Can I split my weekly dose into smaller injections?

No — Wegovy is intended as a single weekly dose. Splitting or repeating injections can upset the dosing schedule and increase side-effect risk. If dose steps feel tough, speak with your clinician; they can extend a step or pause escalation rather than splitting doses.

Why weekly dosing is important

Wegovy (semaglutide) is designed to be given once a week because of the way it works in the body. The medicine has a long half-life, meaning it stays active in the system for around seven days. This allows blood levels to stay steady, making appetite control and weight loss more predictable. Splitting the dose into smaller injections disrupts this balance, leaving you outside the pattern that clinical trials such as STEP-1 and STEP-5 were built on. These trials tested only the weekly schedule, so safety and effectiveness are based on that method alone.

Risks of splitting doses

Taking more than one injection in a week may increase the chance of side effects such as nausea, diarrhoea, or vomiting. Because semaglutide slows digestion, doubling up too soon can overload the system and make symptoms worse. NICE TA875 guidance warns against using Wegovy outside its licensed schedule, as there is no evidence to support alternative dosing. Repeating doses or “topping up” also raises the risk of error, such as injecting too close together, which can push drug levels higher than intended and lead to unnecessary discomfort.

What to do if escalation feels difficult

The step-up process for Wegovy is gradual, starting at 0.25 mg and increasing over several months until the maintenance dose is reached. This slow escalation is based on trial data and is meant to give the body time to adapt. If a new step feels too strong, clinicians can pause escalation, hold you at the same dose longer, or temporarily reduce the dose. NHS weight management teams frequently reassure people that even staying at a lower dose for longer can still support weight loss. The goal is to tolerate the medicine well and remain on it long enough to see the benefits demonstrated in trials.

Why consistency supports results

The STEP clinical programme showed that consistent weekly dosing combined with lifestyle changes led to an average weight loss of around 15% over 68 weeks, with results maintained for up to two years. The SELECT trial later demonstrated that the same weekly dosing reduced cardiovascular events in people with overweight or obesity and established heart disease. These outcomes depended on keeping to the once-weekly rhythm. Splitting doses introduces unpredictability — not only in side effects but also in appetite control and treatment continuity. To match the results seen in research, sticking to the schedule is essential.

Advice from the NHS and regulators

NHS information for weight management services highlights that Wegovy is always prescribed as a once-weekly injection, to be used alongside a reduced-calorie diet and increased activity. MHRA product information is equally clear: the medicine is licensed only for once-weekly administration, with no evidence to support splitting or altering doses. NICE’s technology appraisal (TA875) also bases its cost-effectiveness modelling on weekly use, meaning NHS commissioning relies on the medicine being used as intended. Changing that pattern risks both safety and the reliability of outcomes in routine care.

Supporting patients through side effects

Many people report that the early weeks of treatment are the most difficult, with nausea, bloating, or tiredness more common. NHS clinicians advise that these side effects usually ease after a few weeks as the body adapts. Strategies such as eating smaller meals, avoiding rich or spicy foods, and drinking water regularly can help. For those who continue to struggle, prescribers can adjust the pace of escalation or recommend short-term remedies. This approach is much safer than splitting the dose, which rarely helps and may make side effects worse.

Learning from clinical evidence

Both the STEP and SELECT trials were built on strict adherence to the once-weekly injection plan. Participants who stayed consistent saw the most reliable benefits in terms of weight, cardiovascular health, and long-term outcomes. NICE and the NHS use these data to underpin their recommendations. Splitting doses would move treatment outside the evidence base and could mean benefits are not replicated in real-world practice. Patients are therefore strongly encouraged to seek medical guidance if they find the schedule difficult rather than adjusting it themselves.

Key takeaways

Wegovy is designed as a once-weekly injection, not something to be split into smaller doses. Splitting risks upsetting the balance, worsening side effects, and moving outside what was tested in clinical trials and approved by NICE and the MHRA. If dose steps feel challenging, the safer route is to work with your care team to pause or adjust the escalation. Consistency and open communication make the treatment more effective and keep it aligned with the evidence base that supports its use.