Rybelsus vs Ozempic for weight loss: Which to choose?

Key Points

• Rybelsus and Ozempic both contain the active ingredient semaglutide.
• Rybelsus comes as an oral tablet, while Ozempic is available as an injection.
• Both Rybelsus and Ozempic are FDA approved to treat adults with Type 2 diabetes.
• In separate clinical trials, patients lost up to 3.7 kg (8 lbs) over 26 weeks of taking Rybelsus, and up to 4.7 kg (10 lbs) over 30 weeks with Ozempic.

What are Rybelsus and Ozempic?

Rybelsus and Ozempic are two FDA-approved medications that may be used to treat Type 2 diabetes in adults. Ozempic may also be used to lower the risk of major heart events in people with Type 2 diabetes and heart disease. Both medications contain semaglutide as the active ingredient, and belong to the drug class called glucagon-like peptide 1 (GLP-1) receptor agonists.

Rybelsus is available as an oral tablet that is taken at least 30 minutes before the first food or drink of the day. It is taken by mouth once a day. The tablets must be swallowed whole, and cannot be split, crushed, or chewed.

Ozempic comes as an injection that is administered under the skin once a week. It can be given with or without food. It’s occasionally prescribed off-label for weight loss, but there is another version called Wegovy that is FDA approved for managing weight in certain people.

Do you lose more weight on Rybelsus or Ozempic?

There are not any head-to-head clinical trials comparing weight loss from Rybelsus and Ozempic. Both medications led to some weight loss during separate clinical trials. Patients taking Rybelsus lost up to 3.7 kg (8 lbs) over 26 weeks, while patients taking Ozempic lost up to 4.7 kg (10 lbs) over 30 weeks.

An observational study of patients taking Rybelsus or Ozempic found that both groups experienced similar weight loss (around 6 kg, or 13 lbs) 6 months after starting treatment.

More recent studies have examined the effects of a higher dose of oral semaglutide on weight loss. In one study, adults with type 2 diabetes who were identified as overweight or obese took 50 mg of semaglutide once a day. Researchers found that after 68 weeks more patients taking semaglutide lost at least 5%of their body weight compared to those taking a placebo (no active medication). On average, patients taking semaglutide lost around 15% of their body weight compared to only around 2% in patients taking a placebo. The dose of semaglutide used in this study is much higher than what oral semaglutide (Rybelsus) is currently FDA approved to take.

How do Rybelsus and Ozempic work for weight loss?

Neither Rybelsus nor Ozempic is FDA approved for weight loss. However, some people lose weight while taking these medications. One reason they are thought to promote weight loss is by slowing down how long it takes for your stomach to empty after eating. This may help keep you fuller for a longer period of time, which can cause you to consume less calories.

Related questions

• Ozempic Side Effects to Watch For
• Mounjaro vs Ozempic: How do they compare?
• How do Ozempic, Mounjaro, Wegovy, Zepbound compare for weight loss?

How do you take Rybelsus and Ozempic?

Rybelsus and Ozempic are available in different dosage forms and are taken differently.

Rybelsus comes as an oral tablet in 3 mg, 7 mg, and 14 mg strengths. The usual starting dose is 3 mg by mouth once a day for 30 days. Then, the dose is increased to 7 mg once a day. After 30 days, the dose may be increased to 14 mg once a day if your blood sugar is not well controlled.

Ozempic is available as prefilled pens that deliver 0.25 mg, 0.5 mg, 1 mg, or 2 mg. The usual starting dose is 0.25 mg injected under the skin once a week for 4 weeks. Then, the dose is increased to 0.5 mg once a week. After 4 weeks, the dose may be increased to 1 mg once a week if you need more blood sugar control. It may be raised again after 4 weeks to 2 mg once a week, which is the maximum recommended dose per week.

What are the side effects of Rybelsus and Ozempic?

Many side effects are similar between Rybelsus and Ozempic. One difference is that Ozempic causes more injection site reactions, since it is given as an injection.

Common side effects reported by people taking Rybelsus in clinical trials include:

• Nausea (11-20%)
• Stomach pain (10-11%)
• Diarrhea (9-10%)
• Poor appetite (6-9%)
• Vomiting (6-8%)
• Constipation (5-6%)

Common side effects reported by people taking Ozempic in clinical trials include:

• Nausea (16-20%)
• Vomiting (5-9%)
• Diarrhea (9%)
• Stomach pain (6-7%)
• Constipation (3-5%)

More rare but serious side effects can happen with these medications, including:

• Pancreatitis
• Vision problems
• Low blood sugar
• Kidney damage
• Serious allergic reaction
• Gallbladder problems
• Bowel obstruction

The active ingredient in Rybelsus and Ozempic, semaglutide, has caused thyroid tumors in animals. It is not known if they have the same effect in humans, but there have not been reports of cancer due to taking either medication.

Neither medication is recommended during pregnancy or breastfeeding because of potential risks of harm to babies.

This is not all the information you need to know about Rybelsus and Ozempic for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.