Rybelsus vs. Ozempic: Similarities and Differences
Medically reviewed by Femi Aremu, PharmD
As a byproduct of increased marketing and a social media presence, more people are becoming interested in a class of prescription drugs known as glucagon-like peptide-1 (GLP-1) agonists, non-insulin type 2 diabetes medications that help to lower blood sugar and expedite weight loss.
Some of the medicines in this group are very similar, such as Rybelsus (semaglutide) and Ozempic (semaglutide), making it difficult to know which one might be right for you. A healthcare provider can help you determine that.
But despite these similarities, Rybelsus and Ozempic carry some distinct differences, especially regarding their dosage form, route of administration, and dosing frequency.
This article will compare and contrast Rybelsus and Ozempic, examining their respective uses, dosing guidelines, storage guidelines, safety concerns, and other pertinent information related to the safe consumption of these drugs.
Rybelsus vs. Ozempic: Uses & Ingredients
Rybelsus and Ozempic are brand-name medications with the same active ingredient: semaglutide. Semaglutide, a GLP-1 agonist, works by mimicking a natural protein to stimulate insulin secretion.
The Food and Drug Administration (FDA) has approved both Rybelsus and Ozempic for controlling blood sugar levels in adults with type 2 diabetes, along with diet and exercise.
Ozempic is also FDA-approved to lower the risk of serious cardiovascular problems—mainly heart attack or stroke—in adults with type 2 diabetes.
Healthcare providers also prescribe GLP-1 agonists for weight loss. During clinical trials, people with and without type 2 diabetes who took Rybelsus or Ozempic experienced significant weight loss.
Based on these results, providers sometimes prescribe Rybelsus or Ozempic off-label to assist in weight management for overweight or obese individuals.
However, this would be an off-label use since Rybelsus and Ozempic are not specifically FDA-approved for weight loss.
Rybelsus vs. Ozempic: What’s the Difference?
Rybelsus and Ozempic share many similarities but have a few important differences.
The main differences center around the dosage forms, frequency, strengths, and dosing schedules of the two medications.
Dosage Differences
Dosage form and administration:
Rybelsus is available as a tablet that you swallow. Take Rybelsus with no more than 4 ounces (oz) of water about 30 minutes before your first food, beverages, or other oral medications for the best results. You shouldn’t crush, cut, or chew Rybelsus tablets.
Ozempic is a solution in a prefilled injection pen. It is administered subcutaneously, or directly under the skin. You can inject Ozempic at any time of day, with food or without it.
Frequency:
Rybelsus is taken orally once daily.
Ozempic is given as an injection once weekly.
Strengths and dosing schedules:
Rybelsus tablets are available in 3 strengths: 3 milligrams (mg), 7 mg, and 14 mg. The typical starting dosage of Rybelsus is 3 mg once daily.
Once your body adjusts to the medication, your healthcare provider increases your dose slowly, over several months, until you reach the target dose of 7-14 mg once daily. This is the dosage shown to control blood glucose (sugar) levels.
Ozempic injection pens have several strengths: 2 mg per 3 milliliters (mL), 2 mg/1.5 mL, 4 mg/3 mL, and 8 mg/3 mL. Each pen contains 0.25 mg, 0.5 mg, 1 mg, or 2 mg. The typical starting dosage of Ozempic is 0.25 mg once weekly.
Once your body adjusts to the medication, your healthcare provider gradually increases your dose over several months until you reach the target dose of 0.5 mg, 1 mg, or 2 mg once weekly.
The table below summarizes some key differences between Rybelsus and Ozempic:
| Rybelsus: | Ozempic: |
Dosage Form: | • Oral tablet | • Subcutaneous injection |
Frequency: | • Once daily | • Once weekly |
Typical Starting Dosage: | • 3 mg once daily for 30 days, then increase to 7 mg once daily. | • 0.25 mg once weekly for the first 4 weeks, then increase to 0.5 mg once weekly. |
Typical Maintenance Dosage: | • 7 mg or 14 mg once daily | • 0.5 mg, 1 mg, or 2 mg once weekly |
Maximum Dose: | • 14 mg once daily | • 2 mg once weekly |
Which Is More Effective?
So far, no studies directly compare the effectiveness of Rybelsus and Ozempic. However, the results of two separate but similar clinical trials allow for a robust comparison of the effectiveness of each.
Overall, Rybelsus and Ozempic provide similar blood glucose levels and weight reduction. In clinical trials, Ozempic (1 mg weekly) and Rybelsus (14 mg daily) resulted in decreases in hemoglobin A1c (a measurement reflecting your average blood glucose levels over the past three months) of 1.6% and 1.4%, respectively.
In addition, Ozempic (1 mg weekly) and Rybelsus (14 mg daily) led to a weight loss of 9.9 lbs and 8.2 lbs over about 30 weeks, respectively. These results suggest that Rybelsus (14 mg daily) or Ozempic (1 mg weekly) are similarly effective.
Note that 14 mg daily is the maximum dose of Rybelsus, equivalent to 1 mg weekly of Ozempic.
