Ozempic starts at 0.25 mg once a week for four weeks, then goes to 0.5 mg. The label's words: "Initiate OZEMPIC® with a dosage of 0.25 mg injected subcutaneously once weekly for 4 weeks," then "After 4 weeks on the 0.25 mg dosage, increase the dosage to 0.5 mg once weekly."12 From there it can go to 1 mg and then 2 mg, each step after at least four weeks, if blood sugar control needs it. Below: the full chart, every pen, the missed-dose rule, and what each dose costs through NovoCare.
Your dose, and whether and when it goes up, are set by the clinician who prescribed it. Everything on this page is the manufacturer's published schedule, quoted, so you know what to expect. It is not a recommendation to change a dose.
The Ozempic dosage chart
| Weekly dose | Label role | Earliest week (every step at the 4-week minimum) | Pen | NovoCare self-pay |
|---|---|---|---|---|
| 0.25 mg | Starting dose, 4 weeks | 1 | 2 mg/3 mL pen (0.68 mg/mL) | $199 a month for the first 2 fills, then $349 |
| 0.5 mg | Maintenance, or a step | 5 | 2 mg/3 mL pen (0.68 mg/mL) | $199 a month for the first 2 fills, then $349 |
| 1 mg | Maintenance, or a step; the CKD maintenance dose | 9 | 4 mg/3 mL pen (1.34 mg/mL) | $349 a month |
| 2 mg | Maintenance; maximum | 13 | 8 mg/3 mL pen (2.68 mg/mL) | $499 a month |
Sources: label section 2.2 for the schedule and maintenance doses,123 section 3 for the pens,8 and NovoCare for the self-pay prices.11 "Earliest week" is arithmetic, not a target: it is the first week you could be on that dose if every step came at exactly four weeks and every step was needed.
How the schedule works
The first month is fixed: 0.25 mg for four weeks, then 0.5 mg.12 The label is explicit that 0.25 mg is there to start, not to stay on, and the reason it gives for the whole slow start is to "reduce the risk of gastrointestinal adverse reactions".
After that, the label sets three maintenance doses and a condition for moving between them: "The recommended maintenance dosage is 0.5 mg, 1 mg, or 2 mg, injected subcutaneously once weekly, based on glycemic control."3 If more control is needed after at least four weeks on 0.5 mg, the dose may go to 1 mg; after at least four weeks on 1 mg, to 2 mg. 2 mg is the maximum.
If you have type 2 diabetes and chronic kidney disease
The label has a separate rule for this group, because Ozempic is also approved "to reduce the risk of sustained eGFR decline, end-stage kidney disease, and cardiovascular death in adults with type 2 diabetes mellitus and chronic kidney disease".10 For them the instruction is: "Increase the dosage to the maintenance dosage, 1 mg once weekly, after at least 4 weeks on the 0.5 mg dosage."4 In other words, 1 mg is the target maintenance dose rather than one option among three.
Ozempic is also approved to reduce the risk of heart attack, stroke and cardiovascular death in adults with type 2 diabetes and established cardiovascular disease. It is not approved for weight loss; the same molecule is approved for that as Wegovy, which climbs higher, to 2.4 mg and a 7.2 mg strength (see the Wegovy dosing chart and Wegovy vs Ozempic).
Every Ozempic pen, and the new prefilled syringe
Ozempic comes mostly as multi-dose pens, one pen per dose range. The label's description of the pens, verbatim: "2 mg/3 mL (0.68 mg/mL) for 4 doses of 0.25 mg and 2 doses of 0.5 mg or 4 doses of 0.5 mg, 4 mg/3 mL (1.34 mg/mL) for 4 doses of 1 mg, and 8 mg/3 mL (2.68 mg/mL) for 4 doses of 2 mg in single-patient-use pens".8
| Pen | Strength | Doses it can give | How many |
|---|---|---|---|
| Starter pen | 2 mg in 3 mL (0.68 mg/mL) | 0.25 mg and 0.5 mg | 4 doses of 0.25 mg plus 2 of 0.5 mg, or 4 doses of 0.5 mg |
| 1 mg pen | 4 mg in 3 mL (1.34 mg/mL) | 1 mg | 4 doses |
| 2 mg pen | 8 mg in 3 mL (2.68 mg/mL) | 2 mg | 4 doses |
Two practical points come straight from the pen design. The starter pen only dials the doses it is made for (the instructions describe it as delivering "doses in 0.25 mg or 0.5 mg increments only"), so you cannot dial a 1 mg dose on it. And because one starter pen holds four 0.25 mg doses plus two 0.5 mg doses, the first box usually lasts into the second month; that is why NovoCare defines "one month" as one box of one pen rather than four weeks.12
The label now also lists a single-dose form: "0.25 mg, 0.5 mg or 1 mg per 0.5 mL in a single-dose prefilled syringe".9 Each syringe is one dose. There is no 2 mg syringe in that list, so 2 mg remains a pen dose.
