This content material initially appeared right here. Republished with permission.
Medically Reviewed by Sean Hashmi, MD
Folks can’t cease speaking about semaglutide (Ozempic, Wegovy), the buzzy diabetes and weight reduction drug. Ozempic and Wegovy are injectable drugs: Customers prick themselves with a preloaded syringe as soon as per week. However whereas the recognition of Ozempic has led to shortages, there’s been a lot much less hype for Rybelsus, an oral type of semaglutide — the very same drug.
What Is Rybelsus?
Rybelsus is actually Ozempic within the type of a tablet somewhat than an injection. Ozempic and Rybelsus are made by the identical producer, Novo Nordisk, and have the identical energetic ingredient, semaglutide.[1] Semaglutide, when bought below the model title Ozempic, is meant for folks with kind 2 diabetes. The identical drug can also be bought as Wegovy for the remedy of weight problems.
Semaglutide is a GLP-1 receptor agonist, a kind of drug that mimics the impact of a hormone that stimulates insulin secretion and prompts emotions of fullness. Semaglutide was initially developed and permitted to deal with kind 2 diabetes, and it stays a strong glucose-lowering remedy, it additionally has a profound impact on physique weight. Many semaglutide customers discover themselves shedding weight with out having to consciously reduce energy.[2]
Rybelsus is the one permitted oral type of semaglutide. It’s a each day tablet, and it has been proven to lead to clinically important weight reduction and blood sugar enhancements, each alone and together with different diabetes medication.[3]
Is Rybelsus as Efficient as Ozempic?
Rybelsus seems to be simply as potent as Ozempic, however there’s a catch: It’s only accessible in smaller doses.
In accordance with the U.S. Meals and Drug Administration (FDA), the utmost 14 milligram (mg) each day dose of Rybelsus is equal to the 0.5 mg weekly starter dose of Ozempic — one will be switched for the opposite with out the necessity for a dose adjustment.[4] (Rybelsus makes use of greater quantities of semaglutide than Ozempic, as a result of solely a fraction of the semaglutide that enters the abdomen is correctly absorbed.)[5]
Medical trials present that the 2 doses have a comparable metabolic impact: [6]
| Rybelsus 14 mg each day tablet | Ozempic 0.5 mg weekly injection |
|---|---|
| 1.3 share level drop in A1C | 1.3 share level drop in A1C |
| 10 kilos weight reduction | 9.5 kilos weight reduction |
A research of real-world information discovered related outcomes: Oral semaglutide demonstrated “related effectiveness” to injectable semaglutide.[7]
Whereas these outcomes recommend that Rybelsus and Ozempic could possibly be equally efficient for folks with kind 2 diabetes, the 2 medication should not equal, virtually talking, as a result of Ozempic is accessible in additional highly effective dosages.
Ozempic is moreover accessible in 1 and a pair of mg doses. The utmost dose, when examined in folks with kind 2 diabetes utilizing metformin, led to an A1C drop of two.2 share factors, and weight lack of 15 kilos.[8] Rybelsus can’t match these outcomes — no less than not on the permitted doses. Wegovy is accessible in a good greater dose, 2.4 mg per week.
Greater Doses of Rybelsus Are On The Approach
Within the coming years, greater doses of Rybelsus might change into accessible. In 2023, Novo Nordisk introduced that it might search FDA approval for bigger doses of oral semaglutide for the remedy of kind 2 diabetes.[9]
The PIONEER PLUS trial, which examined two experimental bigger doses of oral semaglutide in folks with kind 2 diabetes, demonstrated that on the highest dose of fifty mg, the drug’s glucose-lowering and weight reduction outcomes have been no less than pretty much as good as these present in Ozempic 2 mg. Examine members had an A1C discount of two share factors, and weight lack of about 20 kilos.[10][11]
Is Rybelsus Accredited for Weight Loss?
Oral semaglutide isn’t but permitted as a weight reduction remedy.
Within the current OASIS 1 trial, nevertheless, researchers examined the impact of a 50 mg dose of oral semaglutide for individuals who have been chubby or had weight problems.[12] After utilizing the drug for over one 12 months, research members misplaced a median of 15.1 p.c of their complete physique weight. That quantity of weight reduction was about equal to that achieved by folks utilizing the utmost dose of injectable semaglutide, suggesting that an oral semaglutide weight reduction tablet could possibly be simply as efficient because the injectable.[13]
Novo Nordisk has already utilized for regulatory approval for a semaglutide weight reduction tablet in each the USA and Europe.[14]
Within the meantime, some docs are prescribing Rybelsus off-label as a weight reduction remedy for folks with out diabetes, particularly those that can not tolerate Wegovy or who’re unable to make use of needles.
The way to Take Rybelsus
If there’s one more reason that Rybelsus hasn’t fairly caught on, it’s that taking the drug is arguably one thing of a trouble.
In accordance with the directions on the FDA label, you might want to take Rybelsus on an empty abdomen, each morning, half-hour earlier than consuming, consuming, or utilizing another oral drugs. You might have as much as 4 ounces of plain water solely throughout this time. When you have your breakfast too early, the tablet will probably be much less efficient. However if you happen to wait longer than half-hour to eat, the tablet’s absorption could also be enhanced (which might additionally result in extra important uncomfortable side effects).
Against this, Ozempic is a single weekly injection and will be taken at any time of day, with or with out meals.
Rybelsus and Facet Results
A considerable minority of Ozempic customers expertise gastrointestinal uncomfortable side effects.[15] For some, the nausea, vomiting, or diarrhea subsides because the physique will get acclimated to the drug. However others don’t really feel higher and find yourself quitting the drug fully.
Medical trials recommend that Rybelsus has related uncomfortable side effects. A roughly related proportion of Rybelsus research members reported experiencing the most typical uncomfortable side effects, together with nausea, stomach ache, diarrhea, and vomiting.
Rybelsus’ FDA label additionally warns of among the identical uncommon, severe uncomfortable side effects as Ozempic, together with pancreatitis (irritation of the pancreas) and acute kidney harm (a sudden lower in kidney operate).[4]
Compounded Oral Semaglutide
Some on-line compounding pharmacies at the moment are promoting “oral semaglutide,” however a few of these merchandise should not, actually, equal to Rybelsus. These semaglutide capsules are taken sublingually (dissolved below the tongue) somewhat than swallowed, and due to this fact have a wholly totally different mechanism for absorption.
Patrons ought to be cautious of such merchandise, as there has by no means been any printed research of sublingual semaglutide, and the security and efficacy of such substances could also be questionable.
The Takeaway
Rybelsus, an oral type of semaglutide, seems to be simply as efficient as Ozempic and Wegovy for diabetes administration and weight reduction, however it’s only accessible in much less highly effective doses. Within the coming years, bigger doses for the remedy of each diabetes and weight problems might change into accessible. Within the meantime, Rybelsus stays an efficient remedy for kind 2 diabetes, and could also be particularly helpful for folks with needle phobia or those that can not take Ozempic for another purpose.
