Guides / GLP-1 dosing

Restarting a GLP-1 after a break

Only some GLP-1 labels say what to do after a long gap, and they don't agree on how long counts as long.

By PeptideTracker editorial team · Updated November 8, 2026 · 15 sources

[00] Short answer

  1. Wegovy injection (US): "If 2 or more consecutive doses ... are missed, reinitiate dosage escalation at a lower dosage"1.
  2. Foundayo (US): if 7 or more daily doses in a row are missed, restart the dose increases at a lower dose6.
  3. Saxenda (US): if more than 3 days have passed since the last dose, restart at 0.6 mg a day7.
  4. Ozempic, Mounjaro, Zepbound and Trulicity (US): no long-gap rule. They only give a missed-dose window2–5.
  5. The labels that do give a restart rule say the lower dose is there to cut the risk of stomach and gut side effects1,6–7.

What do GLP-1 labels say about restarting after missed doses?

Three US labels give a restart rule after a longer gap: Wegovy injection (2 or more weekly doses in a row), Foundayo (7 or more daily doses in a row) and Saxenda (more than 3 days). Ozempic, Mounjaro, Zepbound and Trulicity don't give one1–7.

Long-gap and restart wording in each US label, with the UK wording where it differs
MedicineUS labelUK label
Wegovy injection (semaglutide)2 or more consecutive doses missed: "reinitiate dosage escalation at a lower dosage to reduce the risk of gastrointestinal adverse reactions"1"If more doses are missed, reducing the starting dose for re-initiation should be considered."9
Foundayo (orforglipron), daily tablet7 or more consecutive doses missed: "reinitiate dosage escalation at a lower dosage"6No long-gap rule. A missed dose: resume as soon as possible, no more than one tablet a day12
Saxenda (liraglutide), daily injectionMore than 3 days since the last dose: "reinitiate SAXENDA at 0.6 mg daily and follow the dosage escalation schedule"7No long-gap rule. 12-hour rule for a single missed dose, and no extra dose to make up15
Ozempic (semaglutide)No long-gap rule. Missed dose: take it within 5 days, otherwise skip it2Same as the US8
Mounjaro, Zepbound (tirzepatide)No long-gap rule. Missed dose: take it within 4 days (96 hours), otherwise skip it3–4Mounjaro: same as the US10
Trulicity (dulaglutide)No long-gap rule. Missed dose: take it if at least 3 days (72 hours) are left until the next one5Same as the US11

"No long-gap rule" means the dosing section is silent. It doesn't tell you to restart lower, and it doesn't tell you to go back to your old dose.

What does the Wegovy label say after 2 weeks of missed doses?

The US Wegovy label says that if 2 or more doses in a row are missed, the dose increases start again at a lower dose. The prescribing information doesn't name the restart dose1.

The label says it three ways, for three readers:

  • For prescribers (section 2.4): "If 2 or more consecutive doses of WEGOVY injection are missed, reinitiate dosage escalation at a lower dosage to reduce the risk of gastrointestinal adverse reactions."1
  • For you (Medication Guide): "If you miss doses of WEGOVY for 2 or more consecutive weeks, contact your healthcare provider to talk about how to restart your treatment."1
  • In the UK (SmPC section 4.2): "If more doses are missed, reducing the starting dose for re-initiation should be considered."9

For a single missed dose the US rule is different: take it if the next dose is more than 2 days (48 hours) away, and skip it if less1. The UK uses a 5-day window9. Wegovy tablets have no long-gap rule: a missed tablet is skipped and the next one taken the following day1.

Zepbound's US label has no matching "2 or more doses" wording. Its missed-dose section stops at the 4-day window4.

Why might a prescriber restart a GLP-1 at a lower dose?

The labels that give a restart rule say why: the lower dose is "to reduce the risk of gastrointestinal adverse reactions", meaning nausea, vomiting and diarrhea1,6–7. Saxenda's label links these to restarting treatment in particular7.

The same reason sits behind the slow start. Each label on this page starts low and steps up to reduce these side effects, and three of them say when they mostly happen:

  • Ozempic: "The majority of reports of nausea, vomiting, and/or diarrhea occurred during dose escalation."2
  • Mounjaro: most reports of nausea, vomiting and diarrhea "occurred during dose escalation and decreased over time"3.
  • Zepbound: "The majority of nausea, vomiting, and/or diarrhea events occurred during dose escalation and decreased over time."4

None of the labels give a table of restart doses by length of break. Where a label is silent, the restart dose is your prescriber's call. Our GLP-1 side effects guide has the rates for each medicine.

How long does a GLP-1 stay in your body during a break?

Semaglutide (Ozempic, Wegovy) has a half-life of about 1 week, and the Ozempic label says it's present in the blood for about 5 weeks after the last dose. Tirzepatide (Mounjaro, Zepbound) and dulaglutide (Trulicity) each have a half-life of about 5 days2–3,5.

