Rybelsus vs. Ozempic

If you have Type 2 Diabetes and are struggling to manage your blood sugar levels, you may have heard about Ozempic and Rybelsus. Both drugs contain the active ingredient semaglutide and are non-insulin medications known for their efficacy in substantially lowering hemoglobin A1C levels.

So, what’s the difference? And which one is the better choice?

For those who are averse to injections, the answer is easy: Rybelsus is an oral medication that comes in tablet form, while Ozempic is an injectable medication. That being said, there are also other differences between the two drugs.

In this post, we’ll take a close look at Ozempic and Rybelsus and the factors that set them apart from each other. The information provided below is intended for informational purposes only. Speak directly with your doctor to determine whether a prescription for Rybelsus or Ozempic may be the right choice for your particular needs.

What Is Ozempic?

Ozempic (semaglutide) is a brand-name prescription medication that was FDA-approved in 2017 for the treatment of Type 2 Diabetes and related cardiovascular disease in adults over the age of 18. It is manufactured by Novo Nordisk.

Usage

Ozempic is a once-weekly medication administered via subcutaneous injection to the abdomen, thigh, or upper arm. It comes in pre-filled, single-patient-use injection pens and must be refrigerated before being opened and carefully disposed of after its expiration date.

Dosage

Ozempic comes in the following doses:

• 0.25 mg
• 0.5 mg
• 1 mg
• 2 mg

Ozempic is started at an initial, non-therapeutic dose of 0.25 mg for four weeks before being increased to 0.5 mg per week. Four weeks after starting the 0.5 mg dose, a doctor will evaluate whether or not further dose increases are necessary, to a maximum of 2 mg per week. Gradually increasing Ozempic’s dose over time helps the body to adjust to the new medication and can help to reduce side effects.

What Is Rybelsus?

Rybelsus (semaglutide) is a brand-name prescription medication that was FDA-approved in 2019 for the treatment of Type 2 Diabetes in adults over 18 years of age. It is manufactured by Novo Nordisk.

Usage

Rybelsus is a once-daily oral medication that’s taken in pill form. It must be taken on an empty stomach first thing in the morning with no more than 4 oz. of water and at least 30 minutes before eating breakfast or taking any other medications.

Rybelsus should be stored at room temperature in a dry place. It must be kept in its original container and not combined with other medications or added to a pill organizer.

Dosage

Rybelsus tablets come in the following dosages:

• 3 mg
• 7 mg
• 14 mg

Patients usually start taking Rybelsus at the 3 mg dosage for 30 days. After that, they increase to the 7 mg dosage for another 30 days. At that point, a medical assessment helps to determine whether or not increasing to the maximum dose of 14 mg per day is warranted. Gradually increasing the amount of Rybelsus over time allows the body time to adjust to the new medication and often helps to decrease the overall impact of side effects.

What Are the Main Differences Between Ozempic and Rybelsus?

Ozempic and Rybelsus both contain the active ingredient semaglutide and are essentially different versions of the same drug. The main differences between them are:

• Method of Delivery – Ozempic is delivered once weekly via subcutaneous injection; Rybelsus is taken orally in tablet form once daily.
• Dosage – Ozempic’s dosage ranges from 0.25 – 2 mg weekly; Rybelsus’s dosage ranges from 3 mg – 14 mg daily.
• Indication – Ozempic treats Type 2 Diabetes and related cardiovascular disease in adults; Rybelsus treats Type 2 Diabetes in adults.

How Do Ozempic and Rybelsus Work?

Rybelsus and Ozempic are both classed as glucagon-like peptide 1 (GLP-1) receptor agonists. Their active ingredient, semaglutide, mimics the naturally occurring hormone GLP-1, which is produced in the human gut in response to food.

GLP-1 signals various body systems that digestion is underway. It reduces appetite, stimulates the pancreatic release of insulin, and reduces the amount of glucose released into the bloodstream.

Semaglutide binds to GLP-1 receptors in the body and triggers the same responses as its naturally occurring counterpart. It helps with ongoing blood sugar management, reduces hunger and promotes feelings of satiety by slowing down gastric emptying and the digestive process.

Neither Ozempic nor Rybelsus work in isolation. Both medications are most effective in combination with diet, exercise, and other healthy lifestyle changes.

Are Ozempic and Rybelsus Equally Effective?

This question requires a two-part answer.

If we’re just talking about the ability to lower blood sugar levels in patients with Type 2 Diabetes, then yes. Though no head-to-head research trial has directly compared the two drugs, extensive clinical studies of Ozempic and Rybelsus on their own have found that both drugs are similarly effective for blood sugar management in combination with diet and exercise.

