Treatments
Three medicines. One careful choice.
How each is taken, how the dose builds and what to watch for. A prescriber decides with you whether any of them is right.
Weekly injectionMounjaro
Tirzepatide · starts at 2.5 mg
- How it works
- Acts at GIP and GLP-1 receptors involved in appetite and satiety.
- Worth discussing
- Oral contraception may be less reliable; a barrier or non-oral method is advised for four weeks after starting and each increase.
Weekly injectionWegovy
Semaglutide · starts at 0.25 mg
- How it works
- Acts at GLP-1 receptors involved in appetite and satiety.
- Worth discussing
- Current information includes a rare visual-loss warning, advice not to use in severe gastroparesis, and a two-month stop before a planned pregnancy.
- Daily tablet
Semaglutide tablet
Semaglutide · starts at 1.5 mg
- How it works
- The same active ingredient as Wegovy, taken as a tablet instead of an injection.
- Worth discussing
- Taken first thing on an empty stomach with a sip of water, then a wait before food, drink or other tablets.
How it’s takenPrice to be confirmed
How a treatment is chosen.
These medicines work on appetite and fullness. Which one, if any, depends on more than the medicine itself.
- 01
Medical fit
Your health history, current medicines and pregnancy plans shape what’s suitable.
- 02
A routine you can keep
A weekly injection and a morning tablet ask different things of your day.
- 03
Room to adjust
Every medicine starts low. Your prescriber reviews how you respond before changing the dose.
Start low, build slowly.
Each medicine steps up gradually so your body can adjust. Choose one to see its published schedule and what taking it involves.
- 2.5 mgWeeks 1-4
- 5 mgWeeks 5-8
- 7.5 mgWeeks 9-12
- 10 mgWeeks 13-16
- 12.5 mgWeeks 17-20
- 15 mgFrom week 21
You do not have to reach the top: most people settle at one of the middle steps, and your prescriber sets the pace and how high you go. The full range runs up to 15 mg a week.
The mg numbers are for accuracy, not comparison: these are different medicines at different strengths.
A quick injection once a week. It starts on a tiny dose and steps up every four weeks - that is deliberate, so your body can get used to it before the dose grows.
- What you do
- A quick injection under the skin - stomach, thigh or upper arm, moving the spot each week. Any time of day, with or without food.
- If you miss a dose
- Missed your day? Take it within four days if you can. If it has been longer, skip it and take the next one on your usual day - never two at once.
- Mounjaro (tirzepatide) Summary of Product Characteristics — electronic medicines compendium
- 0.25 mgWeeks 1-4
- 0.5 mgWeeks 5-8
- 1 mgWeeks 9-12
- 1.7 mgWeeks 13-16
- 2.4 mgFrom week 17
2.4 mg a week is the full dose - the smaller steps are just for getting used to it. If 2.4 mg does not suit you, 1.7 mg is kept as a gentler option; if you need more effect, it can go up to 7.2 mg after at least four weeks on 2.4 mg. Your prescriber decides.
The mg numbers are for accuracy, not comparison: these are different medicines at different strengths.
It steps up every four weeks and reaches the full dose at about month four. If you need more effect later, it can go a little higher.
- What you do
- One injection under the skin each week, on the same day. Any time of day, with or without food.
- If you miss a dose
- Missed your day? Take it within five days if you can. If it has been longer, skip it and carry on next week on your usual day.
- Wegovy (semaglutide) Summary of Product Characteristics — electronic medicines compendium
- 1.5 mgMonth 1
- 4 mgMonth 2
- 9 mgMonth 3
- 25 mgFrom month 4
At least a month on each step; your prescriber sets the pace and whether to continue at each level.
The mg numbers are for accuracy, not comparison: these are different medicines at different strengths.
No needles - one tablet each morning. The dose steps up month by month and reaches the full dose at month four.
- What you do
- Swallowed whole first thing, on an empty stomach - at least 8 hours since food - with a sip of water only. Breakfast, coffee and other tablets have to wait a bit.
- If you miss a dose
- Tablets and injections have different rules here: follow the leaflet, and ask your prescriber if you are unsure. Never take two to catch up.
- First GLP-1 tablet for weight loss approved in the UK — MHRA / GOV.UK
What to watch for, honestly.
The short version of common effects, urgent symptoms, and the details that change a treatment decision.
The wobbly days come with each dose rise
Nausea, tummy pain, constipation or diarrhoea are the common effects. For most people they ease as the body adjusts.
Doses climb slowly to limit exactly this - and if it stays rough, a step can be paused or lowered with your prescriber.
Weight change varies. Your prescriber reviews whether to continue, adjust or stop.
Know when not to wait.
Tummy pain that will not stop
Especially pain spreading to your back, with nausea or vomiting. Could be pancreatitis - uncommon but serious. Stop and seek urgent care.
Sudden vision loss or blurring
Needs urgent assessment. Tell the clinician about any existing eye or retina problems from the start.
Vomiting or diarrhoea that will not quit
Ongoing symptoms cause dehydration, which can injure the kidneys. This belongs with a clinician today, not on a waiting list.
Mention these before you start
- 01
Mounjaro & the pill
Back-up contraception for 4 weeks after starting - and after every dose rise.
Tirzepatide can make oral contraceptives less reliable. A barrier method, or a non-oral method, covers the gap.
- 02
Planning a pregnancy
2 months for semaglutide, 1 month for tirzepatide - before trying.
These medicines are not used in pregnancy. Speak to a clinician before you start trying.
- 03
Surgery & sedation
Tell the team - and never stop on your own.
Slowed stomach emptying matters during anaesthesia, so the procedural team needs to know.
- 04
Genuine supply only
Prescriber and pharmacy route, every time.
Falsified pens and unregulated products are a documented risk. The supply route is part of the safety of treatment.
Considering treatment? Start with the pre-screen.
A clinician uses the full assessment to decide whether any medicine is appropriate. Nothing is promised in advance, and a different next step may be recommended.
Sources for this page
- Wegovy (semaglutide) Summary of Product Characteristics — electronic medicines compendium
- Mounjaro (tirzepatide) Summary of Product Characteristics — electronic medicines compendium
- GLP-1 medicines: what you need to know — MHRA
- Strengthened warnings on acute pancreatitis — MHRA Drug Safety Update
- Potential risk of pulmonary aspiration during anaesthesia or deep sedation — MHRA Drug Safety Update
- Reminder of potential side effects and misuse — MHRA Drug Safety Update
- Tirzepatide — NHS
- Semaglutide — NHS
- First GLP-1 tablet for weight loss approved in the UK — MHRA / GOV.UK

