# GLP-1 dose schedules: every ladder, and why the steps are four weeks

Updated 23 August 2026 · Written by the Penwise team

Every GLP-1 starts low and climbs. The ladders differ, the step lengths differ, and the reason behind both is the same piece of arithmetic: a new dose takes four to five half-lives to reach a stable level, and there is no point judging a step before it has arrived. This is every ladder in one place, and what the schedule is actually doing.

## Why a titration step lasts as long as it does

When you start a dose, the level climbs for four to five half-lives before it plateaus. That is not an opinion about tolerance – it is how accumulation works with any repeated dose.

- **~4 weeks**: to steady state on tirzepatide (5-day half-life)
- **~5 weeks**: to steady state on semaglutide (7-day half-life)
- **~3 days**: to steady state on liraglutide (13-hour half-life)
- **2x**: how much semaglutide accumulates over a single dose

The step lengths follow directly. Four weeks per step on the weekly drugs, one week per step on liraglutide. Liraglutide climbs five times faster not because it is gentler but because it settles in days rather than weeks.

The practical consequence gets missed constantly: **week two of a new dose is not that dose.** It is a level still on its way up. Judging whether a step is working, or whether the side effects are tolerable, before it has plateaued is judging something that has not finished happening.

> These are the standard schedules. Prescribers move people faster, slower, or hold them at a step indefinitely, and plenty of people never reach the top of a ladder because they do not need to. Track what you are actually on.

## Tirzepatide: Mounjaro and Zepbound

| Step | Weekly dose | Usual duration |
| --- | --- | --- |
| 1 | 2.5 mg | 4 weeks. A starting dose, not a treatment dose. |
| 2 | 5 mg | 4 weeks or longer. The first dose most people feel properly. |
| 3 | 7.5 mg | 4 weeks or longer |
| 4 | 10 mg | 4 weeks or longer |
| 5 | 12.5 mg | 4 weeks or longer |
| 6 | 15 mg | Maintenance, if you get there |

Six strengths, each dispensed as a separate product. See [tracking Mounjaro](https://penwiseapp.com/en/guides/mounjaro-tracker) and [tracking Zepbound](https://penwiseapp.com/en/guides/zepbound-tracker).

Because every strength is its own box rather than a dial position, moving up a step on tirzepatide means a new prescription line every time. It also means the [pen click](https://penwiseapp.com/en/guides/glp-1-pen-click-chart) arithmetic changes at every step, since the KwikPen delivers the same fixed volume whatever it contains.

## Semaglutide: Wegovy

| Weeks | Weekly dose | Note |
| --- | --- | --- |
| 1 to 4 | 0.25 mg | Starting dose |
| 5 to 8 | 0.5 mg |  |
| 9 to 12 | 1 mg |  |
| 13 to 16 | 1.7 mg | A step some people find harder than the ones before |
| 17 onwards | 2.4 mg | Maintenance |

Sixteen weeks from start to maintenance. See [tracking Wegovy](https://penwiseapp.com/en/guides/wegovy-tracker).

## Semaglutide: Ozempic

| Step | Weekly dose | Note |
| --- | --- | --- |
| 1 | 0.25 mg | 4 weeks, starting dose |
| 2 | 0.5 mg | Many people stay here indefinitely |
| 3 | 1 mg | Requires the 1 mg pen |
| 4 | 1.5 mg | Requires the 2 mg pen |
| 5 | 2 mg | Maximum |

Which doses are available to you depends on which pen you were dispensed – see [tracking Ozempic](https://penwiseapp.com/en/guides/ozempic-tracker).

Ozempic differs from the tirzepatide ladder in one practical way: the pen decides your ceiling. The 0.25 / 0.5 pen cannot reach 1 mg, and the 1 mg pen cannot reach 1.5. A step up sometimes means a new pen and sometimes only a new dial position, which is why supply planning on semaglutide is less predictable than the numbers suggest.

## Liraglutide: Saxenda and Victoza

| Week | Saxenda daily dose | Victoza daily dose |
| --- | --- | --- |
| 1 | 0.6 mg | 0.6 mg |
| 2 | 1.2 mg | 1.2 mg |
| 3 | 1.8 mg | 1.8 mg (maintenance) |
| 4 | 2.4 mg | – |
| 5 onwards | 3.0 mg (maintenance) | – |

One week per step, because liraglutide reaches steady state in about three days. See [tracking Saxenda and Victoza](https://penwiseapp.com/en/guides/saxenda-tracker).

## Oral semaglutide

Tablets climb on their own ladders, and the important thing is that the ladders are not interchangeable between products. A newer tablet formulation absorbs better, so its lower numbers correspond to the higher numbers on the older one. Which step replaces which is a prescriber decision, not arithmetic.

| Product | Dose steps | Cadence |
| --- | --- | --- |
| Rybelsus (current) | 1.5, 4, 9, 25, 50 mg | Daily |
| Rybelsus 3 / 7 / 14 mg (older) | 3, 7, 14 mg | Daily |
| Wegovy tablets | 1.5, 4, 9, 25 mg | Daily |
| Ozempic tablets | 1.5, 4, 9 mg | Daily |

See [tracking Rybelsus and oral semaglutide](https://penwiseapp.com/en/guides/rybelsus-tracker).