That being said, while research indicates that Rybelsus is safe for patients with heart problems, Ozempic has actually been shown to reduce the risk of serious cardiovascular outcomes in patients with Type 2 Diabetes and heart disease. In this respect, Ozempic is the more effective drug.

Can Ozempic and Rybelsus Be Used for Weight Loss?

Because semaglutide decreases appetite, slows down the digestive process, and often causes gastrointestinal symptoms, it’s often associated with weight loss. Indeed, many Type 2 Diabetes patients report losing weight easily while taking both Rybelsus and Ozempic. Research corroborates these reports.

Neither Ozempic nor Rybelsus is officially indicated for weight loss, though they may be prescribed off-label for this purpose at the discretion of a medical professional.

Wegovy, a third semaglutide drug manufactured by Novo Nordisk, was FDA-approved for chronic weight management in adults in 2021 and teens over the age of 12 in 2022. Like Ozempic, Wegovy is an injectable medication with a higher maximum dose of semaglutide (2.4 mg). It’s indicated for patients who are obese or overweight and suffer from at least one weight-related health condition.

Which Drug Is Better for Weight Loss?

As mentioned above, neither Ozempic nor Rybelsus is indicated for weight loss. That fact aside, research suggests that patients typically lose more weight on Ozempic than on Rybelsus. Ozempic’s clinical trials for weight loss ultimately led to the approval of Wegovy as a weight loss drug.

Ozempic and Rybelsus Side Effects

Because Ozempic and Rybelsus both contain semaglutide, their potential side effects are very similar. For both drugs, most side effects are mild and often resolve over time.

Common mild side effects include:

• Nausea
• Vomiting
• Diarrhea
• Constipation
• Abdominal pain
• Injection site reactions (Ozempic only)

Though rare, more serious side effects can also occur with both Rybelsus and Ozempic. Speak with your doctor or seek medical care immediately if you experience any of the following:

• Pancreatitis
• Acute gallbladder disease
• Severe low blood sugar (hypoglycemia)
• Vision changes (Diabetic retinopathy)
• Severe allergic reactions
• Acute kidney problems

Both medications come with a black box warning regarding the potential development of thyroid C-cell tumors. The development of thyroid tumors was documented in animal studies of semaglutide but hasn’t been studied in humans. It’s not recommended to take Ozempic or Rybelsus if you have a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia Type 2 (MENS2).

Ozempic and Rybelsus shouldn’t be taken if you’re pregnant, breastfeeding, or planning to become pregnant.

FAQ

Do I need a prescription for Ozempic and Rybelsus?

Yes. Ozempic and Rybelsus are both prescription drugs. You cannot purchase either one without a prescription from your doctor.

Can I take Ozempic or Rybelsus if I don’t have Type 2 Diabetes?

You should only take Ozempic or Rybelsus as prescribed by your doctor. Both drugs are indicated for the treatment of Type 2 Diabetes but may be prescribed off-label for other purposes, such as weight management.

How long do I need to take Ozempic or Rybelsus?

Type 2 Diabetes is a chronic disease, and Ozempic and Rybelsus are both long-term drugs that may be taken for the rest of your life unless complications arise. If you’ve been prescribed either drug off-label for chronic weight management, be aware that you’re likely to regain the majority of the weight you lost if you stop taking semaglutide.

How much do Ozempic and Rybelsus cost?

Though prices vary from pharmacy to pharmacy and state to state, the average cost of an Ozempic pen (typically one month’s supply) in the U.S. ranges between about $800 and $1300.

For Rybelsus, the average cost is between about $800 and $1,000 for 30 tablets (also one month’s supply).

If you have insurance that covers these medications, costs may be substantially lower. The majority of insurance companies do cover Ozempic and Rybelsus for the treatment of Type 2 Diabetes, but many do not cover them for off-label treatment purposes.

Conclusion

To conclude, Rybelsus and Ozempic are both semaglutide-based drugs produced by Novo Nordisk and are indicated for lowering blood sugar levels in adult patients with Type 2 Diabetes. In addition, Ozempic helps lower the risk of major cardiovascular events in patients with both Type 2 Diabetes and heart disease.

While Ozempic is an injectable medication taken once weekly, Rybelsus is an oral medication taken once daily in tablet form. Neither drug has been approved for weight management, but both have been associated with healthy weight loss when complemented with lifestyle changes such as exercise and a healthy, calorie-deficient diet. Wegovy, an injectable semaglutide medication that comes in a slightly higher dose than Ozempic, has been approved by the FDA for chronic weight management in obese and overweight individuals.

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