Medicines called glucagon-like peptide-1 (GLP-1) receptor agonists have changed how type 2 diabetes is treated. GLP-1 medicines, like semaglutide (Rybelsus), work by acting like the body’s natural GLP-1 hormone to help control blood sugar. Many people also lose weight while taking a GLP-1, especially when paired with healthy lifestyle changes.
Rybelsus was FDA-approved in 2019 as the first oral GLP-1 medicine for type 2 diabetes that could be taken by mouth instead of by injection. It contains the active ingredient semaglutide. Other semaglutide products include Ozempic and Wegovy.
In May 2026, the drugmaker of Rybelsus announced that the medicine is being reformulated and renamed as Ozempic pill. Both medicines contain semaglutide and work the same way, but they come in different doses and are not interchangeable. If you currently take Rybelsus, your health care provider may switch you to the Ozempic tablet and will tell you which dose to take.
Available oral semaglutide products that are approved for type 2 diabetes include:
- Rybelsus tablets: 3 milligrams (mg), 7 mg, and 14 mg
- Ozempic tablets: 1.5 mg, 4 mg, and 9 mg
Below, you’ll find common questions and answers about oral semaglutide for type 2 diabetes, including whether it may be right for you. The rest of this article refers to semaglutide tablets by the original brand name, Rybelsus.
How Does Rybelsus Treat Type 2 Diabetes?
Rybelsus lowers your blood sugar in three ways:
- It stimulates your pancreas to make insulin after you eat.
- It prevents your liver from releasing stored sugar.
- It slows the movement of food through your body.
How Do I Take Rybelsus?
Take Rybelsus by mouth on an empty stomach, with no more than 4 ounces of plain water. It is important that you take Rybelsus when you first wake up, at least 30 minutes before your first food, drink, or other medicines you take by mouth. Waiting less than 30 minutes or taking Rybelsus with food, drinks, or other medicines can lower how much Rybelsus gets absorbed by your body and can cause it not to work as well. Swallow the tablet whole. Do not split, crush, or chew the tablet.
Rybelsus is taken once daily. Treatment is usually started at a lower dose so your body can adjust to the medicine. Your health care provider may slowly increase your dose over time based on your blood sugar levels and how well the medicine is working for you.
Your health care provider may also monitor your hemoglobin A1c (HbA1c), which is a blood test that measures your blood sugar levels over the past 2 to 3 months. Lowering your HbA1c may help reduce the risk of diabetes-related complications. Your provider can help you set blood sugar and HbA1c goals that are right for you.
How Was Rybelsus Studied for Type 2 Diabetes?
Clinical studies were done to see if Rybelsus was safe and effective for people with type 2 diabetes. Studies looked at the effect of Rybelsus on blood sugar over time by checking HbA1c. Weight loss was also measured. People could take Rybelsus alone or along with other medicines for type 2 diabetes. Rybelsus was compared with a placebo containing no medicine and against other medicines for type 2 diabetes medicines. The studies included people who were White Americans, African Americans, or Asian Americans, including those who identified as Hispanic or Latino. People in these studies were between 55 and 70 years old, with an average HbA1c between 7% and 10.5%, and an average body weight between 189 and 211 pounds.
What Benefits Were Seen With Rybelsus?
Overall, people taking Rybelsus alone or with other medicines for type 2 diabetes had a lower HbA1c and lost more weight compared with people taking a placebo. Rybelsus was effective regardless of age, gender, race, weight, diabetes duration, or kidney function. Your results may differ from what was seen in clinical studies.
Rybelsus as the only medicine for type 2 diabetes
Rybelsus was compared to placebo among people whose blood sugar was not controlled with diet and exercise. As compared to placebo, more improvement in HbA1c and weight from the beginning of the study to week 26 was seen with Rybelsus.
Rybelsus 7 mg | Rybelsus 14 mg | Placebo | |
Average change in HbA1c | -1.2% | -1.4% | -0.3% |
Average change in weight | -5.1 pounds | -8.1 pounds | -3.1 pounds |
Rybelsus in people with lowered kidney function
Rybelsus was compared to placebo in people who were taking a stable dose of other medicines for diabetes including metformin and/or sulfonylurea, or basal insulin with or without metformin in people who had lowered kidney function. As compared to placebo, a greater improvement in HbA1c and body weight from the beginning of the study to week 26 was seen with Rybelsus.
Rybelsus 14 mg | Placebo | |
Average change in HbA1c | -1.0% | -0.2% |
Average change in weight | -7.5 pounds | -2.0 pounds |
Rybelsus was compared to placebo among people whose blood sugar was not controlled on insulin with or without metformin. As compared to placebo, more improvement in HbA1c and body weight from the beginning of the study to week 26 was seen with Rybelsus.
Rybelsus 7 mg | Rybelsus 14 mg | Placebo | |
Average change in HbA1c | -0.9% | -1.3% | -0.1% |
Average change in weight | -5.3 pounds | -8.1 pounds | -0.9 pounds |
Rybelsus was also compared with other medicines for type 2 diabetes. In these studies, people were taking other medicines for type 2 diabetes, such as metformin. Below is a summary of how Rybelsus compares to the other medicines it was studied against.
- Compared to empagliflozin(Jardiance), people taking Rybelsus had more lowering of HbA1c. People taking either Rybelsus or Jardiance lost a similar amount of weight.
- Compared to sitagliptin (Januvia), people taking Rybelsus saw more lowering of HbA1c and lost more weight.
- Compared to liraglutide ( Victoza), people taking Rybelsus saw similar HbA1c results but lost more weight.
