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 basically 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 lively ingredient, semaglutide.[1] Semaglutide, when offered beneath the model identify Ozempic, is meant for individuals with kind 2 diabetes. The identical drug can also be offered as Wegovy for the therapy 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 authorised 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 losing a few pounds with out having to consciously lower energy.[2]
Rybelsus is the one authorised oral type of semaglutide. It’s a each day tablet, and it has been proven to end in 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 is just out there in smaller doses.
In response to 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 might be switched for the opposite with out the necessity for a dose adjustment.[4] (Rybelsus makes use of larger 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 comparable outcomes: Oral semaglutide demonstrated “comparable effectiveness” to injectable semaglutide.[7]
Whereas these outcomes recommend that Rybelsus and Ozempic might be equally efficient for individuals with kind 2 diabetes, the 2 medication will not be equal, virtually talking, as a result of Ozempic is on the market in additional highly effective dosages.
Ozempic is moreover out there in 1 and a couple of mg doses. The utmost dose, when examined in individuals 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 authorised doses. Wegovy is on the market in a good larger dose, 2.4 mg per week.
Larger Doses of Rybelsus Are On The Approach
Within the coming years, larger doses of Rybelsus could grow to be out there. In 2023, Novo Nordisk introduced that it might search FDA approval for bigger doses of oral semaglutide for the therapy of kind 2 diabetes.[9]
The PIONEER PLUS trial, which examined two experimental bigger doses of oral semaglutide in individuals with kind 2 diabetes, demonstrated that on the highest dose of fifty mg, the drug’s glucose-lowering and weight reduction outcomes had been no less than nearly as good as these present in Ozempic 2 mg. Examine individuals 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 will not be but authorised as a weight reduction remedy.
Within the current OASIS 1 trial, nonetheless, researchers examined the impact of a 50 mg dose of oral semaglutide for individuals who had been obese or had weight problems.[12] After utilizing the drug for over one 12 months, research individuals misplaced a mean of 15.1 % of their whole physique weight. That quantity of weight reduction was about equal to that achieved by individuals utilizing the utmost dose of injectable semaglutide, suggesting that an oral semaglutide weight reduction tablet might 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 individuals with out diabetes, particularly those that can not tolerate Wegovy or who’re unable to make use of needles.
Find out how 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 response to the directions on the FDA label, you have to take Rybelsus on an empty abdomen, each morning, half-hour earlier than consuming, consuming, or utilizing some other oral drugs. You could have as much as 4 ounces of plain water solely throughout this time. In case you have your breakfast too early, the tablet shall be much less efficient. However in the event you wait longer than half-hour to eat, the tablet’s absorption could also be enhanced (which might additionally result in extra important unintended effects).
In contrast, Ozempic is a single weekly injection and might be taken at any time of day, with or with out meals.
Rybelsus and Aspect Results
A considerable minority of Ozempic customers expertise gastrointestinal unintended 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 totally.
Medical trials recommend that Rybelsus has comparable unintended effects. A roughly comparable proportion of Rybelsus research individuals reported experiencing the most typical unintended effects, together with nausea, belly ache, diarrhea, and vomiting.
Rybelsus’ FDA label additionally warns of a few of the similar uncommon, severe unintended effects as Ozempic, together with pancreatitis (irritation of the pancreas) and acute kidney harm (a sudden lower in kidney perform).[4]
Compounded Oral Semaglutide
Some on-line compounding pharmacies are actually promoting “oral semaglutide,” however a few of these merchandise will not be, in reality, equal to Rybelsus. These semaglutide capsules are taken sublingually (dissolved beneath the tongue) somewhat than swallowed, and due to this fact have a completely completely different mechanism for absorption.
Patrons must 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 is just out there in much less highly effective doses. Within the coming years, bigger doses for the therapy of each diabetes and weight problems could grow to be out there. Within the meantime, Rybelsus stays an efficient remedy for kind 2 diabetes, and could also be particularly helpful for individuals with needle phobia or those that can not take Ozempic for some other purpose.
