Rybelsus (semaglutide) and Ozempic (semaglutide) are brand-name drugs. They’re both prescribed to help manage blood sugar levels in adults with type 2 diabetes. Continue reading to learn about the drugs’ effectiveness, cost, and more.
Rybelsus comes as a tablet that you swallow, while Ozempic is given as a subcutaneous injection.
Both Rybelsus and Ozempic contain the active ingredient semaglutide. They belong to a class of drugs called glucagon-like peptide-1 (GLP-1) agonists. A class of drugs is a group of medications that act in a similar way.
This article explains the main similarities and differences between Rybelsus and Ozempic. If you think one of these drugs might help treat your condition, discussing this information with your doctor can help you decide whether one of these treatments may be right for you.
For more comprehensive information about these two drugs, you can refer to our comprehensive overviews for Rybelsus and Ozempic.
The Food and Drug Administration (FDA) has approved Rybelsus and Ozempic for some of the same uses, as well as different ones.
What Rybelsus and Ozempic are used for
Rybelsus and Ozempic are both FDA approved to help manage blood sugar in adults with type 2 diabetes. Both drugs are typically prescribed in combination with a balanced diet and exercise routine.
Rybelsus and Ozempic are not approved to treat type 1 diabetes or a complication of diabetes called diabetic ketoacidosis. The drugs also haven’t been studied in people with a history of pancreatitis (inflammation of the pancreas). If you’ve had this condition in the past, your doctor will likely recommend a different diabetes medication.
If diet and exercise alone aren’t helping your type 2 diabetes, Rybelsus or Ozempic are add-on options that could be considered.
Other uses of Ozempic
Ozempic is also FDA approved to decrease the risk of:
- major heart problems in people with type 2 diabetes and heart disease
- worsening kidney problems and heart-related death in adults with type 2 diabetes and chronic kidney disease (CKD)
Rybelsus isn’t approved for these uses.
Using Rybelsus vs. Ozempic for weight loss
The active ingredient in Rybelsus and Ozempic, semaglutide, has shown effectiveness for weight loss in some people. However, neither Ozempic nor Rybelsus are FDA approved for this use.
Another brand-name semaglutide drug, Wegovy, is approved for weight management in adults and certain children. Because of this, doctors are unlikely to prescribe Rybelsus or Ozempic for weight loss.
Rybelsus and Ozempic are both FDA approved to treat type 2 diabetes when used in combination with diet and exercise.
These drugs haven’t been directly compared in clinical studies. However, both Rybelsus and Ozempic have been found effective in helping improve blood sugar levels in people with type 2 diabetes.
Both drugs contain the same active ingredient, semaglutide. Because of this, they’re expected to be similarly effective at managing blood sugar levels.
Both Rybelsus and Ozempic treat type 2 diabetes. These drugs can cause some of the same side effects, as well as some different ones. Some of these side effects are mentioned below.
Mild side effects
The following lists contain some of the more common mild side effects of Rybelsus or Ozempic, and some that both drugs share.
- Can occur with Rybelsus:
- decreased appetite
- Can occur with Ozempic:
- injection site reactions, such as skin discoloration or discomfort
- Can occur with both Rybelsus and Ozempic:
- nausea and vomiting
- diarrhea
- abdominal pain
- constipation
- upset stomach
- gas
- weight loss
These side effects may be temporary, lasting a few days or weeks. If the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Serious side effects
This list contains examples of serious side effects that can occur with Rybelsus and Ozempic when taken individually:
- hypoglycemia (low blood sugar) when used with insulin or other diabetes drugs called sulphonylureas
- allergic reaction
- pancreatitis (swelling or irritation of the pancreas)
- complications of diabetic retinopathy (a form of eye damage due to diabetes), such as worsened eyesight
- sudden kidney problems
- thyroid C-cell tumors*
If you have serious side effects while using Rybelsus or Ozempic, call your doctor immediately. If the side effects feel life threatening, or if you believe you’re having a medical emergency, call 911 or your local emergency number right away.
Note: For more information about mild and serious side effects, see our articles on Rybelsus side effects and Ozempic side effects.
* Rybelsus and Ozempic have a boxed warning for the risk of thyroid C-cell tumors. A boxed warning is the most serious warning from the FDA. For more information, see the “Warnings of Rybelsus and Ozempic” section.
How much Rybelsus or Ozempic costs depends on the treatment plan your doctor prescribes, your insurance plan, and your pharmacy. You can visit Optum Perks* for price estimates of Rybelsus and Ozempic.
Both Ozempic and Rybelsus are brand-name drugs. The two medications are not available in a generic form. Brand-name medications are often more expensive than generics.
* Optum Perks is a sister site of Medical News Today.
The chart below outlines the typical dosage and administration details of Rybelsus and Ozempic for type 2 diabetes. Your specific dosage may vary. It’s important to take the dosage your doctor prescribes.
Dosage for type 2 diabetes
| Ozempic | Rybelsus formulation R1 | Rybelsus formulation R2 | |
|---|---|---|---|
| Form | liquid solution for subcutaneous injection | oral tablet | oral tablet |
| Strengths | • 2 milligrams (mg)/3 milliliters (mL) • 4 mg/3mL • 8 mg/3mL | • 3 mg • 7 mg • 14 mg | • 1.5 mg • 4 mg • 9 mg |
| Starting dosage | 0.25 mg once per week | 3 mg once per day | 1.5 mg once per day |
| Maintenance dosage | 0.5 to 2 mg once per week | 7 to 14 mg once per day | 4 to 9 mg once per day |
| Given by | self | self | self |
Ozempic should be injected into your abdomen, thigh, or upper arm. You should give yourself doses on the same day each week. However, you can inject it at any time of day.
