Restarting a GLP-1 after a break: what each label says

If you stopped a GLP-1 for a while, the label for your medicine decides the first question: can you just take the next dose, or should the dose ladder start again lower? Only two labels, Wegovy injection and Foundayo, set a point after which the dose should be stepped up again from a lower level; the others give a missed-dose rule and nothing more. Either way, the restart dose is your prescriber’s call, and it can change what you pay.

One missed dose: the label rules

These are the rules for a single missed dose, from each label.

Medicine	If you miss a dose
Zepbound (weekly shot)	Take it within 4 days; after that, skip it and take the next one on your usual day [1]
Mounjaro (weekly shot)	Same rule: within 4 days, otherwise skip [2]
Ozempic (weekly shot)	Take it within 5 days; after that, skip it [3]
Wegovy injection (weekly)	Take it if your next dose is more than 2 days away; if less than 2 days, skip it [4]
Wegovy tablets (daily)	Skip it and take the next tablet the following day [8]
Ozempic tablets and Rybelsus (daily)	Skip it and take the next tablet the following day [9]
Foundayo (daily pill)	Take it as soon as possible, but do not double the next dose [10]

A longer break: when the ladder starts again

Wegovy injection. If 2 or more doses in a row are missed, the prescribing information says to restart the dose increases at a lower dose, to cut the risk of stomach and gut side effects [5]. The patient medication guide says to contact your provider about restarting after 2 or more weeks of missed doses [6]. Novo Nordisk’s Wegovy website gives a looser answer: after 2 or more weeks, take the next dose on your usual day or call your provider [7]. The FDA label is the document to follow, and your prescriber is the person to ask.

Foundayo. If 7 or more daily doses in a row are missed, the label says to restart the dose increases at a lower dose, for the same reason [11]. The medication guide tells patients to call their provider about restarting after 7 or more days off [12].

Zepbound, Mounjaro, Ozempic, and the semaglutide tablets. In the labels we read, there is no instruction for restarting after a longer gap, only the missed-dose rules above. That silence is not permission to go straight back to your old dose. Contact your prescriber before your next dose if you have been off for more than a couple of weeks.

Why a lower dose, and which one

Both labels that address restarting give the same reason: stepping up again lowers the risk of nausea, vomiting and other gut side effects [5] [11]. Neither label names the exact step to restart on. Your prescriber may choose the starting dose or a step in between. For reference, the starting doses are 2.5 mg for Zepbound [13], 0.25 mg for the Wegovy injection [14] and 0.8 mg for Foundayo [15]. Zepbound’s 2.5 mg dose is only for starting treatment, not for staying on long term [13]. If a step is hard to tolerate, the Wegovy label lets the prescriber wait 4 weeks before the next increase [16], so a restart can take longer than the first climb did.

What the trials saw when people stopped

Breaks have a weight cost as well as a dosing one. In a Zepbound trial, 670 people who had taken tirzepatide for 36 weeks were split into two groups: one kept taking it and the other switched to placebo for 52 weeks [17]. Over those 52 weeks, weight fell another 5.5% on average in the group that kept taking it and rose 14.0% in the group switched to placebo [18]. In an extension of a Wegovy trial, people who stopped semaglutide 2.4 mg and the lifestyle program regained two-thirds of the weight they had lost within one year [19]. These were planned stops in trials, not short gaps, but they show why a break is worth discussing before it happens rather than after. For more trial results, see weight-loss results.

What a restart can cost

A restart on a lower dose can change your bill, because some sellers price each strength differently; Lilly’s regular Zepbound prices, for example, differ by dose [20]. Check what your program charges for the dose you will restart on, not the dose you were on before. Our program pages list what each one charges, and the cost without insurance guide explains the main ways to pay.

Watch for refill rules too. At LillyDirect, the self-pay prices for Zepbound 7.5 mg and higher assume you refill within 45 days; after a longer gap, Lilly’s regular prices apply [20].

If insurance paid before, check whether your approval is still active before you restart; our prior authorization guide explains how those approvals work. You can also compare your options with the savings check.