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Wegovy (semaglutide 2.4 mg) is a once-weekly GLP-1 receptor agonist licensed by the MHRA for chronic weight management in adults with obesity or overweight with weight-related comorbidities. Many patients wonder: can I skip a week of Wegovy if circumstances arise? Whilst missing a single dose does not typically cause immediate harm, understanding the implications for treatment efficacy, side effects, and safe resumption is essential. This article examines the manufacturer's guidance on missed doses, when delays may be medically appropriate, how to restart treatment safely, and the potential risks of inconsistent dosing within the UK clinical context.
Quick Answer: You can skip a week of Wegovy if necessary, but you should take the missed dose within five days of your scheduled injection; if more than five days have passed, skip that dose and resume your regular weekly schedule.
Wegovy (semaglutide 2.4 mg) is a once-weekly subcutaneous injection licensed by the MHRA for chronic weight management in adults with obesity (BMI ≥30 kg/m²) or overweight (BMI ≥27 kg/m²) with at least one weight-related comorbidity, such as type 2 diabetes or hypertension. It belongs to the glucagon-like peptide-1 (GLP-1) receptor agonist class and works by mimicking the action of endogenous GLP-1, a hormone that regulates appetite and food intake.
The mechanism of action involves binding to GLP-1 receptors in the brain, particularly in areas controlling appetite and satiety. This leads to reduced hunger, increased feelings of fullness, and delayed gastric emptying. Semaglutide also improves glycaemic control by enhancing glucose-dependent insulin secretion and suppressing inappropriate glucagon release. The once-weekly dosing schedule is designed to maintain steady therapeutic levels in the bloodstream, with a half-life of approximately one week.
Wegovy follows a structured dose-escalation schedule to minimise gastrointestinal side effects. Treatment typically begins at 0.25 mg weekly for at least four weeks, then increases through 0.5 mg, 1 mg, and 1.7 mg (each for at least four weeks), reaching the maintenance dose of 2.4 mg by week 17. This gradual titration allows the body to adapt to the medication and reduces the likelihood of nausea, vomiting, and diarrhoea—the most commonly reported adverse effects.
Consistent weekly dosing is important for maintaining therapeutic drug levels and achieving optimal weight loss outcomes. However, life circumstances occasionally make it difficult to adhere strictly to the schedule, raising questions about the safety and implications of missing doses.
Missing a single dose of Wegovy does not typically cause immediate harm, but it can affect the medication's effectiveness and your treatment progress. When you skip a week, semaglutide levels in your bloodstream gradually decline, though the drug's long half-life means some therapeutic effect persists for several days. The impact of a missed dose depends on how long you delay the injection and where you are in your treatment journey.
If you miss your scheduled injection day, the manufacturer's guidance states that you should administer the missed dose as soon as you remember, provided it is within five days of the scheduled dose. If more than five days have passed since your missed dose, you should skip that injection entirely and resume your regular schedule with the next planned dose. Taking two doses close together or doubling up is not recommended, as this increases the risk of gastrointestinal side effects without providing additional benefit.
Physiologically, missing a dose may lead to:
Temporary return of appetite and reduced satiety signals
Slight fluctuations in blood glucose levels (particularly relevant for those with diabetes)
Potential disruption to the steady-state drug concentration
Possible reappearance of side effects when restarting, especially if multiple doses are missed
Most patients who miss a single dose and resume promptly do not experience significant setbacks in their weight management progress. However, if more than two consecutive doses are missed, the Wegovy SmPC states that complete re-titration from the 0.25 mg starting dose is required. Patients taking insulin or sulfonylureas should monitor their blood glucose levels more closely when missing Wegovy doses, as adjustments to these medications may be needed. It is important to contact your prescribing clinician if you have missed doses or are uncertain about how to proceed.
There are specific circumstances where delaying or temporarily discontinuing Wegovy may be medically appropriate or necessary. Understanding when it is safe to skip a dose helps you make informed decisions while minimising risks to your treatment outcomes.
Medically appropriate reasons to delay Wegovy include:
Acute gastrointestinal illness: If you are experiencing severe vomiting, diarrhoea, or gastroenteritis, adding Wegovy may worsen dehydration and electrolyte imbalance. Delay your injection until you have recovered and can maintain adequate oral intake.
Planned surgical procedures: GLP-1 receptor agonists delay gastric emptying, which may increase aspiration risk during anaesthesia. The Association of Anaesthetists' 2023 guidance on peri-operative management of GLP-1 receptor agonists recommends individualised assessment based on procedure type and patient factors. For most procedures, withholding Wegovy on the day of surgery is advised. Your surgical team will provide specific guidance on the appropriate timing for resumption.
Severe or persistent side effects: If you develop intolerable nausea, vomiting, or abdominal pain, your GP may recommend temporarily pausing treatment to allow symptoms to resolve before restarting at a lower dose.
