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Ozempic vs Rybelsus

Ozempic and Rybelsus are semaglutide-based prescription 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.

Last Modified: October 24, 2023
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Ozempic and Rybelsus Uses

Both Ozempic and Rybelsus are prescription drugs from manufacturer Novo Nordisk that contain semaglutide, an ingredient used to lower blood sugar in adult patients with Type 2 diabetes. Despite public interest in possible weight loss while taking these drugs, to date, the U.S. Food and Drug Administration hasn’t approved their use for weight loss.

Rybelsus and Ozempic are often compared to Mounjaro, which is also FDA-approved to treat Type 2 diabetes. Mounjaro, however, contains tirzepatide rather than semaglutide and is an Eli Lilly product. Wegovy, another Novo Nordisk product, is currently the only semaglutide drug FDA-approved for medical weight loss.

“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.”
U.S. Food and Drug Administration

Use of Rybelsus or Ozempic for weight loss is off-label and could potentially pose risks. Manufacturer Novo Nordisk recently released a statement expressing concern about uses of their products that aren’t in line with their approved purposes, including cosmetic weight loss.

“While we respect every healthcare provider’s expertise and their right to prescribe medications based on their clinical judgment, we ask that healthcare professionals prescribe semaglutide medicines consistent with their FDA-approved indications,” the company’s statement emphasized. “We’d like to reinforce that each medication has its own indications and its own safety and efficacy profile which is detailed in its respective product label.”

Differences Between Ozempic and Rybelsus

Although both Ozempic and Rybelsus contain semaglutide, they’re not the same. Rybelsus is an oral tablet typically prescribed as a once-daily medication. Ozempic is a weekly subcutaneous injection. When weighing Ozempic vs. Rybelsus, your doctor will take into account your medical history and current needs to determine which is best for you.

5 Key Differences
  • Administration: Ozempic is an injection that comes in a prefilled pen, while Rybelsus is 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 can potentially increase up to 14 mg.
  • Taken With Food or Water: Ozempic injections can be administered at any time, with or without food. It’s recommended Rybelsus be taken in the morning (with no more than 4 ounces of water) on an empty stomach, 30 minutes before eating or drinking.
  • Use: 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 once daily and Ozempic is injected weekly.

Rybelsus and Ozempic have similar side effects as they both contain semaglutide. In terms of cost, these two medications are also comparable. Ozempic can cost roughly $890 per month while Rybelsus can run $900 per month without insurance.

Is Ozempic or Rybelsus More Effective?

Ozempic and Rybelsus are both effective at lowering A1C, particularly when used in combination with exercise and a healthy diet. No direct studies have compared Ozempic to Rybelsus for effectiveness yet, but clinical trials and patient results show similar blood glucose levels achieved with either medication.

Effectiveness of Rybelsus vs. Ozempic
  • Patients taking 1 mg of Ozempic achieved an A1C decrease of about 1.6%
  • Patients taking 14 mg of Rybelsus saw a 1.4% decrease.

None of Novo Nordisk’s semaglutide drugs, including Wegovy approved for medical weight loss, are intended for cosmetic weight loss. Interest in both Ozempic and Rybelsus for off-label weight loss has peaked despite concerns as patients on both drugs have reported similar reductions in weight over a 30-week period.

The drug that is more effective for you depends on a variety of factors that take into account your unique needs and lifestyle. Discuss your health history, medical goals and all medications you’re currently taking, including supplements, with your doctor.

What Are the Differences in Side Effects Between Ozempic and Rybelsus?

Since these are both semaglutide medications, they have the same side effects. When you take the drug as your doctor advises, side effects are normally mild. Serious complications are rare, but can develop.

Ozempic side effects can also include a reaction at the site of the injection. This is typically mild and involves minor discomfort or skin discoloration.

Types of Semaglutide Side Effects
  • Abdominal pain
  • Allergic reactions
  • Diarrhea
  • Fatigue
  • Hypoglycemia
  • Kidney problems
  • Nausea or vomiting
  • Pancreatitis
  • Weight loss

Most side effects are temporary and last a few days to a few weeks. If your side effects persist or become more severe, talk to your doctor or pharmacist. Seek immediate medical attention if you experience serious complications.

When weighing the pros and cons of Ozempic vs. Rybelus with your doctor, you can take these similarities and differences into consideration.

Ozempic and Rybelsus Boxed Warnings and Health Concerns

Both Ozempic and Rybelsus have FDA boxed warnings, the FDA’s most serious type of warning, regarding potential thyroid issues. They may increase thyroid tumor and cancer risks. Both drugs are contraindicated for those who have ever had or have family histories of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome Type 2.

Product packing also warns of an increased risk of pancreatitis, diabetic retinopathy, hypoglycemia, acute kidney injury and acute gallbladder disease. People taking semaglutide drugs have reported experiencing stomach paralysis (gastroparesis) and severe vomiting.

There have also been several reports of patients having thoughts of self-harm or suicide. If you experience mental health effects such as depression or suicidal ideation, immediately contact your doctor or call the Suicide and Crisis Lifeline at 988.

Lawsuit Information
Lawsuits are being filed by people who developed severe gastroparesis after using Ozempic.
View Lawsuits

Can You Take Ozempic and Rybelsus Together?

You should never take both Ozempic and Rybelsus together, and your doctor should never prescribe both at the same time. Taking both increases the chance of overdosing. Taking too much semaglutide can have serious health consequences that require immediate medical attention.

It’s possible to switch from one medication to another under the guidance of your doctor if you feel the other would be of greater benefit to you. Never stop taking your medication or switch without discussing the change with your doctor.

Should I Take Ozempic or Rybelsus?

While both Ozempic and Rybelsus help people with Type 2 diabetes manage their blood sugar, your doctor will factor in your personal needs and medical history to determine which to prescribe for you. Talk to your doctor about any concerns you have, as well as your preferences.

Your doctor may determine neither is right for you and could prescribe another medication or treatment plan. No matter what medications your doctor prescribes, take them exactly as directed.

Keep track of all health improvements or setbacks, side effects and concerns. Follow up with your doctor to discuss your progress so they can continue to make informed recommendations for your health care needs.

Please seek the advice of a medical professional before making health care decisions.