Semaglutide Dosage & Reconstitution in 2026

Semaglutide is a once-weekly injection that starts at a low dose and steps up slowly over months, a process called titration. Most protocols begin around 0.25 mg per week and increase every four weeks, but the schedule that matters is the one your prescriber writes for you.

Here is how dosing works, how to reconstitute a vial, and how to measure a dose on an insulin syringe, all done the pharmacy-grade way. Getting ahead of your metabolic health is a smart step, and this is how to do it right.

The semaglutide titration schedule

Semaglutide is increased gradually so your body adjusts and side effects stay manageable. A widely used schedule follows the one studied for branded semaglutide: start low, hold each dose for about four weeks, then step up. Your prescriber may move faster or slower, or hold you at a lower dose, based on how you respond. This chart is a common reference point, not a prescription.

The goal of titration is comfort, not speed. Moving up too quickly is a common cause of nausea, so many people hold a dose an extra few weeks. There is no prize for reaching the top of the chart, and plenty of people do well below it.

How to reconstitute a semaglutide vial

Some compounded semaglutide ships ready to inject, and some ships as a freeze-dried (lyophilized) powder you mix yourself with bacteriostatic water. If yours needs mixing, your pharmacy label tells you exactly how much water to add. Follow that label, because the amount of water sets the concentration, and the concentration is what turns your prescribed milligrams into marks on a syringe.

1. Let the vial and bacteriostatic water reach room temperature, and wipe both stoppers with an alcohol swab.
2. Draw the exact volume of bacteriostatic water your label specifies into a syringe.
3. Inject the water slowly down the inside wall of the vial, aiming the stream at the glass rather than at the powder.
4. Swirl gently until the solution is clear. Do not shake, which can damage the peptide.
5. Label with the date and store in the refrigerator. Use within the timeframe your pharmacy gives you.

How to measure and inject a dose

Semaglutide is injected under the skin (subcutaneously) once a week, usually in the abdomen, thigh, or back of the upper arm. It is measured on a U-100 insulin syringe, the small syringe marked in units, not the large syringes used for other injections. Your dose in milligrams converts to a number of units based on your vial's concentration.

• Rotate the site each week so the same spot is not used repeatedly.
• Pinch the skin, insert at the angle your clinician shows you, and inject slowly.
• Pick a consistent day of the week. If you miss a dose, follow your prescriber's guidance rather than doubling up.
• Never share a vial or a needle, and dispose of needles in a sharps container.

If you are unsure how many units your dose works out to, use our dosing calculator or confirm with the pharmacy. Getting the units right is the single most important step, and it is where most avoidable problems with compounded vials happen.

How dose relates to side effects

Most semaglutide side effects are digestive and tend to appear right after a dose increase: nausea, fullness, or constipation. That timing is exactly why titration exists. Slowing down, holding a dose longer, or easing back a step usually settles them. For what to expect and how to manage it, see our guide to semaglutide side effects and results.

Who should not take semaglutide

Semaglutide is not right for everyone, and that is decided before any dose is set, not after. It is not used by people with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). It is also stopped ahead of a planned pregnancy. These are firm contraindications, and a licensed physician screens for them at intake so the medicine only reaches people it is appropriate for.

• A personal or family history of medullary thyroid carcinoma (MTC).
• A personal or family history of Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
• Pregnancy, or a pregnancy you are planning. Semaglutide is stopped before a planned pregnancy.

What semaglutide microdosing is

Microdosing semaglutide means a lower, slower schedule than the standard titration above, one that some clinicians use to ease side effects while a person adjusts. It is clinician-directed, not a shortcut and not a way to stretch a vial on your own. The dose is still individualized, chosen by your prescriber for how your body responds, and it steps up the same way, just more gently.

If digestive side effects are the concern, microdosing is one tool a prescriber might reach for, alongside simply holding a dose longer. It is a clinical choice, so it starts with a conversation with your clinician, not a smaller number you pick yourself.

How pru handles dosing

With pru, a licensed physician sets your titration and a 503A pharmacy fills your prescription, so your dose is a clinical decision rather than a guess off a chart. Every vial is labeled with your name, your prescriber, and your concentration, and it ships with a Certificate of Analysis so you know what is in it.

The peptide is priced at cost, itemized, with no markup on the medicine. Deciding to act on your metabolic health is the smart, responsible move, and pru exists to make that choice the accessible one: licensed physicians, pharmacy-grade medicine, and at-cost pricing in one place. When you are ready, start with semaglutide, read the full compounded semaglutide guide, or browse the weight loss and metabolism catalog.

Related reading

• Compounded semaglutide, explained
• Semaglutide side effects and results
• Semaglutide vs Ozempic and Wegovy
• Where to buy compounded semaglutide
• see it on pru

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