The semaglutide dose ladder, and what each step costs

Semaglutide is titrated upward over months rather than started at the target dose, to let gastrointestinal side effects settle. For Wegovy the pen ladder runs 0.25 mg, 0.5 mg, 1 mg, 1.7 mg and 2.4 mg, with a 7.2 mg high-dose strength above it. The part most charts leave out is the money: Novo's own self-pay price is flat at $349 a month across every pen dose from 0.25 to 2.4 mg, so climbing the ladder does not raise the brand price, while many compounded sellers do charge more at higher doses. Here is the ladder, what each step costs at the cheapest verified seller, and which sellers hold one price the whole way.

Julian CaraulaniFounder, PriceTracker GLP-1Last checked Aug 27We track prices. Clinical facts on this site are quoted from the drug's label, the FDA or the published trial, with the source and the date beside each one. We do not write medical guidance and we do not tell anyone what to take.

7 min read · published Aug 27

The short version

1The Wegovy pen ladder is 0.25, 0.5, 1, 1.7 and 2.4 mg, with a 7.2 mg high-dose strength above it.
2Novo's self-pay price is flat at $349/mo across every pen dose from 0.25 to 2.4 mg, so dose escalation does not change the brand price.
3Compounded sellers differ: some hold one price at every dose, others charge more as you climb. That is the difference worth checking before you sign up.
4Your dose and your schedule are set by your prescriber. Everything here is the manufacturer's published ladder, not advice.

Semaglutide is not started at the dose that does the work. It is titrated upward in steps over several months, so the gastrointestinal effects have time to settle. Every dosage chart on the internet shows you that ladder. Almost none of them show you what each rung costs, which is the question that actually decides whether someone finishes the climb.

So here is both. A semaglutide dosing chart and a semaglutide dosage chart are the same thing, and this is it.

Worth knowing

Your dose, and how fast you move between doses, are set by the clinician who prescribed it. The ladder below is the manufacturer's published schedule, reproduced so you know what to expect. It is not a recommendation, and it is not a reason to change anything on your own.

The Wegovy dose ladder

Wegovy is Novo Nordisk's semaglutide for weight management. The pen strengths, and Novo's own self-pay price at each, as published on NovoCare:¹

Phase	Dose	Novo self-pay
Ease in	0.25 / 0.5 mg	$199/mo for a new patient's first two fills, through 31 Dec 2026
Build	1 / 1.7 mg	$349/mo
Maintain	2.4 mg	$349/mo
High dose	7.2 mg (HD)	$399/mo

Quoted from NovoCare's own published terms, checked 22 August 2026:¹

Patients new to the Wegovy Savings offer or NovoCare Pharmacy pay $199 for each month of 0.25 mg & 0.5 mg. Offer for 2 monthly fills through December 31, 2026, then $349 per month for Wegovy 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg and $399 per month for Wegovy HD 7.2 mg.
NovoCare, Wegovy savings offer and self-pay pricing

The thing that chart tells you, that others do not

Read the middle column again. $349 covers 0.25 mg and it covers 2.4 mg. Novo's brand price is flat across the entire standard pen range, which means climbing the ladder costs a brand patient nothing extra until the 7.2 mg high-dose strength.

In plain English

On the brand, your dose going up does not put your bill up. That is not true everywhere else, and it is the single most useful thing to know before you pick a program.

Where it stops being flat

Most people paying cash are not on the brand. They are on compounded semaglutide from a telehealth program, and those sellers price two different ways.

Flat sellers charge the same monthly figure whatever dose you are on. What you pay in month one is what you pay in month twelve.

Climbing sellers price by strength. The entry number in an advert is the 0.25 mg number, and the figure that matters to you is the one at the dose you will actually settle on, which you will reach in a few months and stay at indefinitely.

An advertised price is therefore not comparable between the two without knowing which kind you are looking at. A $99 climbing program and a $149 flat program are not $50 apart over a year of treatment. They may not even be in the same order.

How long the climb takes

The manufacturer's schedule moves a patient up in steps with several weeks at each, which puts the maintenance dose a few months out from the first injection rather than a few weeks. Two consequences worth planning for:

The first months are not the test. Judging the medication on how you feel at 0.25 mg is judging it before it has been asked to do anything.
Budget for the maintenance dose, not the starting one. If a program climbs, the number to compare is the one at the top of the ladder, because that is where you will spend most of the year.

Ozempic, and why its chart is different

Ozempic is the same molecule approved for type 2 diabetes rather than weight management, and its pen strengths differ from Wegovy's: it tops out lower, and Novo prices it separately. There is now also an oral semaglutide line, and it is a genuine mess of three products at three different strengths, which we untangled separately.²

What to actually ask

Two questions, one for each party.

Ask the prescriber: what dose are we aiming for, and how fast are we getting there. Everything about how you feel over the next three months follows from that answer.

Ask the seller, before you pay: does this price hold at every dose. Get it in writing. It is the difference between the price you were quoted and the price you will pay.

Sources2

NovoCare, Wegovy savings offer and self-pay pricing read Aug 22“Patients new to the Wegovy Savings offer or NovoCare Pharmacy pay $199 for each month of 0.25 mg & 0.5 mg. Offer for 2 monthly fills through December 31, 2026, then $349 per month for Wegovy 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg and $399 per month for Wegovy HD 7.2 mg.” ↩
NovoCare Pharmacy, self-pay prices for the Wegovy and Ozempic pills read Aug 27“Self-pay pricing varies by dose. Patients pay $149 for each month of 1.5 mg, $199 per month for 4 mg and $299 per month for 9 mg and 25 mg. One month defined as 1 bottle of 30 tablets.” ↩

Common questions

What is the semaglutide dose ladder?

For Wegovy, the pen strengths are 0.25 mg, 0.5 mg, 1 mg, 1.7 mg and 2.4 mg, with a 7.2 mg high-dose strength above them. Treatment starts at the bottom and steps up over several months so gastrointestinal effects have time to settle. Your schedule is set by your prescriber.

Does semaglutide cost more at higher doses?

On the brand, no. Novo Nordisk's published self-pay price is $349 a month for Wegovy at 0.25, 0.5, 1, 1.7 and 2.4 mg, so the price is flat across the whole standard pen range. The 7.2 mg high-dose strength is $399. Compounded sellers vary: some hold one price at every dose and others charge more as the dose climbs.

How long does it take to reach the maintenance dose?

The manufacturer's schedule holds a patient at each step for several weeks, which puts the maintenance dose a few months out from the first injection rather than a few weeks. Prescribers commonly slow this down further if side effects are difficult.

Why does my program's price go up when my dose does?

Because it prices by strength rather than per month. This is common among compounded telehealth programs and it is legitimate, but it means the advertised entry price is the starting-dose price, not what you will pay at maintenance. Ask whether the price holds at every dose before you sign up.

Is the Ozempic dosage chart the same as Wegovy's?

No. Ozempic is the same molecule approved for type 2 diabetes rather than weight management, its pen strengths top out lower than Wegovy's, and Novo prices the two separately.