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 medicines: 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 quite than an injection. Ozempic and Rybelsus are made by the identical producer, Novo Nordisk, and have the identical energetic ingredient, semaglutide.[1] Semaglutide, when offered below the model identify Ozempic, is meant for individuals with sort 2 diabetes. The identical drug can be offered as Wegovy for the therapy of weight problems.
Semaglutide is a GLP-1 receptor agonist, a sort of drug that mimics the impact of a hormone that stimulates insulin secretion and prompts emotions of fullness. Semaglutide was initially developed and accredited to deal with sort 2 diabetes, and it stays a robust glucose-lowering remedy, it additionally has a profound impact on physique weight. Many semaglutide customers discover themselves shedding weight with out having to consciously lower energy.[2]
Rybelsus is the one accredited oral type of semaglutide. It’s a every 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 accessible in smaller doses.
In keeping with the U.S. Meals and Drug Administration (FDA), the utmost 14 milligram (mg) every 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 increased quantities of semaglutide than Ozempic, as a result of solely a fraction of the semaglutide that enters the abdomen is correctly absorbed.)[5]
Scientific trials present that the 2 doses have a comparable metabolic impact: [6]
| Rybelsus 14 mg every 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 individuals with sort 2 diabetes, the 2 medication should not equal, virtually talking, as a result of Ozempic is out there in additional highly effective dosages.
Ozempic is moreover accessible in 1 and a pair of mg doses. The utmost dose, when examined in individuals with sort 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 — at the very least not on the accredited doses. Wegovy is out there in a fair increased dose, 2.4 mg per week.
Greater Doses of Rybelsus Are On The Approach
Within the coming years, increased doses of Rybelsus might grow to be accessible. In 2023, Novo Nordisk introduced that it will search FDA approval for bigger doses of oral semaglutide for the therapy of sort 2 diabetes.[9]
The PIONEER PLUS trial, which examined two experimental bigger doses of oral semaglutide in individuals with sort 2 diabetes, demonstrated that on the highest dose of fifty mg, the drug’s glucose-lowering and weight reduction outcomes had been at the very least nearly as good as these present in Ozempic 2 mg. Research individuals had an A1C discount of two share factors, and weight lack of about 20 kilos.[10][11]
Is Rybelsus Accepted for Weight Loss?
Oral semaglutide will not be but accredited 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 had been chubby or had weight problems.[12] After utilizing the drug for over one 12 months, research individuals misplaced a mean of 15.1 p.c 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 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 US 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.
How you can 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 keeping 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 medicines. 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 might be much less efficient. However for those who wait longer than half-hour to eat, the tablet’s absorption could also be enhanced (which may additionally result in extra important unwanted effects).
In contrast, 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 unwanted 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 solely.
Scientific trials recommend that Rybelsus has related unwanted effects. A roughly related proportion of Rybelsus research individuals reported experiencing the commonest unwanted effects, together with nausea, belly ache, diarrhea, and vomiting.
Rybelsus’ FDA label additionally warns of among the identical uncommon, severe unwanted effects as Ozempic, together with pancreatitis (irritation of the pancreas) and acute kidney damage (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 should not, actually, equal to Rybelsus. These semaglutide capsules are taken sublingually (dissolved below the tongue) quite than swallowed, and subsequently have a wholly totally different mechanism for absorption.
Consumers needs to be cautious of such merchandise, as there has by no means been any revealed 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 accessible in much less highly effective doses. Within the coming years, bigger doses for the therapy of each diabetes and weight problems might grow to be accessible. Within the meantime, Rybelsus stays an efficient remedy for sort 2 diabetes, and could also be particularly helpful for individuals with needle phobia or those that can not take Ozempic for another purpose.
