Should I Take Rybelsus vs. Ozempic?

Key Points

• Rybelsus and Ozempic are both diabetes medications that use the active ingredient semaglutide.
• The main difference between Rybelsus vs. Ozempic is Rybelsus is an oral tablet and Ozempic is an injectable.
• The medications have different doses but yield similar results.

If you're looking for a diabetes medication, you might be wondering what the difference is between Rybelsus® vs. Ozempic®.

Both drugs have the same active ingredient – semaglutide – and are both made by Novo Nordisk. They are both FDA-approved for the treatment of type 2 diabetes. But they have different dosage forms and levels.

So which is best for you?

Let's break down Rybelsus vs. Ozempic.

What is the difference between Rybelsus vs. Ozempic?

Rybelsus and Ozempic are both drugs produced by Novo Nordisk that use the same active ingredient, semaglutide, for blood sugar management.

Rybelsus is used along with diet and exercise to improve blood sugar in adults with type 2 diabetes. While it is not approved for weight loss, it may help you lose some weight. It does not increase risk for cardiovascular events such as heart attack or stroke.

Ozempic is used along with diet and exercise to lower blood sugar and A1C in adults with type 2 diabetes, as well as lower the risk of cardiovascular events like heart attack or stroke in adults with heart disease. Ozempic is also not indicated for weight loss but may help you lose weight.

The main distinction is how you take it:

Rybelsus comes as a daily oral tablet, while Ozempic requires a weekly under-the-skin injection.

Ozempic and Rybelsus also have different doses, with the maximum dose of Rybelsus being 14 mg and Ozempic being 2 mg.

Which is better to take, Rybelsus or Ozempic?

The American Diabetes Association (ADA) guidelines for treating type 2 diabetes include GLP-1 agonists like Rybelsus and Ozempic.

These guidelines recommend GLP-1 agonists as an additional treatment option when metformin doesn’t lower blood sugar enough.

The best weight loss or diabetes drug for you is determined by your medical provider based on your blood sugar levels, personal or family history, and other medical conditions.

Whether you take Rybelsus or Ozempic may also depend on whether you prefer oral medications or injectables.

Is Rybelsus good for weight loss?

As mentioned, Rybelsus is only FDA-approved for the treatment of type 2 diabetes to help control blood sugar levels. It cannot be prescribed for weight loss but it may help you lose some weight.

Its active ingredient, semaglutide, acts on the part of the brain that influences appetite and fullness. As a result, taking Rybelsus can lead to weight loss, as many people naturally eat less when taking the drug.

You often feel fuller faster and have a decreased appetite. This combined with lower blood sugar levels can lead to improved weight management.

Why is Rybelsus so hard to get?

Since exploding in popularity, weight loss drugs and diabetes medications like Rybelsus and Ozempic have become more difficult to get. They are in high demand due to their efficacy and many want to take it off-label for weight loss.

Due to demand and the general high costs of these brand name medications, some people are seeking off-brand options, such as compounded versions of semaglutide. This means the drug is not produced by the brand name producer but an independent entity like a pharmacy.

Compounded drugs are not FDA-approved and are thus not tested. This means compound weight loss drugs, while perhaps more easily available, come with increased safety risks.

Be safe and stick to brand-name medications.

Dosage difference in Rybelsus vs. Ozempic

How you take Rybelsus vs. Ozempic is different. Both Rybelsus and Ozempic use semaglutide but have different doses.

Rybelsus dosing

Rybelsus starts with a 3 mg daily oral tablet dose for the first 30 days. After that, your doctor will typically increase your dose to 7 mg once per day. This is typically the most effective dose to manage blood sugar levels.

After another 30 days on the 7 mg dose, your doctor can assess your blood sugar control and decide whether to increase the dose. The maximum dose of Rybelsus is 14 mg per day.

Rybelsus is taken on an empty stomach upon waking. You may take the oral tablet with no more than 4 ounces of water. After 30 minutes, you can eat, drink, or take other oral medications or supplements.

If you miss a dose, the missed dose should be skipped, and the next dose should be taken the following day.

Ozempic dosing

Ozempic starts with a .25 mg injection once weekly. After four weeks, your doctor will increase your dose to .5 mg per week.

If, after another four weeks, you still need improved blood glucose control, your doctor may increase your dose to 1 mg. The maximum dose of Ozempic is 2 mg per week.

