By now, you’ve probably heard a lot about Ozempic, the injectable diabetes medication that became a mainstream topic for its weight loss effects. Rybelsus, the pill version of Ozempic, may be a less familiar name. To learn more about if this oral version of Ozempic is right for you, read on to learn about:
What are the differences between Rybelsus and Ozempic?
Rybelsus (oral semaglutide) and Ozempic (semaglutide injection) are both medications used to treat type 2 diabetes, and they share the same active ingredient, semaglutide. However, they are administered differently. While Rybelsus comes in a tablet and is taken orally on a daily basis, Ozempic is administered as a subcutaneous (under the skin) injection.
Because the bioavailability of oral semaglutide is low, the maximum dose of Rybelsus (14 mg daily) is comparable to only 0.5 mg weekly of Ozempic. For those looking for additional blood glucose management and weight loss effects, it is not uncommon to see Ozempic prescriptions of 1.0 mg weekly or even 2.0 mg weekly.
In addition, while timing of Ozempic administration is not impacted by food intake, Rybelsus must be taken on an empty stomach when you first wake up, with no more than 4 oz (125 ml or ½ cup) of water. In order to allow proper absorption of Rybelsus, you need to wait 30 min before eating, drinking, or taking any other medications or supplements.
How does Rybelsus improve blood sugar?
Rybelsus belongs to a class of medications referred to as GLP-1 receptor agonists (glucagon-like-peptide-1 receptor agonists). In our bodies, the GLP-1 hormone is produced in our gut in response to food intake. Rybelsus (as well as Ozempic) mimic the effect of the GLP-1 hormones and works to improve blood sugar in three ways:
By stimulating your pancreas to produce more insulin when blood sugar is high
By decreasing the release of stored sugar from the liver
And by slowing down gastric emptying (speed at which food empties from the stomach). This leads to a slower digestive process, thus a slower (more gentle) rise in blood sugar.
Does Rybelsus help with weight loss like Ozempic?
Yes, just like Ozempic, Rybelsus can be helpful in supporting weight loss. This is mostly due to its effects to slow down gastric emptying. If food is leaving the stomach at a slower rate, we end up feeling full for longer. As a result, most people notice a decrease in hunger and appetite, which leads to the weight loss so famously associated with this class of medications.
Is Rybelsus covered in Canada?
In Ontario, Rybelsus has been covered, as of Dec 29, 2023, by Ontario Drug Benefits (ODB) for people managing type 2 diabetes. ODB is available for individuals who are:
Age 24 or younger
Age 65 or older
Enrolled in the Trillium Drug Program
Ontario Disability Support Program (ODSP)
Ontario Works (OW)
Live in a long term care home
Receive home care services
At this time, to my knowledge, Rybelsus is not yet included in public coverage in any other provinces/territories. If you are living with type 2 diabetes, Rybelsus may be covered by your private insurance provider.
What are the common side effects of Rybelsus?
Similar to Ozempic and other GLP-1 receptor agonists, the most common side effects of Rybelsus include nausea, diarrhea, and abdominal pain.
Prescriptions for Rybelsus often follow a schedule of gradual dose increases to help mitigate the side effects of the medication and allow the body a chance to get used to it. This means starting from 3mg daily for 30 days. If tolerating, increasingly to 7 mg daily for 30 days, followed by an increase to 14 mg daily if required.
From a food intake perspective, avoiding heavy meals (e.g. fried or greasy foods) can help to manage side effects. Higher fat meals empty slower from the stomach to begin with, thus when combined with Rybelsus, it may further aggravate symptoms of nausea or discomfort. Being mindful of portion sizes, and remaining seated upright for at least 2 hours after eating can also help in the management of side effects.
References
How Rybelsus Works. Novo Nordisk. https://www.rybelsus.com/why-rybelsus/how-rybelsus-works.html. Accessed Jan 17, 2024.
How to Start Rybelsus. Novo Nordisk. https://www.rybelsus.com/taking-rybelsus/how-to-start-rybelsus.html. Accessed Jan 17, 2024.
Ontario Drug Benefit Formulary/Comparative Drug Index Edition 43. Government of Ontario. https://www.ontario.ca/files/2023-12/moh-ontario-drug-benefit-odb-formulary-edition-43-summary-en-2023-12-22.pdf. Accessed Jan 18, 2024.
Product Monograph: Rybelsus. Novo Nordisk Canada. https://www.novonordisk.ca/content/dam/nncorp/ca/en/products/Rybelsus-PM-EN-monograph.pdf. Accessed Jan 18, 2024.
What to Expect with Rybelsus. Novo Nordisk. https://www.rybelsus.com/taking-rybelsus/what-to-expect-with-rybelsus.html. Accessed Jan 17, 2024.
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