Rybelsus vs Ozempic: Which Medication Is Right For You?

Rybelsus and Ozempic are two brand names for semaglutide, a type of medication used to treat type 2 diabetes. 

Why are there two brand names for the same drug? And which one is better?

We’ll answer these questions and more in this comparison article of Rybelsus vs Ozempic.

What is Rybelsus?

Rybelsus is an oral form of the drug semaglutide, a type of GLP-1 receptor agonist (1). The United States Food and Drug Administration (FDA) approved Rybelsus in 2019 to treat type 2 diabetes.

GLP-1 receptor agonists like Rybelsus (and Ozempic) work to increase insulin secretion while reducing the secretion of glucagon, a hormone that raises blood sugar levels. 

GLP-1 receptor agonists slow the rate of digestion, which can make you feel fuller longer after you eat. Delayed stomach emptying can cause weight loss, which is considered a potential benefit for patients with type 2 diabetes who are also overweight or obese.

Rybelsus comes in 3-, 7-, and 14-milligram tablets. The 3-milligram dosing is only used to initiate treatment and isn’t typically a therapeutic dose.

The dosing for Rybelsus is typically as follows:

• Start taking Rybelsus at a dose of 3 milligrams daily for 30 days.
• After you’ve been taking the 3-milligram dose for 30 days, increase your dose to 7 milligrams daily.
• If you’re not meeting your blood sugar targets after 30 days on the 7-milligram dose, increase your Rybelsus dose to 14 milligrams daily, which is the maximum dose.

What is Ozempic?

Ozempic is a brand name for an injectable form of semaglutide. The FDA approved Ozempic to treat type 2 diabetes in 2017, two years before Rybelsus was approved.

Ozempic is a non-insulin injectable medication, which sets it apart from many other diabetes medications, including Rybelsus.

The typical starting dose of Ozempic is 0.25 milligrams once weekly for four weeks, then 0.5 milligrams weekly for at least four weeks. If patients don’t meet their blood sugar targets with 0.5 milligrams weekly, the dose can gradually be increased to a maximum of 2 milligrams weekly.

Ozempic is injected under the skin, typically in the abdomen, thigh, or back of the arms. You shouldn’t inject Ozempic into your muscle.

Are Rybelsus and Ozempic the same?

There can be many different brand names for the same drug name. Rybelsus and Ozempic are the same drug, which is semaglutide. 

However, the main difference between Rybelsus and Ozempic is that Rybelsus is in tablet form and is taken orally, while Ozempic is an injectable medication.

Rybelsus vs Ozempic effectiveness

GLP-1 receptor agonists can be more effective at lowering blood sugar compared to other types of medications, such as metformin (2).

GLP-1 receptor agonists can also be added to an existing treatment regimen, such as metformin, sulfonylureas, and even insulin.

Rybelsus

One study noted that Rybelsus is just as effective as injectable forms of semaglutide (3). 

According to a six-month study, taking 7 milligrams of Rybelsus resulted in a 1.2% reduction in hemoglobin A1c levels (average starting A1c was 8%).

With the same average starting A1c of 8%, taking 14 milligrams of Rybelsus resulted in a 1.4% reduction in hemoglobin A1c levels over the six-month study.

Rybelsus might also help you lose weight. In the same six-month study referenced above, the average weight loss while taking Rybelsus was 5-8 pounds. 

Ozempic

According to clinical studies, Ozempic lowered A1c levels by around 1.5% after 30 weeks and lowered A1c levels by around 1% by week 8 of a 56-week study. 

Ozempic helps promote weight loss, but it isn’t a weight-loss drug. According to a clinical trial,  participants experienced a 15-18% weight loss while taking Ozempic, which is significant. Losing 5-10% of your body weight can help improve insulin sensitivity and blood sugar levels.

Ease of use for Rybelsus vs Ozempic

Rybelsus

Rybelsus is a once-daily oral medication. If you want to try a GLP-1 receptor agonist, Rybelsus is the only oral version, which is its main appeal.

Rybelsus should only be stored in its sealed container and shouldn’t be used in weekly pill organizers. You should take Rybelsus on an empty stomach when you first wake up. 

Don’t drink more than four ounces of water with Rybelsus, and avoid all vitamins, supplements, and other medications for at least 30 minutes after you take your dose of Rybelsus.

If you miss a dose of Rybelsus, you should skip that dose and resume regular dosing on the next day.

Ozempic

Ozempic is a once-weekly medication, which might appeal to you if you have difficulty remembering to take daily medications, travel often, or do shift work. 

This medication is injectable, which isn’t ideal for everyone, especially if you have a fear of needles or might have a difficult time doing your own injections.

Handling a missed dose of Ozempic is pretty straightforward. If you miss a dose of Ozempic, you can take it within five days after the missed dose. If it’s been longer than five days, skip the missed dose and take your next dose as scheduled.

Benefits of Rybelsus vs Ozempic

A major benefit of Rybelsus is that it’s an oral medication, not injectable. Many patients prefer oral medications over injectible, especially in the case of needle phobia or inability to perform self-injections.

Compared to Rybelsus, Ozempic is more flexible in terms of dosing. Ozempic is only taken once weekly, whereas Rybelsus has to be taken daily.

