Recommended Starting Dosage for Adolescents
Wegovy (semaglutide) is approved for adolescents aged 12 years and older with obesity (BMI ≥95th percentile) or overweight (BMI ≥85th percentile) with weight-related conditions. Treatment begins with 0.25 mg injected subcutaneously once weekly for 4 weeks.[1][2]
Dosage Escalation Schedule
Doses increase gradually every 4 weeks to minimize side effects:
- Weeks 5-8: 0.5 mg once weekly
- Weeks 9-12: 1 mg once weekly
- Weeks 13-16: 1.7 mg once weekly
- Week 17 and onward: 2.4 mg once weekly (maintenance dose)
This schedule matches adult dosing but starts lower. If tolerability issues arise, the dose can stay at the prior level for an additional 4 weeks before advancing.[1][3]
Administration Details
Inject under the skin in the abdomen, thigh, or upper arm, rotating sites weekly. Use on the same day each week, with or without food. No dosage adjustments for mild to moderate kidney or liver impairment.[1][2]
Why the Gradual Increase?
Escalation reduces gastrointestinal side effects like nausea, which are common early on. In the STEP TEENS trial (327 adolescents), 73% reached the 2.4 mg dose with this approach, achieving 16.1% mean weight loss at 68 weeks versus 0.6% on placebo.[3][4]
Differences from Adult Dosing
Identical to adults after initiation; adolescents follow the same titration to 2.4 mg. Approval for this group came in late 2022 based on pediatric trial data.[2][5]
What If a Dose Is Missed?
Take as soon as possible within 5 days, then resume the regular schedule. Skip if more than 5 days late; do not double up.[1]
Sources
[1]: Wegovy Prescribing Information (FDA)
[2]: Novo Nordisk Wegovy Dosing for Adolescents
[3]: NEJM: STEP TEENS Trial Results
[4]: FDA Approval Announcement for Adolescents
[5]: Drugs.com Wegovy Dosage Guide