Ozempic vs Rybelsus: Which Is Better for You?

Anyone trying to manage their blood sugar or lose weight has likely heard of semaglutide by now. Ozempic is the most popular drug of this class, but there are other semaglutide drugs on the market, such as Rybelsus. 

Rybelsus is the oral form of Ozempic. Both prescription drugs are made by the Danish drug company Novo Nordisk and were approved by the FDA in 2017 to treat type 2 diabetes. If you're weighing the options between Ozempic and Rybelsus, here's everything you need to know about these popular drugs.

{{mid-cta}}

What Are the Differences Between Rybelsus and Ozempic?

The key difference between Ozempic and Rybelsus is that Ozempic comes as a pre-filled injection that you take once a week, and Rybelsus is a pill that you take once a day. Ozempic and Rybelsus work similarly because they contain the same active ingredient: Semaglutide. 

Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor that mimics the action of the GLP-1 hormone. Our bodies naturally make the GLP-1 hormone in the intestines, and semaglutide is a synthetic version of this hormone. GLP-1 works by slowing down gastric emptying, the process in which foods pass from the stomach to the intestines, causing you to feel fuller for longer. GLP-1 also triggers the body to produce more insulin, decreasing blood glucose levels and helping with glycemic control. The effects of synthetic semaglutide (and GLP-1 receptor agonists) have been shown to last longer than natural GLP-1, which is why they're so effective. 

Ozempic and Rybelsus are approved by the U.S. Food and Drug Administration (FDA) to help manage blood sugar (in conjunction with a healthy diet and exercise) in people with type 2 diabetes. Neither of these drugs is approved for people with type 1 diabetes.¹

Currently, semaglutide drugs are also used off-label to help people with overweight and obesity lose weight; however, the FDA does not technically approve using Ozempic or Rybelsus for weight loss.^{2, 3} While Ozempic and Rybelsus work similarly, they have a few key differences:

Form and Frequency

The main difference between Ozempic and Rybelsus is that Ozempic is an injection, and Rybelsus is a pill. 

• Ozempic: Ozempic is a subcutaneous injection that you'll inject in your abdomen, thigh, or upper arm. You can administer Ozempic at any time of the day, with or without meals. 
• Rybelsus: Rybelsus is a once-daily tablet that you take with 4 ounces (or less) of plain water on an empty stomach for at least 30 minutes before consuming any food, drinks, or other oral medications. The tablets must be swallowed whole, so you shouldn't cut, crush, or chew them.

Dosage 

• Ozempic: Dosages start at 0.25 mg once weekly. After four weeks, your doctor might increase the dose to 0.5 mg once weekly. Then, after at least four more weeks, increasing to 1 mg weekly dosage is possible. The maximum dosage for Ozempic is 2 mg per week.
• Rybelsus: Your doctor will probably start you at the lowest dose of Rybelsus, 3 mg once daily for 30 days. After 30 days on the 3 mg dose, you'll increase the dose to 7 mg once daily. After another dose, you and your doctor can increase your dosage to 14 mg daily, the maximum dose.

Cost

• Ozempic: A month's supply of Ozempic costs $935.77 without insurance. Depending on your insurance plan, you'll probably be able to get Ozempic for much cheaper than its list price—insurance usually covers part or all of the cost.
• Rybelsus: Rybelsus has the same out-of-pocket cost as Ozempic; a month's supply of tablets costs $935.77 without insurance. If you're diagnosed with type 2 diabetes and your doctor prescribed you Rybelsus, your insurance may cover part or all of the cost.

Possible Side Effects

Ozempic and Rybelsus contain the same drug (semaglutide), so they have similar side effects. The most common side effects associated with these diabetes medications include:

• Nausea
• Vomiting
• Diarrhea
• Abdominal pain
• Constipation
• Decreased appetite
  

These side effects are most common when you first start using semaglutide drugs, and they often subside as you continue taking them. While the most common side effects of these drugs are relatively mild, Rybelsus and Ozempic are also associated with more serious, long-term side effects. If you notice any of the symptoms below, schedule a visit with your doctor as soon as possible.

Serious side effects of semaglutide include:

• Pancreatitis, or Inflammation of the Pancreas: Signs and symptoms of pancreatitis include severe pain in the stomach and back and vomiting.
• Changes in Vision and Worsening of Diabetic Retinopathy.
• Low Blood Sugar (Hypoglycemia): Some signs and symptoms of low blood sugar may include dizziness or lightheadedness, blurred vision, anxiety, irritability or mood changes, sweating, shakiness, fast heartbeat, and jitters.
• Kidney Failure: Diarrhea, nausea, and vomiting may cause dehydration—and if you already have kidney problems, this can make your condition worse. 
• Serious Allergic Reactions: Symptoms of a serious allergic reaction include problems breathing, severe rash, rapid heartbeat, feeling faint or dizzy, or swelling of the face, lips, tongue, or throat. Stop medication use immediately and contact your healthcare provider if you notice any of these symptoms.
• Gallbladder Problems: Symptoms include pain in your upper stomach, yellowing of skin or eyes (jaundice), fever, and clay-colored stools.
• Thyroid Tumors, Including Cancer: Signs include a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath. Both Ozempic and Rybelsus have a boxed warning, which is the FDA's highest safety warning, for thyroid cancer. Rat studies have shown that semaglutide causes thyroid cancer cell tumors in rodents, and it's still unknown if the drugs can cause thyroid cancer in humans. That's why Rybelsus and Ozempic are not recommended for people with a personal or family history of medullary thyroid carcinoma (MTC) or people with multiple endocrine neoplasia syndrome type 2 (an endocrine disorder). 

