In the last few years, novel medications that aid in blood sugar level control have gained much attention. While their original indication was the management of type 2 diabetes, they have been observed to also aid weight loss, which is another benefit, especially for those living with type 2 diabetes and struggling with weight management.
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While the number of these drugs is increasing in the market, it is important to understand the benefits, risks, and differences between currently available products. This article provides a comprehensive comparison of Rybelsus vs. Ozempic so you can better understand the similarities and differences between these two forms of the same drug.
What is Rybelsus?
Rybelsus is an oral tablet developed by Novo Nordisk to control blood sugar levels in individuals with type 2 diabetes. This medication was approved by the Food and Drug Administration in 2019 for the U.S. market, and it is also available in other markets such as the European Union, Canada, and Australia.
This is a prescription-only medication that should be combined with a healthy diet and exercise. The active substance in this FDA-approved drug is semaglutide, which works as an agonist of the hormone glucagon-like peptide-1 (GLP-1). This molecule helps to reduce blood sugar levels.
In recent years, GLP-1 agonists have been also shown to have positive effects on body weight. Therefore, many drugs containing semaglutide, such as Rybelsus, have been used off-label for weight management. This means that the drug is used for a condition or for the population that it is not its approved or intended use. These situations are typically not as well-researched as the intended purpose but still have valid scientific and clinical backing.
Rybelsus is currently available in three dosages — 3 mg, 7 mg, and 14 mg. The starting daily dose is 3 mg, which can be increased after one month to 7 mg and further to 14 mg if required and indicated by a medical professional.
Novo Nordisk has been testing higher concentrations of 25 mg and 50 mg of oral semaglutide for weight loss in their clinical trials.
What is Ozempic?
Ozempic is an injectable medication also developed by Novo Nordisk. It was approved by the FDA in 2017 to lower blood sugar levels in individuals with type 2 diabetes. Similar to Rybelsus, it is also available in other markets worldwide.
It is a prescription-only medication with the same active ingredient as Rybelsus — semaglutide. Therefore, it is used to lower blood sugar levels and is sometimes used off-label for weight management.
This FDA-approved drug is available in four dosages — 0.25 mg, 0.5 mg, 1 mg, and 2 mg per single injection. The starting dose of Ozempic is 0.25 mg once a week. After four weeks, this dose is usually increased to 0.5 mg, and if needed, the dose can be further adjusted under the guidance of a medical specialist.
Novo Nordisk is also testing the use of Ozempic in individuals with chronic kidney disease. Their recent clinical trials have shown that administering 1 mg of semaglutide once a week significantly decreases the risk of major kidney disease events.
Key differences between Rybelsus and Ozempic
Before starting the medication, whether for blood sugar management or off-label use for weight loss, it is important to understand the differences and what each of these can offer. The table below compares Rybelsus vs. Ozempic so you can better understand their similarities and differences.
| Rybelsus | Ozempic | |
| Form and frequency | Oral tablet taken daily on an empty stomach, 30 minutes before food or other medications | Subcutaneous injection taken weekly |
| Dosage | Tablets of 3 mg, 7 mg, and 14 mg | Injections of 0.25 mg, 0.5 mg, 1 mg, 2 mg |
| FDA indication | FDA-approved for type 2 diabetes management; used off-label for weight loss | FDA-approved for type 2 diabetes management; used off-label for weight loss |
| Active ingredient | Semaglutide | Semaglutide |
| Availability | Prescription only | Prescription only |
| Cost | Generally lower due to oral formulation | Typically more expensive due to injectable form |
| Storage requirements | Store at room temperature | Store in a refrigerator until use |
Side effects and warnings
According to the package inserts of both Rybelsus and Ozempic, the side effects include:
Both Rybelsus and Ozempic might also cause serious adverse reactions, such as:
Both medications have been issued a box warning by the FDA. This warning alerts doctors and users about serious or life-threatening risks associated with the drug. In trials with rodents, Rybelsus and Ozempic caused thyroid C-cell tumors. Currently, it is unknown if these medications cause thyroid C-cell tumors, including medullary thyroid carcinoma (MTC) in humans.
Therefore, these weight loss drugs should not be taken by individuals who:
- Have a personal or family history of medullary thyroid carcinoma (MTC)
- Have multiple endocrine neoplasia syndrome type 2 (MEN 2)
- Have had a serious reaction to semaglutide or other ingredients of Rybelsus or Ozempic
How effective are Rybelsus and Ozempic?
Despite the fact that both medications contain the same active ingredient, semaglutide, it is difficult to directly compare the effectiveness of Rybelsus and Ozempic. This is because the medications vary in terms of dosage, route of administration, and frequency.
Clinical trials have shown that semaglutide, whether taken orally (Rybelsus) or via injection (Ozempic), is effective at improving glycemic control in individuals with type 2 diabetes. Studies have demonstrated that both can achieve similar reductions in blood glucose levels and glycated hemoglobin levels (HbA1c).
Neither Rybelsus nor Ozempic has been approved by the FDA for weight management or weight loss, and they are used for this indication off-label. Ozempic might have a slight edge, as clinical trials with injectable semaglutide showed a slightly higher percentage of weight loss compared to baseline than the orally taken semaglutide.
