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. Additionally, it is unlikely that insurance will cover Rybelsus or Ozempic if they are prescribed for weight management specifically.
“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 glucagon-like peptide-1 (GLP-1) receptor agonist medications by Truveta Research, which is a group of more than 30 health care operations responsible for 18% of daily clinical care in the U.S.
Usage Comparisons
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.
The most commonly prescribed GLP-1 receptor agonist overall. It has
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, with 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, as both can cause gastrointestinal side effects. Rybelsus should be taken first thing in the morning on an empty stomach for maximal effectiveness.
Well-established efficacy in both diabetes management and weight loss. Ozempic causes gastrointestinal side effects in up to 50% of patients, including nausea, vomiting, diarrhea, and constipation.
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 serious side effects.
Side-by-Side Comparison
Though the same manufacturer produces both Rybelsus and Ozempic and the medications contain the same active ingredient called semaglutide, there are several major differences between the two drugs.
7 Key Differences Between Rybelsus and Ozempic
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. You should take Rybelsus in the morning with no more than 4 ounces of water on an empty stomach, at least 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.
Schedule
Rybelsus is taken by mouth once daily and Ozempic is injected under the skin once weekly.
Side Effects
Rybelsus and Ozempic share similar side effects since both contain semaglutide. Gastrointestinal side effects are the most common.
Cost
Ozempic costs about $935 per month without insurance, or it could be 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 cost 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.
“Ozempic has the edge on Rybelsus for better efficacy in glucose control and weight loss. However, for patients who aren’t willing to take an injectable medication, Rybelsus’s oral formulation offers an alternative.
”
Side Effects of Rybelsus vs. Ozempic
Since both Rybelsus and Ozempic are semaglutide medications, they tend to have similar 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.
Semaglutide side effects include:
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 only 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 the 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 you are experiencing symptoms, seek medical attention promptly.
People have filed Ozempic lawsuits claiming the medication resulted in stomach paralysis or other severe side effects.
Drugwatch partners with trusted law firms to help you take legal action. After submitting the form, one of Drugwatch's partners will contact you for a free case review.
Is Rybelsus or Ozempic More Effective?
Rybelsus and Ozempic are effective in lowering hemoglobin A1C (HbA1c) compared to placebo when combined with a healthy lifestyle of diet and exercise.
Effectiveness of Rybelsus vs. Ozempic
Patients taking 1 mg of Ozempic achieved a 1.6% reduction in HbA1c
Patients taking 14 mg of Rybelsus experienced a 1.4% decrease in HbA1c
Although no direct studies have compared their effectiveness, both drugs have proven results. Studies have shown that taking Rybelsus and Ozempic each caused weight reductions over 30 weeks. Ozempic 1.0 mg led to a 4.5 kg weight loss, whereas Rybelsus 14 mg led to a 3.7 mg weight loss. Of note, 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 both 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.
Please seek the advice of a medical professional before making health care decisions.
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“Ozempic has the edge on Rybelsus for better efficacy in glucose control and weight loss. However, for patients who aren’t willing to take an injectable medication, Rybelsus’s oral formulation offers an alternative. ”