Rybelsus plus other medicines for type 2 diabetes
Rybelsus was compared to empagliflozin among people whose type 2 diabetes was not controlled on metformin. Compared to empagliflozin, more improvement in HbA1c from the beginning of the study to week 26 was seen with Rybelsus. People who got either Rybelsus or empagliflozin lost a similar amount of weight.
Rybelsus | Empagliflozin | |
Average change in HbA1c | -1.3% | -0.9% |
Average change in weight | -8.4 pounds | -8.1 pounds |
Rybelsus was compared to sitagliptin. People were uncontrolled on other medicines for diabetes (metformin with or without a sulfonylurea such as glimepiride or glipizide). As compared to sitagliptin, more improvement in HbA1c and body weight from the beginning of the study to week 26 was seen with Rybelsus.
Rybelsus 7 mg | Rybelsus 14 mg | Sitagliptin 100 mg | |
Average change in HbA1c | -1.0% | -1.3% | -0.8% |
Average change in weight | -4.8 pounds | -6.8 pounds | -1.3 pounds |
Rybelsus 1was compared to a medicine for type 2 diabetes called liraglutide and was also compared to a placebo. People were uncontrolled on metformin, with or without a medicine called an SGLT-2 inhibitor (bexagliflozin, canagliflozin, dapagliflozin, empagliflozin, or ertugliflozin). Compared to placebo, more improvement in HbA1c and body weight from the beginning of the study to week 26 was seen with Rybelsus. The effect of Rybelsus and liraglutide on HbA1c was similar, but people lost more weight with Rybelsus.
Rybelsus 14 mg | Liraglutide 1.8 mg | Placebo | |
Average change in HbA1c | -1.2% | -1.1% | -0.2% |
Average change in weight | -9.7 pounds | -6.8 pounds | -1.1 pounds |
How Can I Tell if Rybelsus Is Working?
You can tell if Rybelsus is working when you start to see your blood sugar levels and your HbA1c fall. Based on the clinical studies, Rybelsus may show its full HbA1c-lowering effects after a few months. Talk to your health care provider about monitoring your blood sugar levels at home. Consider making a blood sugar log/diary that you can record your blood sugar readings in to bring to your visits with your health care provider. Your health care provider will likely monitor your HbA1c while you are on Rybelsus and may increase your Rybelsus dose, add another medicine for type 2 diabetes, or change you to another medicine for type 2 diabetes.
What Are the Side Effects of Rybelsus, and How Can I Prevent or Manage Them?
The most common side effects with Rybelus are nausea, stomach pain, diarrhea, decreased appetite, vomiting, and constipation. Nausea, vomiting, and diarrhea are the most common when you first start Rybelsus. If you are having these side effects, make sure to drink plenty of water to avoid becoming dehydrated. Call your health care provider if you are having nausea, vomiting, or diarrhea that is not getting better. They may adjust your dose to find the lowest dose of Rybelsus that works to control your blood sugar and minimizes side effects.
Here are more ways to manage side effects from Rybelsus.
- Avoid greasy, sweet, and spicy foods.
- Eat smaller and more frequent meals.
- Eat slowly.
- Do not lie down after eating.
- Maintain a low-fat diet, which includes eating soup and yogurt.
- Eat bland foods such as crackers and rice.
- Stay hydrated.
- Avoid strong smells such as from cooking, perfume, or smoke.
These are not all of the side effects of Rybelsus. Talk with your health care provider if you are having symptoms that bother you. You can also report side effects to the FDA at 800-FDA-1088 (800-332-1088).
When Should I Stop Taking Rybelsus?
Stop Rybelsus and call your health care provider right away if you have severe stomach pain that will not go away. The pain may radiate to your back, and you may have vomiting. These may be signs of inflammation of the pancreas called pancreatitis. Make sure your health care provider knows if you develop pancreatitis. Rybelsus was not studied in people who had pancreatitis, and the medicine should not be continued for people who develop it.
Talk with your health care provider if you want to become pregnant. Rybelsus should be stopped at least 2 months before you become pregnant. After your last dose, Rybelsus takes about 5 weeks to leave the body.
What Interactions With Food or Other Medicines Can Happen With Rybelsus?
Rybelsus works by slowing down the movement of food through your body. Because of this, it may affect how other medicines that you take by mouth are absorbed. Talk with your health care provider if you feel that other medicines that you take by mouth are not working as well as they used to while taking Rybelsus.
Rybelsus also works by stimulating insulin production after you eat and prevents your liver from releasing stored sugars. Low blood sugar (hypoglycemia) may happen if you take Rybelsus with insulin or some other medicines for diabetes such as a sulfonylurea. Talk to your health care provider about low blood sugar, so you know what number is too low.
If your blood sugar gets too low, eat some sugar. Sugar sources include glucose tablets, glucose gel, 4 ounces of juice or non-diet soda, or a tablespoon of sugar, honey, or corn syrup. Call your health care provider if you have any of the following symptoms of low blood sugar or if your blood glucose goes too low.
- Dizziness
- Shakiness
- Sweating
- Anxiety
- Crankiness or mood changes
- Hunger
- Fast heartbeat
- Sleepiness
- Headache
- Tingling in your cheeks, lips, or tongue
How Can I Get Rybelsus?
Rybelsus requires a prescription from a health care provider. You can get it at any pharmacy.
A savings offer may be available from the drugmaker that may allow you to pay as little as $25 for your prescription. Whether you are eligible depends on the type of insurance plan you have and if your insurance covers Rybelsus. You can find out more at www.rybelsus.com/savings-and-support.html, by texting READY to 21848, or by calling 877-304-6855.
For questions about cost, insurance coverage, or any other questions related to Rybelsus or Ozempic tablets, you can also call the drugmaker at 833-GLP-PILL (833-457-7455).
