule
Safety
Is it
safe?
Safety Profile
Semaglutide has been studied in over 20,000 participants across multiple large clinical trials, making it one of the most thoroughly researched weight loss medications available. The FDA approved it after rigorous review of safety data. While GI side effects are common (especially early on), serious side effects are rare. The SELECT trial showed it actually reduces cardiovascular events, adding a safety benefit beyond just weight loss.
The safety profile is supported by multiple Phase 3 trials including STEP 1-4 (weight loss) and SELECT (cardiovascular outcomes), with follow-up extending to nearly 4 years. Long-term studies continue, and post-marketing surveillance actively monitors for rare adverse events. The thyroid tumor signal seen in rodents has not been confirmed in humans after years of widespread use.
Common Side Effects
Experienced by some users
Nausea
The most frequently reported side effect, affecting about 44% of users at higher doses. Usually worst during the first few weeks and when increasing doses, then typically improves significantly.
Management: Eat smaller meals, avoid fatty or fried foods, stay upright after eating, and consider ginger or peppermint tea. The slow dose escalation protocol specifically minimizes this. If severe, your doctor may slow the dose increases.
Constipation or Diarrhea
GI motility changes are common as semaglutide slows stomach emptying. Some people experience constipation, others diarrhea, and some alternate between both.
Management: Stay well hydrated, increase fiber intake gradually, and maintain physical activity. Over-the-counter remedies like stool softeners (for constipation) or anti-diarrheals can help. Symptoms usually improve over time.
Decreased Appetite
This is actually how semaglutide works—it's a feature, not a bug. You'll naturally want to eat less and feel full faster. Some people find this dramatic enough that they forget to eat.
Management: While reduced appetite is the goal, make sure you're still eating regular nutritious meals. Focus on protein and vegetables at each meal. Skipping meals entirely can lead to muscle loss and nutritional deficiencies.
Vomiting
About 24% of users experience vomiting, especially during dose increases. Like nausea, it's typically transient and improves as your body adjusts.
Management: Eat bland foods, avoid lying down after meals, and stay hydrated. If vomiting is frequent, contact your healthcare provider—they may recommend staying at the current dose longer before increasing.
Less Common
- •Gallbladder Problems
- •Hair Loss (Telogen Effluvium)
These typically resolve with continued use or dose adjustment.
Stop and Seek Help If
- ×Severe or persistent nausea and vomiting that prevents adequate nutrition despite dose adjustments
- ×Signs of pancreatitis—severe abdominal pain radiating to the back
- ×Allergic reaction—rash, itching, swelling, difficulty breathing
- ×Signs of thyroid tumors—neck lump, hoarseness, trouble swallowing
- ×Pregnancy or planning to become pregnant (stop at least 2 months before conception)
- ×Severe kidney problems or dehydration from GI symptoms
- ×Your healthcare provider recommends discontinuation
Semaglutide is a prescription medication that should only be started, adjusted, or stopped under medical supervision. This information is educational and does not replace professional medical advice. Stopping suddenly is generally safe, but discuss any changes with your healthcare provider.
Interactions
With other peptides
- !Never combine GLP-1 medications—they work through the same mechanism and combining would increase side effects without additional benefit.
- ✓No direct interaction data exists. BPC-157 is sometimes used for GI healing, which could theoretically help with semaglutide's GI side effects, but this is speculative.
- ✓Limited interaction data. Some users combine them, but this should be done under medical supervision as both can affect glucose metabolism.
With medications
- !Insulin - Semaglutide enhances insulin's blood sugar-lowering effect. Insulin doses typically need to be reduced 20-50% when starting semaglutide to prevent hypoglycemia. Work closely with your doctor.
- !Sulfonylureas (glipizide, glyburide) - High risk of hypoglycemia when combined. Sulfonylurea dose usually needs reduction. Monitor blood sugar closely.
- ✓Oral Contraceptives - Semaglutide's effect on gastric emptying may affect absorption of oral medications. Consider taking birth control at a consistent time relative to meals, or discuss alternative contraception.
- ✓Warfarin - May affect warfarin absorption and metabolism. More frequent INR monitoring recommended when starting or changing semaglutide doses.
- ✓Levothyroxine - Take thyroid medication on an empty stomach as usual. Semaglutide shouldn't significantly affect absorption if taken at different times.
With supplements
- ✓Vitamin B12 - Long-term GLP-1 use may reduce B12 absorption. Consider B12 supplementation, especially if you've been on semaglutide for over a year.
- ✓Fiber Supplements - Can help manage constipation from semaglutide. Start slowly to avoid worsening GI symptoms. Psyllium husk is a good option.
- ✓Protein Supplements - Helpful for ensuring adequate protein intake when appetite is reduced. Aim for at least 60-80g protein daily to preserve muscle mass during weight loss.
- ✓Probiotics - May help with GI side effects. Some users find them helpful for digestive comfort during semaglutide therapy.
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