## Climbing faster than the level settles

Moving up before a step has plateaued means the new increase lands on a level that was still rising. The two additions stack, and the fortnight afterwards is doing the work of two adjustment periods at once.

That is the mechanism behind most avoidable nausea on these drugs, and it is also why a fast climb feels like it is working – eating very little because you feel unwell produces exactly the short-term result people are looking for, and it is not the result the dose was supposed to produce.

The reverse mistake is just as common: concluding a dose has stopped working three weeks in, when the level has not reached its plateau yet. [The side effect timeline](https://penwiseapp.com/en/guides/glp-1-side-effects-timeline) and [the plateau guide](https://penwiseapp.com/en/guides/glp-1-weight-loss-plateau) both come back to this.

## Holding, pausing and coming back down

None of these ladders is a schedule you are obliged to complete. Holding a step for months because it is working and tolerable is a completely ordinary outcome. So is going up and coming back down, and so is pausing entirely for a while.

What matters for tracking is that the history stays honest. Penwise records the schedule you are actually on: skip, postpone or reschedule any individual dose, and the reason and the date stay in the record rather than being overwritten. A step you held for eleven weeks should read as eleven weeks, not as a gap in a plan.

## What Penwise tracks against the ladder

- The dose you were on for **every single day**, so any symptom or weight reading can be read against it.
- When each step **started and ended**, dated.
- The doses you **skipped, postponed or moved**, with what you decided.
- Adherence drift – whether you are running late and by how much – reported only when there is enough history to be sure.
- With Penwise+, the **estimated level**, so the climb to each plateau is visible rather than assumed.

**Track the ladder you are actually on** Every step dated, every skip recorded, every symptom laid against the right dose. Free core tracker.

## Common questions

**How long should I stay on each GLP-1 dose?**

The standard schedules use four weeks per step on the weekly injectables and one week per step on liraglutide, because that is roughly how long each drug takes to reach a stable level. Your prescriber sets the actual pace, and holding a step longer is common.

**Why do I have to wait four weeks before increasing?**

Because a new dose takes four to five half-lives to plateau. Increasing sooner means stacking an increase on a level that is still climbing, which is where a lot of unnecessary side effects come from.

**Do I have to reach the maximum dose?**

No. Many people settle partway up a ladder and stay there. The top of a ladder is the licensed maximum, not a target you are expected to hit.

**Can I go back down a dose?**

People do, on clinical advice, usually because of tolerability. Penwise records a decrease the same way it records an increase, so the history stays readable either direction.

**How do the tirzepatide and semaglutide ladders compare?**

They do not convert. The milligram scales are unrelated – 1 mg of semaglutide is not comparable to 10 mg of tirzepatide – and switching usually means starting near the bottom of the new ladder. See [Mounjaro versus Ozempic](https://penwiseapp.com/en/guides/mounjaro-vs-ozempic).

**Does Penwise remind me when a step is due?**

It reminds you about doses, on the schedule you set, and it shows how long you have been on the current step. It does not tell you when to increase – that is a prescriber decision and the app deliberately stays out of it.

## Sources

Every factual claim on this page traces to the product information a regulator publishes, or to a published trial. Links open on the site of whoever issued the document.

- [Mounjaro: EPAR product information](https://www.ema.europa.eu/en/medicines/human/EPAR/mounjaro), European Medicines Agency
- [Ozempic: EPAR product information](https://www.ema.europa.eu/en/medicines/human/EPAR/ozempic), European Medicines Agency
- [Wegovy: EPAR product information](https://www.ema.europa.eu/en/medicines/human/EPAR/wegovy), European Medicines Agency
- [Saxenda: EPAR product information](https://www.ema.europa.eu/en/medicines/human/EPAR/saxenda), European Medicines Agency
- [Rybelsus: EPAR product information](https://www.ema.europa.eu/en/medicines/human/EPAR/rybelsus), European Medicines Agency

Penwise is a tracking and education tool, not a medical device. Nothing on this page is medical advice, a diagnosis or a recommendation to start, stop or change a dose. Dosing decisions belong to you and your clinician. Ozempic, Wegovy, Rybelsus, Saxenda and Victoza are trademarks of Novo Nordisk; Mounjaro, Zepbound and Trulicity are trademarks of Eli Lilly. Penwise is not affiliated with, endorsed by or connected to either company.

## Keep reading

- [Nausea, constipation and sulphur burps: managing the gut effects](https://penwiseapp.com/en/guides/glp-1-nausea-and-constipation): Why these drugs upset the gut, what actually helps for each effect, the symptoms that mean call someone today, and when it is a dose question rather than a coping question.
- [A Saxenda and Victoza tracker built for a daily injection](https://penwiseapp.com/en/guides/saxenda-tracker): Liraglutide is daily, not weekly, and a thirteen-hour half-life changes everything about reminders, site rotation and what a missed dose means.
- [Missed a GLP-1 dose? What it actually costs you](https://penwiseapp.com/en/guides/missed-glp-1-dose): A day late on semaglutide is nothing. A day late on liraglutide is a real gap. Why the same question has a different answer for every product.
- [GLP-1 medications and contraception: the interaction people miss](https://penwiseapp.com/en/guides/glp-1-and-contraception): Tirzepatide carries a specific label warning about the pill that semaglutide does not. When it applies, how long for, and what to do about it.