Missed Your Semaglutide Dose? Here's Exactly What to Do

Quick Answer: If you miss your weekly semaglutide injection, take it as soon as you remember if it's within 5 days of your scheduled dose. If more than 5 days have passed, skip that dose and take your next dose on your regular scheduled day. Never double up on doses to make up for a missed one. Missing a single dose occasionally won't significantly impact your long-term weight loss progress.

Table of Contents

• What to Do When You Miss a Dose
• The 5-Day Rule Explained
• How to Get Back on Your Regular Schedule
• Will Missing a Dose Affect My Weight Loss?
• What Happens to Side Effects?
• Missing Multiple Doses
• How to Avoid Missing Doses
• Frequently Asked Questions

What to Do When You Miss a Dose

The FDA-approved prescribing information for Wegovy (semaglutide 2.4 mg) provides clear guidance on handling missed doses (Source: Wegovy Prescribing Information, FDA):

Step-by-Step Instructions:

1. Determine how much time has passed since your scheduled dose day

• Count the number of days from when you were supposed to inject
• Example: If your scheduled day was Saturday and today is Wednesday, 4 days have passed

2. Follow the appropriate action based on timing:

3. Never double up on doses

• Do not take two injections to "catch up"
• Do not take a higher dose than prescribed
• Do not take injections closer than 48 hours apart

The 5-Day Rule Explained

The 5-day rule is based on semaglutide's pharmacokinetics—how the medication is absorbed, distributed, and eliminated from your body.

Why 5 Days?

Semaglutide has a long half-life of approximately 7 days, meaning:

• After one week, about 50% of your dose is still in your system
• After two weeks, about 25% remains
• It takes approximately 4-5 weeks for complete elimination

Because semaglutide stays in your system for an extended period, there's a window of time when you can still take a missed dose without disrupting your treatment schedule or causing gaps in medication levels.

The 5-Day Cutoff

Within 5 days: Medication levels are still therapeutic (effective). Taking your dose late keeps continuous coverage without significant gaps.

After 5 days: You're approaching your next scheduled dose. Taking the late dose would mean having two doses too close together, increasing side effect risk. It's safer to skip and resume your regular schedule.

How to Get Back on Your Regular Schedule

Depending on when you take your late dose, you have two options for resuming your schedule:

Option 1: Shift Your Weekly Schedule (1-2 Days Late)

Example:

• Regular schedule: Saturday injections
• You remember on Monday (2 days late)
• Action: Take your dose on Monday
• New schedule: Monday injections from now on

Pros:

• Simplest approach—just shift to your new day
• Maintains weekly intervals
• No schedule juggling needed

Cons:

• Your injection day permanently changes
• Need to update reminders/calendar

Option 2: Return to Original Schedule (3-5 Days Late)

Example:

• Regular schedule: Saturday injections
• You remember on Wednesday (4 days late)
• Action: Take your dose on Wednesday
• Next dose: Return to Saturday (3 days later—shorter interval this one time)
• Ongoing: Resume regular Saturday schedule

Pros:

• Maintains your original injection day long-term
• No need to change reminders permanently

Cons:

• One shorter interval (3-5 days instead of 7)
• May experience slightly stronger side effects during that shorter week

Important: If you take this approach and experience increased side effects during the shorter interval week, they should resolve once you're back on your normal 7-day schedule.

Will Missing a Dose Affect My Weight Loss?

Missing a single dose occasionally is unlikely to significantly impact your long-term weight loss results:

Short-Term Effects (One Missed Dose):

• Appetite: You may notice increased hunger 5-7 days after your missed dose as medication levels drop
• Weight: Possible 1-2 pound fluctuation, but unlikely to affect fat loss trajectory
• Cravings: Food cravings may temporarily increase
• Fullness: You might be able to eat larger portions than usual

Long-Term Impact:

• One missed dose among 52 annual doses = less than 2% of your total treatment
• Clinical trials showed successful weight loss despite some participants missing occasional doses
• As long as you resume your schedule promptly, long-term effectiveness is maintained
• The cumulative effect of consistent dosing is what matters most

When Missing Doses Becomes a Problem:

Regularly missing doses (more than one per month) can impact results:

• Inconsistent appetite suppression makes calorie control harder
• You may not reach steady-state medication levels
• Weight loss progress may stall or slow
• You may experience more frequent side effects as your body repeatedly adjusts

For comprehensive information about expected weight loss timeline with consistent dosing, see our semaglutide weight loss timeline guide.

What Happens to Side Effects?

Missing a dose and then resuming can affect side effects in a few ways:

When You Miss a Dose:

• Current side effects improve: Nausea, reduced appetite, or GI symptoms may lessen as medication levels drop
• Temporary relief: Some people welcome the break from side effects
• Return to baseline: By day 5-7 after a missed dose, you may feel like you did before starting semaglutide

When You Resume Dosing:

• Side effects may return: Nausea and GI symptoms often recur when restarting, similar to when you first began treatment
• Usually milder: The recurrence is typically less intense than your initial experience
• Shorter duration: Side effects often resolve more quickly (2-3 days instead of 5-7 days)
• Varies by individual: Some people notice no difference; others have a more pronounced response

Minimizing Side Effect Recurrence:

• Take your late dose with food to reduce nausea
• Avoid fatty or heavy meals for 2-3 days after resuming
• Stay well-hydrated
• Eat smaller, more frequent meals
• Have anti-nausea remedies available (ginger tea, crackers)

For detailed strategies on managing side effects when they occur, see our guide on managing semaglutide side effects.