Ozempic is not drawn up in units: the pen dials the dose in mg. If you are using compounded semaglutide from a vial, the units depend on the vial's concentration, which differs by pharmacy; the dosing calculator does that arithmetic and the semaglutide dosage chart covers the compounded side.
Timing, missed doses and changing your injection day
Ozempic is injected "once weekly, on the same day each week, at any time of the day, with or without meals",7 under the skin of the abdomen, thigh or upper arm, rotating the site each week. The label's rules for the week, which are shorter and longer than Mounjaro's in different places:
| Situation | The label's rule |
|---|---|
| Missed a dose, 5 days or less ago | Take it as soon as possible within 5 days of the missed dose, then go back to the usual day.5 |
| Missed a dose, more than 5 days ago | Skip it and take the next dose on the regular day.5 |
| Want to change the weekly day | Allowed, as long as there are at least 2 days (more than 48 hours) between two doses.6 |
| Also using insulin | Separate injections, never mixed; the same body region is fine, but not right next to each other. |
What each Ozempic dose costs
How you pay decides almost everything.
With commercial insurance that covers Ozempic
Novo's savings card: "Pay as little as $25, subject to a maximum savings of $100/month. Eligibility and restrictions apply. Government beneficiaries excluded."12 The card is for up to 3 months of the lower price, and it does not change by dose. How the cap works against your copay is in the Ozempic coupon.
Paying cash through NovoCare
NovoCare's terms, verbatim: new patients "pay $199 for each month of 0.25 mg and 0.5 mg. Offer for 2 monthly fills through December 31, 2026, then $349 per month for Ozempic® 0.25 mg, 0.5 mg, or 1 mg, and $499/month for Ozempic® 2 mg."11 So unlike Lilly's flat Mounjaro price, Ozempic's cash price does climb, once, at the top dose.
The arithmetic for a first year at NovoCare's published prices, twelve monthly fills:
| If your prescriber keeps you at | Months 1 to 2 | After that | First year |
|---|---|---|---|
| 0.5 mg | $199 + $199 | 10 x $349 | $3,888 |
| 1 mg | $199 + $199 | 10 x $349 | $3,888 |
| 2 mg (reached in month 4 at the earliest) | $199 + $199 | 1 x $349, then 9 x $499 | $5,238 |
These are illustrations of the published prices, not a plan: the $199 offer runs through December 31, 2026 and Novo can change it. The dose ladder with the date we last checked Novo's prices, beside the cheapest verified semaglutide seller:
The cheaper route most people compare against
Compounded semaglutide is the same molecule made by compounding pharmacies. It is not FDA-approved and it is not Ozempic, but it is how many people paying cash buy semaglutide. The cheapest verified price on the board today:
Titration schedule and cost prices each month of the climb for both routes, and is compounded semaglutide safe covers what the FDA says about it.
Ozempic vs Mounjaro dosing, side by side
The two type 2 diabetes injections people compare most are dosed on different rules. From each label, read the same day:
| Ozempic (semaglutide) | Mounjaro (tirzepatide) | |
|---|---|---|
| Starting dose | 0.25 mg weekly for 4 weeks1 | 2.5 mg weekly |
| How it climbs | To 0.5 mg after 4 weeks, then 1 mg and 2 mg if needed, each after at least 4 weeks23 | 2.5 mg steps after at least 4 weeks, if more glycemic control is needed |
| Named maintenance doses | 0.5, 1 or 2 mg; 1 mg with chronic kidney disease34 | None named; climbs only as needed |
| Maximum | 2 mg | 15 mg (adults), 10 mg (children 10+) |
| Missed dose window | 5 days5 | 4 days (96 hours)13 |
| Minimum gap when changing the day | 2 days (more than 48 hours)6 | 3 days (72 hours) |
| Cash price from the maker | $199 for 2 months, then $349; $499 at 2 mg11 | From $499 a month at every strength14 |
Neither label is a weight-loss label; Wegovy and Zepbound are the weight-loss versions of the same two molecules. Which one controls blood sugar or weight better is a trial question, not a dosing one, and Mounjaro vs Ozempic quotes the head-to-head trial. The full Mounjaro schedule is in the Mounjaro dosage chart.
The short version
0.25 mg for four weeks, then 0.5 mg; 1 mg and then 2 mg only if blood sugar control needs it, each after at least four weeks; 1 mg as the maintenance dose with chronic kidney disease.1234 Missed by five days or less, take it; more than five, skip it.5 With commercial coverage the card takes it to as little as $25; paying cash through NovoCare it is $199 for the first two months, then $349, and $499 at 2 mg.1112 The dose itself is your prescriber's call.
