What is Rybelsus used for?

Rybelsus (semaglutide) is a once-daily oral medication used with diet and exercise to lower blood sugar levels in adults with type 2 diabetes mellitus (T2DM). It is the only semaglutide product that is not an injection. Rybelsus is an effective treatment option when taken every day. In clinical studies, people taking it lowered their A1C levels by 1.2% to 1.4% after 26 weeks of treatment. A1C measures your average blood sugar level over the past 3 months. The target level for most people with T2DM is under 7%. In this study, 69% to 77% of those taking Rybelsus had their A1C fall under 7%.
While not approved, Rybelsus is also sometimes used as a weight loss drug. Its use for this indication has increased over the last year or so due to drug shortages of the other semaglutide products Ozempic and Wegovy.
Rybelsus FAQs
What conditions does Rybelsus treat?
Rybelsus (semaglutide) is a brand-name prescription drug manufactured by Novo Nordisk. It is approved along with diet and exercise by the U.S. Food and Drug Administration (FDA) to improve blood glucose levels in adults with T2DM.
Rybelsus has a boxed warning against its use in people with a personal or family history of certain types of thyroid cancer. It should also be avoided if you have type 1 diabetes (T1DM) or diabetic ketoacidosis.
How does Rybelsus work?
The active ingredient in Rybelsus is semaglutide, which belongs to a drug class called glucagon-like peptide 1 or GLP-1 receptor agonists. GLP-1 is a natural hormone released by your gut when you eat. Rybelsus works by activating GLP-1 receptors. This causes your pancreas to release more insulin while stopping the secretion of sugar from your liver into the bloodstream. It also slows down digestion to help you eat less and lose weight.
What doses of Rybelsus are available?
- 3 mg
- 7 mg
- 14 mg
What is the best way to take Rybelsus?
Take Rybelsus exactly as your healthcare provider prescribes it to you. It is typically taken on an empty stomach when you first wake up with no more than 4 ounces of water. It should be taken at least 30 minutes before your first food, beverage, or other oral medications. Swallow Rybelsus tablets whole and do not crush, split, or chew them.
If you miss a dose, skip the missed dose and go back to your regular schedule.
Are there any drug interactions with Rybelsus?
When Rybelsus is taken with other drugs, it can change how they work or make some side effects more likely or severe. You should ask your healthcare provider if any of the prescription medications, over-the-counter (OTC) drugs, vitamins, or supplements you take may interact with Rybelsus, including:
- Other diabetic medications such as insulin, sulfonylureas, and metformin
- Oral medications, since Rybelsus slows down gastric emptying and can change absorption
What are the possible side effects of Rybelsus?
Common side effects include:
- Nausea
- Diarrhea
- Abdominal pain
- Decreased appetite and weight loss
- Constipation
- Vomiting
Other possible side effects include:
- Bloating
- Indigestion and reflux
- Gas
Serious side effects include:
- Allergic reactions including anaphylaxis
- Increased risk of thyroid tumors
- Pancreatitis
- Complications from diabetic retinopathy
- Low blood sugar (hypoglycemia)
- Kidney problems including dehydration
- Gallbladder problems and gallstones
Contact your healthcare professional for medical advice about any possible adverse effects. You can report effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Who should not take Rybelsus?
Rybelsus should not be taken if you are allergic to semaglutide or any inactive ingredients in this product. Avoid if you have a family or personal history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2.
What should you tell your healthcare provider before starting Rybelsus?
- Kidney or pancreas problems
- Vision problems from T2DM
- If pregnant or planning to become pregnant
- If breastfeeding or planning to breastfeed
Is Rybelsus prescribed for weight loss?
Rybelsus is not FDA-approved for weight loss but may be used off-label. The active ingredient semaglutide is approved as Wegovy for obesity and as Ozempic for T2DM and cardiovascular prevention.
How much weight can you lose on Rybelsus?
People taking 14 mg of Rybelsus lost an average of 4.4 kg after 52 weeks. Those taking placebo lost 0.5 kg.
How quickly does Rybelsus work for weight loss?
Most people started seeing weight loss within the first week or two. Steady weight loss continued until week 26, then leveled off.
Does Rybelsus cause hair loss?
Hair loss was not reported in clinical trials. However, type 2 diabetes itself may be linked to hair loss.
Will insurance cover Rybelsus for weight loss?
Rybelsus is not approved for weight loss, so insurance may not cover it when prescribed off-label. However, some people obtain it at a discount through sites like Universal Drug Store with a valid prescription.
How should you store Rybelsus?
Store Rybelsus in the original container at room temperature (68°F to 77°F or 20°C to 25°C), in a dry place away from moisture. Keep out of reach of children.
Related Medications
- Wegovy (semaglutide)
- Ozempic (semaglutide)
- Mounjaro (tirzepatide)
- Saxenda (liraglutide)
- Victoza (liraglutide)
- Trulicity (dulaglutide)
Sources
- Rybelsus Prescribing Information
- Rybelsus Medication Guide
- Medscape
- Prescriber’s Digital Reference
- Pratley R, Amod A, et al. PIONEER 4 trial. Lancet. 2019;394(10192):39-50.