Rybelsus vs. Ozempic
Rybelsus and Ozempic are both prescription semaglutide medications used to help control blood sugar levels in patients with Type 2 diabetes. The main difference is that Ozempic is an injection and Rybelsus is an oral tablet. Your doctor can help you determine which drug is best for your needs.
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Key Differences Between Rybelsus and Ozempic
Rybelsus and Ozempic are two semaglutide medications that Novo Nordisk manufactures to manage Type 2 diabetes. Neither is FDA-approved for weight loss, but the FDA has approved Wegovy, another Novo Nordisk semaglutide product, for chronic weight management.
Though Rybelsus and Ozempic are sometimes prescribed off-label for weight loss, Novo Nordisk cautions against off-label use.
“Ozempic injection and Rybelsus tablets are approved to lower blood sugar levels in adults with Type 2 diabetes mellitus, in addition to diet and exercise. Ozempic is also approved to reduce the risk of heart attack, stroke or death in adults with Type 2 diabetes mellitus and known heart disease.”
Ozempic is a weekly injection and Rybelsus is a daily pill. Both share similar side effects and cost around $800-$1,000 monthly without insurance. Consult your doctor to choose which may be better suited for you based on your medical history and needs.
Usage Differences Between Rybelsus and Ozempic
In part, because they rely on the same active ingredient, Rybelsus and Ozempic are competitive in the market to treat Type 2 diabetes, according to an analysis of GLP-1 medications by Truveta Research, a group of more than 30 health care operations responsible for 18% of daily clinical care in the U.S.
| COMPARISON | RYBELSUS | OZEMPIC |
|---|---|---|
| Prescribing Trends | The second most commonly prescribed GLP-1 receptor agonist overall. It shows increasing prescribing rates, albeit slower than in Ozempic. | Most commonly prescribed GLP-1 receptor agonist overall. Higher first-time prescribing rates compared to Rybelsus. |
| Dispensing Rates | Lower dispensing rates compared to Ozempic, especially towards the later part of the study period. This may indicate differences in patient acceptance or access challenges compared to Ozempic. | Higher initiation rates, with more first-time prescriptions being dispensed within 60 days. More consistent dispensing rates compared to Rybelsus. |
| Patient Characteristics | Generally similar patient characteristics to Ozempic. Potential for capturing market share due to its oral rather than injectable formulation, which may appeal to some patients. | Preferred across different age groups, consistent prescribing trends observed over time. Higher prevalence in patients with Type 2 diabetes and/or overweight or obesity. |
| Safety & Effectiveness | Comparable efficacy to Ozempic, as it contains the same active ingredient (semaglutide). The safety profile is similar to that of Ozempic, but there are considerations related to gastrointestinal side effects associated with oral GLP-1 receptor agonists. | Well-established efficacy in both diabetes management and weight loss. Generally well tolerated with a good safety profile. |
| Market Competition and Access | Positioned as an alternative to injectable GLP-1 receptor agonist medications like Ozempic. Offers convenience of oral administration, potentially expanding patient access and acceptance. | Established market leader in the GLP-1 receptor agonist category, with high brand recognition and market share. It may face competition from Rybelsus, particularly due to its oral formulation. |
You should never take both Rybelsus and Ozempic together, and your doctor should never prescribe both at the same time. Taking both increases the chance of overdosing.
Side-by-Side Comparison
Though the same manufacturer produces both Rybelsus and Ozempic and the medications contain the same active ingredient, semaglutide, there are several major differences between the two diabetes drugs.
- Administration
- Ozempic is an injection that comes in a pre-filled pen, while Rybelsus is taken as an oral tablet.
- Dosage
- Ozempic injections begin at a dose of 0.25 mg and increase progressively over four weeks, potentially up to 2 mg. Doses of Rybelsus tablets can increase every 30 days, beginning at 3 mg and potentially increasing up to 14 mg.
- Taken With Food or Water?
- You can administer Ozempic injections at any time, with or without food. Take Rybelsus in the morning with no more than 4 ounces of water on an empty stomach, 30 minutes before eating or drinking.
- Use and Indication
- While both drugs lower blood sugar in Type 2 diabetes patients, only Ozempic is also approved to lower the risk of heart attack, stroke and death. Both may be prescribed off-label for weight loss.
- Schedule
- Rybelsus is taken once daily and Ozempic is injected weekly.
- Side Effects
- Rybelsus and Ozempic share similar side effects since both contain semaglutide.
- Cost
- Ozempic costs about $935 per month without insurance or as little as $25 per month with a discount card from Novo Nordisk. Rybelsus costs about $500 to $1,000 per month without insurance. Insurance may reduce the costs considerably.
The semaglutide in Rybelsus and Ozempic stimulates insulin and inhibits glucagon secretion in response to blood sugar levels.
“This mechanism, along with delayed gastric emptying, contributes to blood glucose reduction,” immunologist Daniel Neumeier, Ph.D., life sciences specialist at L.E.K. Consulting, told Drugwatch.
The gastric emptying effect also allows semaglutide to spur weight loss in people taking the medications — a beneficial side effect of semaglutide.
Side Effects of Rybelsus vs. Ozempic
Since both Rybelsus and Ozempic are semaglutide medications, they tend to have the same side effects.
“This can include everything from diarrhea and vomiting to stomach pain, burping and flatulence,” registered dietitian Catherine Rall told Drugwatch.
Rybelsus and Ozempic side effects are normally mild. Serious complications are rare but can develop.
- Abdominal pain
- Allergic reactions
- Diarrhea
- Fatigue
- Hypoglycemia
- Kidney problems
- Nausea or vomiting
- Pancreatitis
- Weight loss
Semaglutide drugs like Rybelsus and Ozempic may lead to higher rates of diarrhea, nausea and vomiting compared to older GLP-1 agonists such as Byetta (exenatide), Victoza (liraglutide) and Trulicity (dulaglutide).
Temporary side effects usually last a few days. Contact your doctor or pharmacist if they persist or worsen. Seek immediate medical attention for serious complications.
Boxed Warnings and Severe Side Effects
Rybelsus and Ozempic carry FDA box warnings due to potential thyroid tumor risks, including cancer. They warn that people with a history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome Type 2 should not use these medications.
Additional warnings include risks of pancreatitis, diabetic retinopathy, hypoglycemia, kidney injury, gallbladder disease, stomach paralysis, severe vomiting and mental health effects such as depression and suicidal ideation. If experiencing symptoms, seek medical attention promptly.
People have filed Ozempic lawsuits claiming the medication resulted in stomach paralysis or other severe side effects.
Is Rybelsus or Ozempic More Effective?
Rybelsus and Ozempic are effective in lowering A1C when combined with a healthy lifestyle of diet and exercise.
- Patients taking 1 mg of Ozempic achieved an A1C decrease of about 1.6%
- Patients taking 14 mg of Rybelsus saw a 1.4% A1C decrease
Although no direct studies have compared their effectiveness, both drugs have proven results. Patients taking Rybelsus and Ozempic have reported similar weight reductions over 30 weeks — but these are not intended for cosmetic weight loss.
Discuss with your doctor to determine which drug is more effective for you.
Should You Take Rybelsus or Ozempic?
If you’re considering Rybelsus or Ozempic for Type 2 diabetes management, understanding their differences is crucial. Both contain semaglutide and effectively manage blood sugar levels combined with diet and exercise.
However, Ozempic also reduces the risk of significant heart problems in individuals with Type 2 diabetes and heart disease, a benefit not shared by Rybelsus. Discussing these distinctions with your doctor can guide you toward the most suitable treatment option.
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