Why You Still Need to Start Wegovy at a Low Dose: Even If You’ve Been on Mounjaro

With the rising cost of Mounjaro (tirzepatide) in the UK, many patients are now exploring alternative treatments like Wegovy (semaglutide) for weight management. It’s understandable to feel frustrated if you’ve been stable on a higher dose of Mounjaro, being told to start Wegovy at the lowest dose can feel like starting over.

Your prescriber carefully considers this decision and does not act out of reluctance. Legal and clinical requirements protect patient safety and ensure we deliver treatment responsibly.

Why Wegovy Must Start at 0.25mg

Wegovy is approved in the UK by the Medicines and Healthcare products Regulatory Agency (MHRA), and it comes with a clearly defined dosing schedule. The treatment must begin at 0.25mg once weekly, increasing gradually over several weeks to the full therapeutic dose.

This titration schedule is not optional. It is outlined in the Summary of Product Characteristics (SmPC) for Wegovy, which healthcare professionals and pharmacies are legally obligated to follow.

Two Key Reasons for the Gradual Dose Increase

Even if you’ve previously been on Mounjaro at a higher dose, the switch to Wegovy still requires this stepwise approach. This is due to factors such as:

Safety and Tolerability

Semaglutide, the active ingredient in Wegovy, can cause gastrointestinal side effects; nausea, vomiting, and stomach discomfort being the most common. The gradual dose increase allows your body to adjust, reducing the risk of side effects. Even though both Mounjaro and Wegovy are GLP-1 medications, they are different drugs and can affect people differently.

Legal Licensing

UK regulations strictly prohibit starting Wegovy at higher doses than licensed. Doing so would be considered off-label prescribing. While off-label prescribing is sometimes appropriate and permitted within our clinical governance for certain conditions, initiating Wegovy at a higher dose than licensed is not one of them. In this case, we must follow the MHRA-approved dosing schedule to ensure patient safety and regulatory compliance. As a regulated UK pharmacy, we commit to prescribing safely and following evidence-based practices.

What If You Can’t Afford Mounjaro Anymore?

We know the increase in Mounjaro’s cost has made it unaffordable for some patients. While Wegovy offers a more cost-effective alternative, we’re also aware that starting from a lower dose feels like a step backwards. Please know this isn’t about denying access, it’s about ensuring a safe, effective transition within the bounds of UK medical regulations.

The Bottom Line

At The Family Chemist, we understand how important your treatment journey is. If the cost of Mounjaro has led you to explore alternatives, we’re here to support you with guidance, safer options, and regulated care. Our clinicians are available to discuss your situation and help you find a treatment plan that balances both safety and affordability.