Ozempic can be taken any time of the day, with or without food. Rybelsus has more strict guidelines – it must be taken on an empty stomach with minimal water (no more than four ounces). And you can’t take any vitamins, supplements, or other medications until 30 minutes after you take Rybelsus.

Similarities and differences

Ozempic and Rybelsus are the same type of drug, which is semaglutide. Because they are both semaglutide, they have similar side effects, risks, and potential benefits.

If you have cardiovascular disease (also known as heart disease), Rybelsus might be a safe choice for you. Rybelsus was given to over 3,100 people with type 2 diabetes who were also at a high risk of a cardiovascular event (heart attack, stroke, and death). 

According to that study, taking Rybelsus did not increase the risk of major cardiovascular events. In studies, Rybelsus reduced the risk of heart-related death by 51%.

Similar to Rybelsus, Ozempic might help protect you against major cardiovascular events like heart attack and stroke. A study compared injectable semaglutide to a placebo and found that the rate of major cardiovascular events and death was much lower in those receiving injectable semaglutide (Ozempic) (4).

The main difference between Ozempic and Rybelsus is in their dosing. Ozempic is a once-weekly injectable medication, whereas Rybelsus is an oral medication taken daily.

Does Rybelsus have the same side effects as Ozempic?

Rybelsus and Ozempic have similar side effects because they are the same type of drug. 

Side effects of Ozempic include:

• Gastrointestinal symptoms like upset stomach (nausea and vomiting), stomach pain, loss of appetite, heartburn, burping, gas, and bloating
• Diarrhea or constipation 
• Headache
• Dizziness
• Fatigue
• Injection site pain

More rarely, Ozempic might cause thyroid cancer, pancreatitis, and kidney problems.

The more commonly reported side effects of Rybelsus include:

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

Like Ozempic, you shouldn’t take Rybelsus if you have a history of thyroid cancer, pancreatitis, or kidney problems.

Which is cheaper, Ozempic or Rybelsus?

Ozempic and Rybelsus are newer medications used to treat type 2 diabetes. Newer medications can be more expensive compared to those that have been around for a while, like metformin.

If you have health insurance and/or prescription drug coverage, your cost for Ozempic or Rybelsus will vary. 

According to GoodRx at the time this article was written, here are the out-of-pocket cost estimates for both medications.

30 tablets of 7 mg Rybelsus tablets: $950-$1,100 depending on which pharmacy is used. One prefilled pen containing 2 milligrams of Ozempic: around $900.

2 milligrams is the maximum weekly dose for Ozempic. If your dose was only 0.5 milligrams weekly (the lowest dose), then the cost for a 2 milligram pen would be around the same as a 30-day supply of Rybelsus tablets at the standard dose of 7 milligrams daily.

However, if you’re taking more than the lowest dose of Ozempic, it will likely be more expensive vs Rybelsus when paying out-of-pocket. 

You can check with your pharmacy to see if there are any coupons for Ozempic or Rybelsus in order to help make it more affordable.

Can I switch from Ozempic to Rybelsus?

If you want to switch from Ozempic to Rybelsus, you should consult your healthcare provider. You might be a good candidate to switch if you prefer oral medications over injectables and have had good results while taking Ozempic.

Your medical/prescription drug coverage might prefer one medication over the other. If you want to switch from Ozempic to Rybelsus and Rybelsus isn’t covered, it will likely make more sense to stick with Ozempic in order to avoid paying a lot of money out-of-pocket.

If you’re wondering which medication your insurance company covers, you can always reach out to their customer service number, which is often listed on your proof of insurance card.

Are there any natural alternatives to Rybelsus and Ozempic?

Some people are good candidates for more natural alternatives to prescription medication like vitamins and supplements. If you and your healthcare team have decided that natural alternatives are a good fit for you, here are some alternatives to Rybelsus and Ozempic.

Berberine

Berberine is a compound found in some plants that might help you manage high blood sugar levels.

A pilot study compared berberine vs metformin (a popular pill used to treat diabetes) directly for their ability to help treat symptoms of type 2 diabetes (5). 

The researchers found that berberine produced identical results as metformin in terms of improving blood glucose metabolism. 

According to a small study on people with metabolic syndrome (a condition that can lead to type 2 diabetes), berberine improved insulin sensitivity and reduced the waist circumference of participants (6).

Berberine may help promote weight loss by improving insulin resistance, the primary cause of type 2 diabetes.

Magnesium

Type 2 diabetes stems from insulin resistance, which is when your body doesn’t use insulin effectively. Magnesium supplementation can help improve insulin sensitivity, which means it can help lower blood sugar levels (7). 

Taking magnesium is safe, generally well-tolerated, and has a very low cost compared to certain prescription medications.

Conclusion

Rybelsus and Ozempic are both semaglutide, a GLP-1 receptor agonist drug. The biggest difference between them is in their form and dosage. Rybelsus is an oral, once-daily medication and Ozempic is a weekly injectable medication.

There are pros and cons for both Rybelsus and Ozempic when it comes to ease of use and delivery route (oral vs injection), as well as potential price differences. 

Other than that, Rybelsus and Ozempic are similar because they work in the same way to lower blood sugar levels in people with type 2 diabetes.

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