But a healthcare provider may prescribe up to 2 mg weekly for Ozempic.
In studies, people taking Ozempic (2 mg weekly) experienced even more weight loss and A1c reduction than those taking Ozempic (1 mg weekly).
Side Effects & Safety
Since Rybelsus and Ozempic contain the same active ingredient (semaglutide), they have similar side effects.
Most side effects for Rybelsus and Ozempic are mild and occur more frequently when you first start treatment or after the dose increases.
However, continuously monitor for emergency side effects if taking Rybelsus or Ozempic.
And in the case that any side effects begin to worsen or affect your ability to take either drug, contact your healthcare provider immediately.
Common Side Effects
Some of the more common side effects of Rybelsus and Ozempic include:
Specific side effects of Rybelsus or Ozempic are unique to each drug. During separate clinical trials, Rybelsus caused decreased appetite in 6% to 9% of participants.
With Ozempic, fewer than 1% of participants experienced reduced appetite. In addition, Ozempic may cause injection site reactions or discomfort.
Severe Side Effects
Rarely, treatment with Rybelsus or Ozempic may result in more severe side effects. Certain medical conditions or other medications can increase the risk of severe side effects.
Some of the more severe side effects of Rybelsus and Ozempic may include:
Acute kidney injury. A short-term reduction in kidney function may occur, especially in people with preexisting kidney problems. Symptoms can include reduced urination, fatigue, or confusion.
Hypoglycemia. If you take Rybelsus or Ozempic with other diabetes medications, such as insulin, you may be at risk for hypoglycemia (low blood sugar). Symptoms of low blood sugar may include dizziness, sweating, headache, and blurred vision. Without prompt treatment, hypoglycemia can become severe or even life-threatening. Monitor your blood glucose levels according to your provider’s instructions.
Complications with diabetic retinopathy. Diabetic retinopathy is an eye condition resulting in damage to the blood vessels in the eye that can occur in people with diabetes. Over time, this may lead to vision loss or blindness. When blood glucose control improves with Rybelsus or Ozempic, a temporary worsening of diabetic retinopathy may occur.
Gallbladder disease. During clinical trials, inflammation of the gallbladder or gallstones was reported during Rybelsus and Ozempic therapy. These conditions may cause symptoms of abdominal pain, fever, or yellowing of the skin and eyes (also known as jaundice).
Pancreatitis. Inflammation of the pancreas may occur. Possible symptoms include severe abdominal pain and vomiting.
Allergic reaction. You should not take Rybelsus or Ozempic if you are allergic to either drug, its ingredients, or another GLP-1 agonist drug.
Ileus. Symptoms include abdominal pain, vomiting, nausea, constipation, bad breath, and abdominal fullness.
Boxed Warning
Rybelsus and Ozempic have a boxed warning for the risk of thyroid C-cell tumors. The FDA requires boxed warnings for drugs that may cause potentially severe or dangerous side effects.
Rybelsus and Ozempic caused thyroid tumors in mice and rats during animal studies. It isn’t known if the same effect could occur in humans.
As a precaution, however, Rybelsus and Ozempic are not recommended for people with a personal or family history of medullary thyroid carcinoma (MTC), a type of thyroid cancer, as well as those with multiple endocrine neoplasia syndrome type 2 (MEN 2).
Rybelsus or Ozempic: Which One Should I Take?
The choice between Rybelsus and Ozempic depends on the patient’s goals, preferences, and the professional opinion of their healthcare provider.
If you want to avoid needles, you might prefer Rybelsus tablets. Sometimes, insurance plans might cover one or the other, so cost is another factor to consider.
Switching between Rybelsus and Ozempic is possible. You might switch due to a change in your insurance coverage or personal preference, such as injection site irritation from Ozempic.
Talk to a healthcare provider before stopping or switching any medications.
Summary
Rybelsus and Ozempic have many similarities but also have significant differences. They both contain the same active ingredient, semaglutide.
Rybelsus is an oral tablet version of semaglutide taken once daily, while Ozempic is a subcutaneous injection administered once weekly.
Both medications lower blood glucose levels and aid in weight loss. Both drugs are used to treat type 2 diabetes, while Ozempic is also used to reduce the risk of heart attack and stroke in people with type 2 diabetes and heart disease.
A healthcare provider can help determine which option may be right for you.
Frequently Asked Questions
Is there a cost difference between Rybelsus and Ozempic?
Possibly. The list price for a 30-day supply of Rybelsus or Ozempic is $935, but only a few people pay the list price for medications.
Your cost for either drug may be lower depending on insurance coverage, savings programs, discount cards, and the pharmacy you use.
Talk to a healthcare provider or pharmacist to learn how to make prescription medications more affordable.
Are there any similar medications to Rybelsus or Ozempic?
Yes. Wegovy is another brand-name prescription drug. It also contains semaglutide, the active ingredient in both Rybelsus and Ozempic.
Wegovy, however, is approved by the FDA specifically for weight management in adults and children ages 12 and older who have obesity or medical conditions related to being overweight.
Read the original article on Verywell Health.
