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What is the maintenance dose of Ozempic?

GLP Guidebook teamUpdated 14 Oct 20266 sourcesWritten from published sources
What we checked6 sources, each one opened and linked to the sentence it supportsLast checked 14 Oct 2026 · Next review due 14 Oct 2027 · How we write
The short answer

Canada’s Ozempic (semaglutide) monograph makes 0.5 mg once a week the first treatment dose, after 4 weeks on a 0.25 mg starting dose. It can rise to 1 mg, then 2 mg, if blood sugar needs more control; 2 mg is the maximum. Ozempic is approved for type 2 diabetes, not weight loss.

How do the Ozempic doses step up?

Every step lasts at least 4 weeks. The 0.25 mg starting dose “is not a therapeutic dose”; it is there to let your body adjust.1

  • Weeks 1 to 4: 0.25 mg once a week.1
  • From week 5: 0.5 mg once a week.1
  • If more blood-sugar control is needed: 1 mg, after at least 4 weeks on 0.5 mg.1
  • If still more is needed: 2 mg, after at least 4 weeks on 1 mg. This is the maximum.1

For people with type 2 diabetes and chronic kidney disease, the monograph names 1 mg as the maintenance dose.1 BC PharmaCare covers up to 1 mg a week; the 2 mg dose was still under review.2

What are the maintenance doses of Wegovy and Zepbound?

Wegovy’s maintenance dose is 2.4 mg a week, reached at week 17. Zepbound’s is 5, 10 or 15 mg a week.3,4

Adults who can’t tolerate Wegovy 2.4 mg may drop to 1.7 mg for up to 4 weeks, then go back up; teens may stay on 1.7 mg.3 For sleep apnea, Zepbound’s maintenance dose is 10 or 15 mg.4 The full dose charts are in Wegovy vs Zepbound.

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Is there a lower dose for keeping weight off?

The Canadian monographs we checked describe doses going up, not stepping down after weight loss. Ozempic isn’t approved for weight in Canada, and the national obesity guideline discourages weight-only use of medicines that lack approval or evidence-based recommendations for it.1,3,5

One trial has tested a lower tirzepatide dose for keeping weight off; it is covered in Guide 9: Stopping. Any change to your dose is your prescriber’s decision.

RisksThe risks, in brief
  • Stomach effects rise with the dose. In Canada’s Ozempic monograph, 17 in 100 people on 0.5 mg and 20 in 100 on 1 mg felt sick (nausea), against 6 in 100 on comparison treatments.1
  • Low blood sugar is more likely if you also take insulin or a sulfonylurea, such as gliclazide.1
  • Pancreatitis (an inflamed pancreas) is uncommon (up to 1 in 100) on the EU Ozempic label.6
  • Who shouldn’t take it. Not for anyone with a personal or family history of medullary thyroid cancer or MEN 2. Stop at least 2 months before a planned pregnancy.1
Full detail in Guide 5: Side effects and risks →

Read the full picture

Related questions

How much is Ozempic in Canada without insurance? Is there a generic Ozempic in Canada? Do you need to stop Ozempic before surgery? Wegovy vs Ozempic
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Sources

  1. Novo Nordisk Canada. Ozempic (semaglutide injection) Product Monograph, 13 July 2026 (type 2 diabetes indications, including reducing the risk of major heart and blood-vessel events in adults with type 2 diabetes and heart or chronic kidney disease, and of kidney decline in type 2 diabetes with chronic kidney disease; GLP‑1 receptor agonist; 0.25 mg for 4 weeks, then 0.5 mg, then 1 mg and 2 mg if needed, maximum 2 mg; SUSTAIN 2 and SUSTAIN 9 results; Table 2 adverse reactions: nausea 17.0% on 0.5 mg and 19.9% on 1 mg vs 6.3% on comparators; once weekly “at any time of the day, with or without meals”; missed dose within 5 days; stop at least 2 months before a planned pregnancy; perioperative aspiration warning). PDF
  2. BC PharmaCare. Limited coverage drugs: semaglutide (Special Authority for type 2 diabetes after inadequate control on maximum tolerated metformin; coverage up to 1 mg weekly; 2 mg under review). Checked 14 October 2026. Link
  3. Novo Nordisk Canada. Wegovy (semaglutide injection) Product Monograph, 2 October 2026 (indications; dose escalation 0.25, 0.5, 1, 1.7 mg every 4 weeks to 2.4 mg; reassess after 12 weeks on the maintenance dose; STEP 1–3 results; Table 4: nausea 44% vs 16% on placebo; perioperative aspiration warning). PDF
  4. Eli Lilly Canada. Zepbound (tirzepatide injection) Product Monograph, 11 June 2026 (indications; 2.5 mg start, maintenance 5, 10 or 15 mg; “The ZEPBOUND multi-dose KwikPen contains 4 doses”; SURMOUNT-1 results; Table 2: nausea 28.0% on 15 mg vs 8.5% on placebo; not to be combined with other tirzepatide or GLP‑1 products; aspiration warning). PDF
  5. Pedersen SD, Manjoo P, Dash S, et al. Canadian Adult Obesity Clinical Practice Guideline: Pharmacotherapy for Obesity Management in Adults, 2025 update. Obesity Canada, Version 3, 11 August 2025 (recommendations; six medicines approved for obesity in Canada; off-label use discouraged; trial summaries including when average weight plateaued; stopping and regain). PDF
  6. European Medicines Agency. Ozempic: EPAR product information (package leaflet section 4: nausea and diarrhea “very common (may affect more than 1 in 10 people)”; vomiting and gallstones “common”; acute pancreatitis “uncommon (may affect up to 1 in 100 people)”). PDF

Last checked 14 Oct 2026 · Next review due 14 Oct 2027 · Report an error

How this answer was made. Written by the GLP Guidebook team from the sources above, all checked on 14 Oct 2026. It’s general information, not medical advice, and not an advertisement for any medicine. Talk to a doctor, nurse practitioner or pharmacist before starting, stopping or changing any medicine. How we write