Ozempic is administered as a subcutaneous injection once per week. You should administer your dose on the same day every week, but the medication can be taken at any time, with or without food.

You can change the day of the week you use Ozempic as long as your last dose was taken two or more days before.

Ozempic comes in an injectable pen with four pre-measured doses, so you use one pen per month.

How well do Rybelsus and Ozempic manage blood sugar levels?

Both Rybelsus and Ozempic have shown promising results as diabetes and blood sugar medications.

They also show promising results for weight management, although they are only FDA-approved for blood sugar control.

Semaglutide is the only GLP-1 available in both an injectable and oral formulation.

In a Rybelsus study by Novo Nordisk, nearly 8 out of 10 people taking 14 mg of Rybelsus reached an A1C of <7% after six months, with an average change of -1.4%. In the same study, people lost around 8 pounds (with an average starting weight of 194 pounds).

In an Ozempic study by Novo Nordisk, a majority of adults taking Ozempic reached an A1C under 7% and maintained it. In the same studies, adults with type 2 diabetes lost up to 14 pounds (with an average starting weight of 219 pounds).

These results suggest that Ozempic has stronger results on lower blood sugar levels and weight management. However, it's important to account for the difference between an oral tablet and an injection.

Oral vs injectable semaglutide: Which is more convenient?

Many patients are resistant to the idea of an injectable treatment, fearing pain, having concerns about when and where they might need to inject, being nervous about injecting correctly, and having concerns about adverse events.

Medical providers can share some of these concerns as well, with concerns about patient adherences and general lack of knowledge about these newer drugs.

For patients with these concerns, taking semaglutide in oral form may be preferable.

On the other hand, some patients may prefer the lower frequency of injectables. They may be adverse to the strict protocol of taking the oral medication on an empty stomach and may prefer the flexibility of the injectable.

In a meta-analysis, no clinical trials or studies directly compared injectable vs. oral semaglutide head-to-head, but no statistically significant difference was observed between 1 mg subcutaneous semaglutide and 14 mg daily oral semaglutide.

It's important to note, however, that Ozempic can now be administered at a 2 mg dose, so more research is necessary to compare the two.

What are the cons of Rybelsus?

When taking Rybelsus, you may experience side effects.

The most common side effects are nausea, stomach (abdominal) pain, diarrhea, decreased appetite, vomiting, and constipation.

Rybelsus may cause serious side effects, including:

• Thyroid tumors, including thyroid cancer
• Pancreatitis or acute kidney injury
• Hypoglycemia (low blood sugar)
• Kidney problems or kidney failure
• Severe stomach pain or problems
• Gallbladder issues

Contact your doctor immediately if you feel you are experiencing any of these serious side effects. Otherwise, plan to discuss your side effects at your next check-up appointment. Do not stop taking the medication without medical advisory.

Ozempic side effects

Ozempic has similar side effects and risks as Rybelsus. The most common drug effects are nausea, abdominal pain, constipation, diarrhea, and vomiting. Your side effects may improve the longer you are on the medication, but you may experience an uptick in side effects as you increase your dosage.

Ozempic also has a risk of thyroid cancer, issues with the pancreas or kidneys, and impaired vision. Do not use Ozempic if you have a personal or family history of MTC or MEN 2.

To avoid nausea, try avoiding greasy or fried foods, avoid laying down after eating, eat slowly, and eat bland foods. Talk to your doctor about any concerns you may have.

Achieve your goals with a dietitian

Whether you're still comparing Rybelsus vs. Ozempic or are already on a weight management or diabetes drug, one of the best things you can do to succeed in the long term is work with a registered dietitian.

A dietitian is the support and partner you need for lasting results with diabetes or weight management. An RD can walk you through what to expect as you start one of these prescription drugs and create a custom diet plan that accompanies your course of treatment.

Whether you're taking Rybelsus or Ozempic, your dietitian will know just what to do to help you succeed. If you hit a weight plateau and aren't seeing the numbers you want in your average blood glucose levels, your RD can adjust your plan to ensure progress continues and you reach your goals.

It's easy to connect with a qualified diabetes or weight loss dietitian with Fay. And Fay gets your care covered by insurance, making top-of-the-line nutrition counseling easier than ever to access.

Get started with Fay today.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.