Missing Multiple Doses

If you've missed more than one dose in a row, the approach differs from a single missed dose:

Missed 2 Weeks (14 Days Without Medication):

• Resume at your current dose
• Expect side effects to return (like starting over)
• Medication levels are very low but some remain in your system
• Monitor closely for increased side effects

Missed 3+ Weeks (21+ Days Without Medication):

• Contact your healthcare provider before resuming
• They may recommend restarting at a lower dose and re-escalating
• Your body has mostly cleared the medication
• Resuming at your previous dose may cause significant side effects
• You'll essentially need to restart the dose escalation process

When to Restart Dose Escalation:

Most providers recommend restarting at 0.25 mg (the beginning dose) if you've been off semaglutide for:

• More than 4-6 weeks continuously
• Any duration where you experienced severe side effects when initially starting
• If you have concerns about tolerating your previous dose

This conservative approach minimizes side effect risk and allows your body to re-adjust gradually.

How to Avoid Missing Doses

Consistency is key for optimal results. Here are practical strategies to help you remember your weekly injection:

Technology Solutions:

• Phone calendar alerts: Set a recurring weekly reminder with a notification 1 hour before injection time
• Multiple alarms: Set a reminder the day before as a "preparation" alert, then another on injection day
• Medication reminder apps: Apps like Medisafe, MyTherapy, or CareZone track medication schedules
• Smart home devices: Ask Alexa or Google to remind you weekly

Habit Stacking:

• Link to existing habits: "Every Saturday morning after my coffee, I take my injection"
• Weekend routines: Make it part of your Saturday or Sunday morning routine
• Visual cues: Place medication in a visible spot you'll encounter on injection day

Physical Reminders:

• Weekly pill box: Even though it's an injection, use a weekly pill organizer with a note for each week
• Calendar markings: Physical wall calendar with injection days marked
• Medication station: Dedicated spot where you always keep supplies visible

Lifestyle Integration:

• Choose a consistent day: Saturday or Sunday work well for most people (at-home, relaxed)
• Same day as other routine: Coordinate with grocery shopping, meal prep, or other weekly activities
• Partner accountability: Ask family member or friend to remind you weekly
• Set medication as "event": Treat it like an important appointment you wouldn't miss

Travel and Schedule Changes:

• Pack medication first: Before any trip, pack semaglutide in carry-on luggage
• Flexible timing: Remember you can inject any time on your scheduled day—adjust for time zones
• Set travel alerts: Extra reminder when away from home
• Backup supplies: Keep alcohol wipes and sharps container in travel bag

Getting Support with Your Semaglutide Treatment

Whether you've missed a dose or want to ensure consistent treatment, having support from experienced providers makes all the difference.

At Contour Health, we provide:

• Personalized guidance: Help with missed doses and schedule adjustments
• Consistent supply: Regular medication delivery so you never run out
• Ongoing support: Check-ins to help you stay on track with your treatment
• Affordable options: Compounded semaglutide that makes consistent treatment sustainable

Learn more about our compounded semaglutide program and get the support you need for successful treatment.

Frequently Asked Questions

What if I'm only a few hours late taking semaglutide?

If you're just a few hours late on your scheduled injection day (for example, you usually inject at 9am but it's now 3pm), go ahead and take your dose. Semaglutide doesn't need to be taken at the exact same time each week—just the same day. Even if you're 12-24 hours late but still within your scheduled day, take your injection and continue your regular weekly schedule.

Can I take my semaglutide one day early instead of late?

It's better to take a dose one day late than one day early. However, if you know you'll miss your scheduled day (for example, traveling), taking your dose one day early is acceptable. Just maintain at least 6 days between injections. Taking doses too close together (less than 6 days apart) increases side effect risk. If you take a dose one day early, resume your regular schedule the following week.

How many doses can I miss before I have to start over?

If you miss 3-4 weeks of doses (21-28 days without medication), contact your healthcare provider before resuming. Most providers recommend restarting dose escalation from the beginning (0.25 mg) if you've been off medication for a month or longer. Missing 1-2 weeks, you can typically resume at your current dose, though side effects may return temporarily.

Will I gain weight if I miss one semaglutide dose?

Missing a single dose is unlikely to cause significant weight gain. You might notice a 1-2 pound fluctuation due to increased appetite and water retention, but this isn't fat gain. Resume your regular dosing schedule promptly, and your weight loss trajectory should continue normally. Consistent long-term dosing matters more than perfect adherence.

What if I took two semaglutide doses by accident?

Contact your healthcare provider immediately if you accidentally injected a double dose. Monitor for increased side effects, especially nausea, vomiting, low blood sugar (if you have diabetes), and severe stomach pain. Drink plenty of fluids and eat small, frequent meals if you can tolerate food. Seek emergency care if you experience severe symptoms like persistent vomiting, severe abdominal pain, or signs of pancreatitis.

Can I split my weekly semaglutide dose into two smaller doses?

No, semaglutide is designed to be taken once weekly at the full prescribed dose. The medication's long half-life and pharmacokinetics are optimized for weekly dosing. Splitting your dose could reduce effectiveness and make side effects harder to predict. Always follow your prescribed dosing schedule—one injection per week on the same day.

How late can I take my semaglutide injection?

You can take your injection up to 5 days after your scheduled day and still maintain effectiveness. Within those 5 days, take the dose as soon as you remember. After 5 days, skip the missed dose and wait for your next regularly scheduled injection day. The 5-day window exists because semaglutide remains in your system for an extended period due to its long half-life.

Should I adjust my diet if I miss a semaglutide dose?

Yes, being more mindful of your eating can help minimize weight fluctuation from a missed dose. As medication levels drop, your appetite will increase. Focus on high-protein, high-fiber foods that promote fullness. Track your food intake more carefully during the week of the missed dose. Increase your water intake and physical activity slightly. These strategies can help you maintain progress until your next dose.