Rybelsus should be taken on an empty stomach at the start of your day. You should swallow Rybelsus tablets whole, without splitting, chewing, or crushing them. After you take Rybelsus, it’s important to wait at least 30 minutes before eating a meal.
Note: Rybelsus tablets come in two formulations, which are not interchangeable. For example, one 3-mg tablet of Rybelsus formulation R1 is not equivalent to two 1.5-mg tablets of formulation R2. If you have questions about the differences between each Rybelsus formulation, talk with your doctor or pharmacist.
For more information about dosage, see our articles on Rybelsus dosage and Ozempic dosage.
Rybelsus and Ozempic may not be right for you if you have certain medical conditions or other factors that affect your health. Here, these are referred to as warnings. The two drugs share some of the same warnings, but they also have different ones. Some of these warnings are mentioned below. Before you start using Rybelsus or Ozempic, be sure to talk with your doctor to see if these warnings apply to you.
Boxed warning: Risk of thyroid tumors
Both Rybelsus and Ozempic have a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.
In animal studies of Rybelsus and Ozempic, semaglutide increased the risk of thyroid C-cell tumors. (Semaglutide is the active drug in both Rybelsus and Ozempic.) It’s not known if these medications increase the risk of thyroid tumors in humans.
You should not take Rybelsus or Ozempic if you or a family member have ever had a type of thyroid cancer called medullary thyroid carcinoma. You also should not take these drugs if you have a rare form of cancer called multiple endocrine neoplasia syndrome type 2.
If you develop symptoms of thyroid cancer while taking Rybelsus or Ozempic, see your doctor right away. Symptoms may include trouble swallowing, hoarseness that doesn’t get better, shortness of breath, and a lump in your neck.
Other warnings
In addition to boxed warnings, Rybelsus and Ozempic have other warnings.
Before using Rybelsus or Ozempic, talk with your doctor if any of the following conditions or health factors apply to you:
- if you’ve had an allergic reaction to either drug or any of its ingredients
- if you’re pregnant or breastfeeding
- if you have a history of pancreatitis
- if you have kidney problems, such as kidney failure
- if you have ever been diagnosed with diabetic retinopathy (an eye condition caused by diabetes)
- if you’re taking another medication that may affect your blood sugar, including insulin or an insulin secretagogue
- if you have a history of severe gastroparesis (slow stomach emptying), which may be a complication of diabetes
- if you have an upcoming medical procedure that requires general anesthesia or sedation
Your doctor may switch you to Rybelsus from Ozempic if you’d prefer a medication that you swallow instead of injecting. Or they may switch you to Ozempic from Rybelsus if you prefer taking a drug once a week instead of once per day.
The process for switching between the drugs may vary depending on which Rybelsus formulation you’re taking. The manufacturer for Rybelsus provides the following instructions for switching from 0.5-mg weekly Ozempic injections to daily doses of Rybelsus. For more specific instructions, talk with your doctor or pharmacist.
Switching between Ozempic and Rybelsus formulation R1
If you’re switching to Rybelsus formulation R1 from Ozempic, your doctor will likely prescribe the 7- or 14-mg tablet. You’ll take this tablet once per day, starting 1 week after your last Ozempic dose.
If you’re switching to Ozempic from Rybelsus formulation R1, your doctor will likely prescribe the 0.5-mg weekly Ozempic dose. You’ll give yourself this dose once per week, starting the day after your last dose of Rybelsus.
Switching between Ozempic and Rybelsus formulation R2
If you’re switching to Rybelsus formulation R2 from Ozempic, your doctor will likely prescribe the 4- or 9-mg tablet. You’ll take this tablet once per day, starting 1 week after your last Ozempic dose.
If you’re switching to Ozempic from Rybelsus formulation R2, your doctor will likely prescribe the 0.5-mg weekly Ozempic dose. You’ll give yourself this dose once per week, starting the day after your last dose of Rybelsus.
Always seek your doctor’s approval and guidance before switching medications. These recommendations may not apply to you if you’re currently prescribed a different dosage of Rybelsus or Ozempic than outlined above. Your doctor or pharmacist can provide more information.
If you’re considering starting Rybelsus or Ozempic treatment for type 2 diabetes or switching from one drug to the other, talk with your doctor. They can advise you on which of these drugs may be best for you or if another diabetes treatment may be more suitable. They’ll review your personal health history, as well as the potential positives and negatives of both drugs.
Some of the key points to consider when comparing the drugs include:
- Both Rybelsus and Ozempic contain the same active drug (semaglutide).
- Rybelsus comes as an oral tablet that you’ll likely take once per day. Ozempic is given as a subcutaneous injection that you’ll likely give yourself once a week.
- If your blood sugar isn’t well managed with other diabetes drugs, your doctor may look at adding Rybelsus or Ozempic to your treatment regimen. Either drug would be used in combination with diet and exercise.
- Ozempic is approved to reduce the risk of heart attack or stroke in people with type 2 diabetes and heart disease. It’s also approved to reduce the risk of kidney disease progression or heart-related death in people with type 2 diabetes and CKD. Rybelsus is not approved for these uses.
If you’d like to learn more about Rybelsus or Ozempic, talk with your doctor or pharmacist. They can help answer any questions you have about similarities and differences between the drugs.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