Both medications also have shown a reduction of cardiovascular disease risks in individuals with type 2 diabetes.
How to choose between Rybelsus and Ozempic
Both Rybelsus and Ozempic have been shown to control average blood glucose levels, which is reflected in lower values of HbA1c (a marker of long-term blood sugar control). Therefore, both medications can be used by individuals with type 2 diabetes. Ozempic, due to its way of administration (injection), might be slightly more potent in lowering blood sugar levels, and therefore, it might be recommended for individuals who need more aggressive management of blood sugar levels.
Rybelsus and Ozempic share the same active ingredient, and they have been shown to be effective in reducing body weight, which can be an added benefit for individuals with type 2 diabetes who are overweight or obese. The decision between Rybelsus or Ozempic should be made by a medical doctor, depending on the preferred route of administration and the health status of an individual.
An important factor when deciding between Rybelsus and Ozempic is their route of administration. Rybelsus is an oral tablet that should be taken daily, while Ozempic is an injection administered once per week. Rybelsus might be a more suitable option for individuals who have a needle phobia or an increased risk of hemorrhage, while Ozempic might be preferable for individuals who want to take medication less frequently.
While the cost of the treatment should not be a decision factor as the primary objective is the well-being of the patients, it might be taken into consideration. The price between the two medications might differ depending on the insurance coverage. You might consult your healthcare provider to discuss your options.
Final word
The market for medications for blood glucose level control is booming due to the high prevalence of type 2 diabetes. Rybelsus, Ozempic, and other drugs have been shown to be effective treatments in individuals with type 2 diabetes, but they have also been shown to aid weight control in the same population. This has caused many to be interested in the use of these drugs, even though they are not designed for healthy individuals looking for weight loss aids.
However, as with any medication, they help manage specific conditions but also have side effects. Therefore, if you need to start taking any of these, it is important not only to understand the differences between Rybelsus vs. Ozempic and the various available options but also to follow the advice of a medical professional who prescribed it for you.
If your goal is weight loss and you do not have type 2 diabetes, it is worth remembering that these medications are not suitable for your situation. A comprehensive approach to weight loss, including a balanced diet, exercise, and lifestyle modifications, are the keys to managing your weight in a safe and healthy manner. If you are considering any medication for weight loss, you should consult with your healthcare provider for the best advice and suitable weight management strategies for you.
FAQ
Which is better for weight loss, Ozempic or Rybelsus?
Ozempic and Rybelsus are designated for treating type 2 diabetes, and they have not been approved for weight management. These medicines have been used as off-label weight loss drugs in specific situations, and as they are not designed for weight loss, their specific effects on body weight are yet to be evaluated.
Can Rybelsus and Ozempic be used together?
No. Rybelsus and Ozempic cannot be used together as both drugs contain the same active substance — semaglutide. Consuming these medications together can lead to increased levels of this drug in your body, resulting in serious and life-threatening side effects, such as hypoglycemia (very low levels of glucose). It is important to consult a healthcare professional who can help you determine which of these two drugs is suitable for you.
Can I switch from Rybelsus to Ozempic?
If you want to switch from Rybelsus to Ozempic, you must discuss it with your healthcare provider, who will first determine the need for changing the medication and guide you through the process to make the change safely.
Which works faster, Rybelsus or Ozempic?
There is no clinical data to compare the effectiveness of these two drugs. Both are designed to work gradually, with robust effects on blood sugar and weight developing over weeks or months. The response would vary between individuals. As Ozempic is administered in the form of injections, it might act faster due to its quicker route to the bloodstream.
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Both Rybelsus and Ozempic are drugs developed by Novo Nordisk for the treatment of type 2 diabetes; both are prescription medicines.
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The active substance in both medicines is semaglutide, which is an agonist of GLP-1, responsible for interacting with the pancreas to stimulate insulin production and manage blood sugar levels.
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Rybelsus and Ozempic have also been used off-label for weight loss. Rybelsus is available in tablet form, while Ozempic is available as an injection.
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Rybelsus and Ozempic should not be administered to pregnant or breastfeeding individuals, people under 18, those who have had pancreatitis, or individuals with a history of thyroid cancer.
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The most common side effects of these medications include nausea, abdominal pain, constipation, diarrhea, or vomiting. Serious side effects might include hypoglycemia or thyroid tumors, including thyroid cancer.
8 resources
- FDA. Ozempic.
- FDA. Rybelsus.
- Drugs. Semaglutide: first global approval.
- The Lancet. Efficacy and safety of once-daily oral semaglutide 25 mg and 50 mg compared with 14 mg in adults with type 2 diabetes (PIONEER PLUS): a multicentre, randomised, phase 3b trial.
- The New England Journal of Medicine. Effects of semaglutide on chronic kidney disease in patients with type 2 diabetes.
- EMA. Ozempic.
- EMA. Rybelsus.
- Circulation. GLP-1 receptor agonists for the reduction of atherosclerotic cardiovascular risk in patients with type 2 diabetes.
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