Pregnancy or planning pregnancy: Wegovy is contraindicated in pregnancy. If you discover you are pregnant or are planning to conceive, discontinue the medication immediately and consult your healthcare provider. The manufacturer recommends stopping Wegovy at least two months before a planned pregnancy.
Situations where skipping is generally not advisable include minor schedule conflicts, travel, or simply forgetting. In these cases, it is better to adjust your injection day slightly (within the five-day window) rather than skip entirely. If you need to permanently change your injection day for practical reasons, consult your prescriber for guidance on the safest transition method. Never skip doses as a strategy to accelerate weight loss or reduce costs, as this undermines treatment efficacy and may lead to dose re-escalation requirements.
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Resuming Wegovy after missing one or more doses requires careful consideration of the duration of interruption and your current dose level. The approach to restarting depends primarily on how long you have been off the medication, as prolonged gaps may necessitate dose re-titration to minimise side effects.
If you have missed one week (5–14 days):
Administer your next scheduled dose as soon as possible and continue with your regular weekly schedule thereafter. Most patients can resume at their current maintenance dose without significant issues. You may experience mild gastrointestinal symptoms (nausea, reduced appetite) as your body readjusts, but these typically resolve within a few days. Ensure adequate hydration and consider taking the injection in the evening to sleep through initial side effects if they occur.
If you have missed two or more consecutive doses:
According to the Wegovy SmPC, if more than two consecutive doses are missed, you should restart at the 0.25 mg dose and follow the full dose-escalation schedule. Contact your prescribing clinician before resuming treatment for specific guidance tailored to your situation.
Practical tips for resuming treatment:
Choose a consistent injection day that fits your routine to prevent future missed doses
Set reminders on your phone or use a medication tracking app
Keep your Wegovy pen in a visible location (while maintaining proper refrigeration)
Monitor for side effects during the first week after resuming, particularly nausea and gastrointestinal discomfort
When to seek medical advice: Contact your GP or prescriber if you experience severe abdominal pain, persistent vomiting, signs of pancreatitis (severe upper abdominal pain radiating to the back), or any concerning symptoms after restarting. Do not attempt to "catch up" by taking extra doses or shortening the interval between injections.
Inconsistent dosing of Wegovy can compromise treatment effectiveness and potentially increase the risk of adverse effects. Understanding these risks helps emphasise the importance of adherence while providing realistic expectations if interruptions occur.
Impact on weight management outcomes:
Clinical trials demonstrating Wegovy's efficacy were conducted with consistent weekly dosing. Irregular use may result in suboptimal weight loss, weight regain during gaps, or failure to achieve target weight reduction. The medication works best when steady therapeutic levels are maintained, allowing sustained appetite suppression and metabolic effects. Frequent interruptions may lead to a "yo-yo" pattern that undermines long-term success.
Increased side effect risk:
Each time you restart Wegovy after a gap, your body must readjust to the medication. This can lead to:
Recurrent gastrointestinal symptoms: Nausea, vomiting, diarrhoea, and constipation may return or worsen with each restart
Injection site reactions: Redness, itching, or discomfort at the injection site
Hypoglycaemia risk: Particularly relevant for patients taking Wegovy alongside other glucose-lowering medications
Rare but serious adverse effects associated with semaglutide include acute pancreatitis (severe abdominal pain, nausea, vomiting), gallbladder disease, and potential thyroid effects. While there is no official link suggesting inconsistent dosing increases these risks specifically, maintaining regular contact with your healthcare provider ensures appropriate monitoring. Suspected side effects should be reported via the MHRA Yellow Card Scheme (yellowcard.mhra.gov.uk).
Practical strategies to maintain consistency:
Discuss barriers to adherence with your prescriber—they may offer solutions such as adjusting injection timing or addressing side effects
Ensure you have an adequate supply of medication and plan ahead for holidays or travel
Consider setting up a repeat prescription service to avoid running out
Join patient support groups or weight management programmes for accountability
NICE guidance (TA875) emphasises that pharmacological weight management interventions should be part of a comprehensive programme including dietary modification, increased physical activity, and behavioural support. Inconsistent medication use may indicate the need for additional support or reassessment of treatment suitability. If you find yourself frequently missing doses, discuss this openly with your healthcare team to identify underlying issues and develop strategies to improve adherence.
If you miss your Wegovy dose, take it as soon as you remember within five days of the scheduled injection. If more than five days have passed, skip that dose entirely and resume your regular weekly schedule with the next planned injection.
Yes, according to the Wegovy Summary of Product Characteristics, if you miss more than two consecutive doses, you should restart at the 0.25 mg starting dose and follow the full dose-escalation schedule. Contact your prescribing clinician for specific guidance.
Medically appropriate reasons to delay Wegovy include acute gastrointestinal illness with vomiting or diarrhoea, planned surgical procedures, severe or persistent side effects, or if you are pregnant or planning pregnancy. Always consult your healthcare provider for guidance specific to your situation.
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DisclaimerThis content is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional with any medical questions or concerns. Use of the information is at your own risk, and we are not responsible for any consequences resulting from its use.
