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What is the dosing strategy for semaglutide?

When trying to lose weight with semaglutid the goal is the least amount of nausea with the most amount of weight loss. I start patients at 0.25mg or 5 units on an insuli-n syringe. Each week patients increase their dosing by 0.25mg or 5 units until they are losing 2-5# weekly. Once a patient hits a dosing where they are losing 2# weekly, I recommend staying at this dosing until weight has plateaued for two weeks. At this point, moving up by 5 units or 0.25mg would be prudent to continue the weight loss. If nausea occurs for more than 1 day at any dosing, use a slightly lower dose the following week. For example, if week 3 at 0.75mg or 15 units made you nauseous for 2 days, bump down to 13 units or 0.65mg. If nausea does occur, use ginger as much as possible to lower this nausea.

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