Semaglutide Dosing Protocol: Week-by-Week Optimization

Published January 11, 2026 | Medical Review | 8 min read

The Semaglutide dosing protocol is a carefully designed titration schedule that minimizes side effects while maximizing weight loss results. This guide covers the complete Lagos-approved protocol used by our medical team.

Understanding the Titration Schedule

Semaglutide works by gradually increasing body tolerance. Starting low and titrating up prevents nausea, vomiting, and GI distress that patients experience with rapid escalation.

Week	Dose	Injection Day	Expected Effects	Monitoring Focus
1-4	0.25mg weekly	Monday morning	Mild appetite reduction, baseline tolerance	Nausea levels, appetite baseline
5-8	0.5mg weekly	Monday morning	Moderate appetite suppression, weight drop begins	GI tolerance, blood glucose
9-12	1.0mg weekly	Monday morning	Strong appetite control, 2-4kg weight loss	Energy levels, eating patterns
13+	1.5-2.4mg weekly	Monday morning	Maintenance dose, consistent results	Metabolic markers, adherence

Week 1-4: Initial Tolerance Phase

The first month is about establishing baseline tolerance. Most users report minimal side effects because the dose is intentionally low.

Expected Weight Change

0-1 kg

What to monitor:

Nausea level (1-10 scale) - should be 0-2
Appetite suppression onset - day 3-5
GI discomfort - most users report none
Energy levels - should remain stable

Lagos dosing note: We prepare 4x 0.25mg pens for month one. Store at 2-8°C in your refrigerator. Rotate injection sites weekly.

Week 5-8: Escalation Phase

Doubling to 0.5mg marks the effective dose phase. Weight loss accelerates. Some users experience increased nausea lasting 24-48 hours post-injection.

Expected Weight Change

2-4 kg

Side Effect Protocol: If nausea exceeds level 5/10, stay on 0.25mg for an additional 4 weeks before escalating.

Week 9-12: Effective Dose Range

The 1.0mg dose is where most weight loss occurs. Appetite suppression becomes powerful. Most users report eating 40-50% less than baseline.

Critical Metrics at 1.0mg

Appetite Score: 7-8/10 suppression (meaning 7-8 out of 10 hunger reduction)

Eating Frequency: 1-2 meals daily (vs. 3-4 baseline)

Portion Sizes: 300-400g per meal (vs. 500-700g baseline)

Weight Loss Rate: 1-2kg per week consistent

Week 13+: Maintenance Phase

Most medical protocols stop escalation at 1.5-2.4mg weekly. Going higher increases side effects without proportional benefit.

Maintenance optimization:

Standard maintenance: 1.0mg weekly (most users)
Enhanced efficacy: 1.5mg weekly (for larger baseline weights)
Maximum dose: 2.4mg weekly (rare, prescribed cases only)

Data Tracking Protocol

Track these metrics weekly to optimize your Semaglutide protocol:

Daily Weight Tracking

Same time, same scale

Measure mornings after bathroom, before eating. Weekly average more accurate than daily.

Appetite Suppression Score

1-10 scale

1 = no suppression, 10 = no appetite at all

Nausea Frequency

Hours per day

Track duration, not intensity. Most users adapt after 48 hours.

Side Effect Management

Semaglutide side effects peak at 24-48 hours post-injection, then fade. Here's the evidence-based management protocol:

Nausea Protocol

First-line: Ginger supplement (500mg) + small frequent meals + hydration

Second-line: Ondansetron 4mg every 4-6 hours (prescription, available in Lagos pharmacies)

Prevention: Inject before bed, eat light breakfast next day

GI Distress Protocol

Constipation (most common): Increase water (3-4L daily) + fiber supplement

Diarrhea (less common): BRAT diet days post-injection, electrolyte drinks

Both: Magnesium citrate evening dose helps normalize

Lagos Medical Oversight

Our telemedicine team monitors your protocol progress at:

Week 1: Baseline tolerance assessment
Week 4: Side effect review, dose approval
Week 8: Efficacy check, metabolic markers
Week 12: Long-term protocol adjustment

Contact our medical team anytime for protocol concerns via WhatsApp: +234 701 234 5678

Key Optimization Factors

Your results depend on these variables:

Injection Timing

Consistency > Perfection

Monday morning creates predictable rhythm. Same time weekly matters more than exact hour.

Nutrition Quality

Protein Focus

120-150g protein daily prevents muscle loss. Higher satiety with quality foods.

Exercise Adaptation

Week 3+ Only

First 2 weeks: walking only. Body adjusts energy production during dose escalation.

When to Escalate vs. Stay

Not everyone escalates through all doses. Evidence shows:

Scenario	Decision	Reasoning
Tolerating well, losing 1-2kg/week at 0.5mg	Continue 0.5mg	Some users plateau early at lower dose. Optimization > more drug.
Severe nausea above 7/10	Stay 4+ weeks	Body tolerance increases. Most nausea resolves in 4-week cycles.
No weight change 4 weeks at same dose	Escalate dose	Metabolic adaptation requiring higher GLP-1 receptor activation.
Excellent results at 1.0mg, no side effects	Continue 1.0mg long-term	Maintenance at effective lowest dose is medical best practice.

3-Month Results Projection

Evidence-based expectations for typical Lagos patient:

Month 1: 1-3 kg loss, appetite normalization, side effect adaptation
Month 2: 4-8 kg total loss, eating patterns change, energy increase
Month 3: 8-14 kg total loss, clothing sizes change, metabolic rate shifts

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References

Medically Reviewed by Dr. Chukwuemeka Okonkwo

MBBS, FMCP - Endocrinology

Content reviewed by qualified healthcare professionals for accuracy.