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HomeDiabetes CareRybelsus is Ozempic in a Pill. Is It Just as Good?

Rybelsus is Ozempic in a Pill. Is It Just as Good?

People can’t stop talking about Ozempic, the buzziest diabetes and weight reduction drug in memory. Ozempic is an injectable medication: users prick themselves with a pre-loaded syringe once per week. But while Ozempic is so popular that it’s led to shortages, there’s been hardly any hype for Rybelsus, an oral type of the very same drug. Why aren’t people talking about Rybelsus? Is it just pretty much as good as Ozempic?

What Is Rybelsus?

Rybelsus is actually Ozempic in the shape of a pill slightly than an injection.

Ozempic and Rybelsus are made by the identical manufacturer, Novo Nordisk, and have the identical lively ingredient, semaglutide.

Semaglutide is a GLP-1 receptor agonist, one in every of a family of medicine that mimic the effect of a hormone that stimulates insulin secretion and prompts feelings of hunger. Semaglutide was originally developed and approved to treat type 2 diabetes, but it surely turned out to be one in every of the best weight reduction drugs ever invented. A high percentage of semaglutide users find themselves losing a few pounds almost effortlessly — they simply eat less because they’re not as hungry anymore.

A 3rd type of semaglutide, Wegovy, has been approved as a weight reduction drug for people without diabetes.

Rybelsus is the one oral type of this powerful diabetes and weight reduction medication. It has been shown to grant each weight reduction and blood sugar improvements in many various populations, each alone and together with other diabetes drugs.

Is Rybelsus as Effective as Ozempic?

Rybelsus appears to be just as effective as Ozempic, but there’s a catch: Ozempic is out there in additional powerful doses.

To evaluate the potency of every drug, we will compare their ends in studies that tested similar populations. In response to the FDA (PDF), the utmost 14mg each day dose of Rybelsus is corresponding to the 0.5mg weekly dose of Ozempic — one will be switched for the opposite without the necessity for titration or adjustment.

(When you’re wondering why Rybelsus has so way more semaglutide in it than Ozempic, 14mg per day vs 0.5mg per week, it’s because only a tiny fraction of the semaglutide that enters the stomach is properly absorbed.)

The PIONEER 2 trial assessed Rybelsus’ efficacy for individuals with type 2 diabetes using metformin. After six months on the utmost dose, trial participants saw their average A1C drop 1.3 percentage points; after one 12 months, they’d lost about 10 kilos.

The SUSTAIN 2 trial assessed Ozempic in the same population, individuals with type 2 diabetes using either metformin or a TZD. The 0.5mg dose of Ozempic conferred an A1C drop of 1.3 percentage points and a weight reduction of 9.5 kilos. These extremely similar results suggest that the 2 drugs are equally effective.

But Ozempic is out there in additional powerful dosages. Ozempic’s maximum dose of two.0mg, when tested in individuals with type 2 diabetes using metformin, led to a really impressive A1C drop of two.2 percentage points, and weight reduction of 15 kilos. Wegovy is out there in a fair higher dose, 2.4mg per week. Rybelsus can’t match these results — at the very least not on the approved doses — and it hasn’t yet been tested as a weight-loss medication for people without type 2 diabetes.

Taking Rybelsus

If there’s another excuse that Rybelsus hasn’t caught on, it’s that taking the drug is type of a hassle.

In response to the FDA label, it’s worthwhile to take Rybelsus on an empty stomach, every morning, half-hour before eating, drinking, or using some other oral medications. You will have as much as 4 ounces of plain water only during this time. If you have got your breakfast too early, the pill might be less effective. But in the event you wait longer than half-hour to eat, the pill’s absorption could also be enhanced

Against this, Ozempic is a single weekly injection and will be taken at any time of day, with or without meals.

Is a Higher Dose of Rybelsus on the Way?

Novo Nordisk is currently pushing for approval for the next dose of Rybelsus.

How will we know that larger doses of Rybelsus might be simpler? Novo Nordisk recently announced the headline results of its PIONEER PLUS trial. This robust experiment tested larger doses of oral semaglutide, 25mg and 50mg per day. The trial ran for 68 weeks, with over 1,000 participants with type 2 diabetes. Here were the outcomes:

Dose A1C Reduction Weight Loss
14mg 1.5 percent 9.9 lbs
25mg 1.9 percent 15.4 lbs
50mg 2.2 percent 20.3 lbs

The very best dose offered A1C and weight reduction advantages on par with, or even perhaps higher than, Ozempic’s current maximum dose of two.0mg.

Novo Nordisk stated that it will apply for approval for these larger doses this 12 months, even though it’s difficult to guess when it might be available for patients.

Rybelsus and Side Effects

A considerable minority of Ozempic users experience gastrointestinal unwanted side effects. For some, the nausea, vomiting, or diarrhea subsides as their bodies acclimate to the powerful drug. But others are forced to quit the drug entirely.

Rybelsus has a reasonably similar side effect profile. Here’s the variety of people who experience belly troubles, in response to the information that the FDA lists on its official labels for the 2 drugs at equivalent doses:

Side Effect Ozempic (%) Rybelsus (%)
Nausea 20 20
Abdominal Pain 7 11
Diarrhea 9 10
Vomiting 5 8
Constipation 5 5

As you’ll be able to see, the numbers are very similar across the board.

The PIONEER PLUS trial did find that gastrointestinal unwanted side effects were more common with larger doses, though we don’t yet have the main points on how way more common.

It stands to reason that Rybelsus, if particularly effective, may additionally cause “Ozempic face,” a phenomenon by which Ozempic users lose a lot weight that additionally they lose healthy-looking fat from their faces, leading to a saggy, aged appearance. To the most effective of our knowledge, “Ozempic face” is only attributable to weight reduction, which suggests that some other weight-loss medication can potentially have the identical effect.

Rybelsus, like Ozempic, may carry a risk of other rare but serious unwanted side effects — please discuss this together with your doctor.


Rybelsus, an oral type of semaglutide, appears to be just as powerful as Ozempic pound for pound, each for weight reduction and diabetes management. Nonetheless, it’s not quite as popular, likely for the next two reasons:

  • Rybelsus is a hassle to take — it have to be swallowed on an empty stomach, every morning, exactly half-hour before eating or drinking anything apart from water, or using some other oral medications.
  • Rybelsus is out there in less powerful doses than Ozempic, which suggests less weight reduction.

Despite these disadvantages, Rybelsus stays a really effective therapy for type 2 diabetes, granting each weight reduction and glycemic improvement. It could be especially useful for individuals with needle phobia or those that cannot take Ozempic for some other reason.

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