Interactions With Other Drugs

If you're on medications and considering adding semaglutide to your routine, speak to your healthcare provider about potential drug interactions. Ozempic and Rybelsus may interact with other medications, including:

• Insulin
• Sulfonylureas
• DPP-4 inhibitors
• Glinides

Patients

• Ozempic: Ozempic is FDA-approved for the treatment of type 2 diabetes as well as to help decrease the risk of heart attack, stroke, and death in people with both type 2 diabetes and heart disease.
• Rybelsus: Rybelsus is FDA-approved for the treatment of type 2 diabetes. Unlike Ozempic, it's not approved to decrease the risk of major heart issues in people with type 2 diabetes and cardiovascular disease.

Ozempic vs Rybelsus: Which Is More Effective?

To date, no studies compare the effectiveness of Ozempic versus Rybelsus. However, separate clinical trials show that both drugs are clinically and similarly effective in helping treat type 2 diabetes.

A 2021 Frontiers report looked at two separate studies and summarized the results: People with type 2 diabetes (who also managed their condition through diet and exercise) who took 1 mg of semaglutide saw their HbA1c levels (the average blood glucose levels over the past three months) decrease by 1.6% after 30 weeks. People who took 14 mg of oral semaglutide (tablets) experienced a reduction in HbA1c of 1.4% after 26 weeks. Meanwhile, the injectable semaglutide group lost an average of 9.9 pounds, while the oral semaglutide group lost an average of 8.2 pounds.

If you're looking into either of these drugs for help with weight management, know that the FDA approves neither Ozempic nor Rybelsus for weight loss. If you are overweight or obese, you might consider Wegovy, a semaglutide drug that the FDA approves for weight loss.

Can You Switch Between Ozempic and Rybelsus?

Yes, it is possible to switch between Ozempic and Rybelsus. Your doctor may switch you to Ozempic if you have type 2 diabetes and heart disease since Ozempic is FDA-approved to decrease the risk of heart disease-related events. Your doctor may switch you to Rybelsus if you're not comfortable injecting yourself with medication and rather take a tablet instead.

Speak to your healthcare team about the pros and cons of switching from one medication to another and the best dosage plan for you.

<p class="pro-tip"><strong>Learn More: </strong><a href=ozempic-for-prediabetes>Can People With Prediabetes Take Ozempic?</a>.</p>

Rybelsus vs Ozempic: Which Is Better for You?

Ozempic and Rybelsus are brand-name prescription drugs that contain the same active drug (semaglutide). While their effectiveness is near-identical, their main difference is in the form. 

Ozempic is a subcutaneous semaglutide injection that you take once a week, and it might be the better option for people who have trouble swallowing pills or can't remember taking a pill every day. Rybelsus is the oral tablet form of semaglutide, and it's meant to be taken once a day. Rybelsus might work better for people who are afraid of needles or don't want to deal with injecting themselves. 

Both Ozempic and Rybelsus are FDA-approved to treat blood glucose issues associated with type 2 diabetes. But Ozempic is also approved to treat heart issues related to heart disease, so if you have heart disease and T2D, Ozempic may have an edge over Rybelsus.

Remember, GLP-1 medication is not a one-size-fits-all, and the drug you ultimately choose depends on many different factors that you'll thoroughly discuss with your healthcare team.

Frequently Asked Questions

Can You Take Rybelsus for Weight Loss Only?

Rybelsus isn't approved by the FDA for cosmetic weight loss. If weight loss is your concern, you might consider speaking to your doctor about Wegovy, an FDA-approved semaglutide. 

Is Mounjaro Better Than Rybelsus for Weight Loss?

Neither Mounjaro nor Rybelsus is FDA-approved for weight loss, but their active ingredients are present in other approved drugs. Mounjaro's active drug (tirzepatide) seems to be more effective than Rybelsus' active ingredient (semaglutide). 

Does Rybelsus Help With Belly Fat?

Rybelsus can help people lose weight, but it's not FDA-approved for this use. If weight loss is your concern, consider speaking to your doctor about Wegovy, a semaglutide that's FDA-approved for weight loss. 

Can I Take Rybelsus if I Am Not Diabetic?

The FDA approves Rybelsus only for people with type 2 diabetes, but semaglutide is sometimes used off-label for weight loss. The FDA doesn't recommend taking semaglutide such as Rybelsus for people without diabetes because of the potential risks associated with this drug, namely thyroid cancer.

Learn More About the Signos CGM Program

Signos incorporates cutting-edge research and the proven power of continuous glucose monitoring. The data gleaned from the Signos app can help guide your health journey. Not sure if Signos is right for you? Take this quiz to find out! Interested in learning more about nutrition and healthy eating habits? Check out more articles on our blog.