Half-life and time to steady levels, from each US label (section 12.3)
Ingredient (brands)Half-lifeSteady levels reached after
Semaglutide (Ozempic, Wegovy)About 1 week. Present in the blood for about 5 weeks after the last dose24 to 5 weeks of weekly doses2
Tirzepatide (Mounjaro, Zepbound)About 5 days34 weeks of weekly doses3
Dulaglutide (Trulicity)About 5 days52 to 4 weeks of weekly doses5
Orforglipron (Foundayo)About 29 to 49 hours6About 1 week of daily doses6

These numbers explain why levels fall during a break. The labels don't turn them into a restart rule, so they aren't a guide to which dose to restart on.

[Tool]See how long your medicine stays in your systemUses the half-life from each label

Restarting a GLP-1 in the UK

In the UK, the Wegovy SmPC says a lower restart dose "should be considered" if more doses are missed9. The UK Ozempic, Mounjaro and Trulicity SmPCs give no long-gap rule, the same as the US8,10–11. The UK Saxenda SmPC has no "more than 3 days" restart rule15.

  • Foundayo: the UK SmPC has no 7-dose rule. It says to resume as soon as possible and not to take more than one tablet a day12. The UK leaflet adds: don't take a double dose to make up for a forgotten one13.
  • Mounjaro: the UK leaflet says not to stop using Mounjaro without talking to your doctor, and that blood sugar can rise if you have type 2 diabetes and stop14.

For a single late dose, the rules are in our missed GLP-1 dose guide.

Questions

I missed 2 weeks of Wegovy. Do I restart at 0.25 mg?

The US label says that after 2 or more missed doses in a row, the dose increases restart at a lower dose. It doesn't name which one. The Medication Guide says to contact your healthcare provider to talk about how to restart.

I missed 3 weeks of Mounjaro or Zepbound. What dose do I restart on?

The Mounjaro and Zepbound labels don't say. Their missed-dose sections only cover a dose up to 4 days (96 hours) late. Your prescriber decides the restart dose.

Does the Ozempic label say to restart at 0.25 mg after a break?

No. The US and UK Ozempic labels give a 5-day missed-dose window and no rule for longer gaps.

Why would I restart at a lower dose if I was fine on my old dose?

The labels that give a restart rule (Wegovy, Foundayo and Saxenda) say the lower dose reduces the risk of stomach and gut side effects. The Ozempic, Mounjaro and Zepbound labels say most nausea, vomiting and diarrhea happened during dose increases.

How many missed Foundayo tablets before I need to restart lower?

The US label says 7 or more doses in a row. The UK SmPC has no such rule: it says to resume as soon as possible and never take more than one tablet a day.

Is semaglutide still in my body after a 2-week break?

The Ozempic label gives semaglutide a half-life of about 1 week and says it's present in the blood for about 5 weeks after the last dose.

Sources

Checked against US prescribing information and Medication Guides for Wegovy, Ozempic, Mounjaro, Zepbound, Trulicity, Saxenda and Foundayo (2026), and the UK SmPCs and leaflets for Wegovy, Ozempic, Mounjaro, Trulicity and Foundayo. How we check

  1. 1Wegovy (semaglutide) injection and tablets: US prescribing information and Medication Guide, Novo Nordisk. section 2.4 and Medication Guide, revised 06/2026
  2. 2Ozempic (semaglutide) injection: US prescribing information, Novo Nordisk. sections 2.1, 6.1 and 12.3, revised 05/2026
  3. 3Mounjaro (tirzepatide): US prescribing information, Eli Lilly. sections 2.1, 6.1 and 12.3, revised 08/2026
  4. 4Zepbound (tirzepatide): US prescribing information, Eli Lilly. sections 2.3 and 6.1, revised 08/2026
  5. 5Trulicity (dulaglutide): US prescribing information, Eli Lilly. sections 2.3 and 12.3, revised 03/2026
  6. 6Foundayo (orforglipron) tablets: US prescribing information, Eli Lilly. sections 2.3, 12.3 and 17, revised 07/2026
  7. 7Saxenda (liraglutide): US prescribing information and Medication Guide, Novo Nordisk. section 2.1, revised 02/2026
  8. 8Ozempic solution for injection: UK SmPC. section 4.2, revised 07/2026
  9. 9Wegovy FlexTouch solution for injection: UK SmPC. section 4.2, revised 09/2026
  10. 10Mounjaro KwikPen solution for injection: UK SmPC. section 4.2, revised 29 Aug 2026
  11. 11Trulicity solution for injection: UK SmPC. section 4.2, revised 25 Feb 2026
  12. 12Foundayo 0.8 mg film-coated tablets: UK SmPC. section 4.2, revised 10 Aug 2026
  13. 13Foundayo: UK patient leaflet. section 3, emc updated 12 Aug 2026
  14. 14Mounjaro KwikPen: UK patient leaflet. section 3, emc updated 3 Sep 2026
  15. 15Saxenda 6 mg/mL solution for injection: UK SmPC. section 4.2, revised 11/2025

This guide explains what labels and published studies say. It isn't medical advice and doesn't replace your prescriber or pharmacist.

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