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Rybelsus (Semaglutide)

1.5mg
4mg
9mg
Rybelsus contains semaglutide, which belongs to a class of medicines called GLP-1 receptor agonists. It works by controlling blood sugar levels, slowing down digestion, and reducing appetite. It contains Semaglutide, the same active ingredient found in the injection version of Ozempic & Wegovy.
The pills are made by Novo Nordisk, the Danish pharmaceutical company behind Wegovy, Ozempic, and Saxenda.
Rybelsus is licensed for the treatment of Type 2 Diabetes in the UK under the authority of the Medicines and Healthcare products Regulatory Agency. Ozempic is the injectable version of Semaglutide for Type 2 Diabetes.
Tablets may suit people who:
Prefer not to use injections
Like taking medication as part of a daily routine
Don't mind taking medication before breakfast
Injections may suit people who:
Prefer once-weekly treatment
Want greater flexibility around meal timing
Are comfortable with self-injection
Your healthcare professional can help you decide which option best fits your lifestyle and weight loss goals.
Rybelsus works in several ways to help manage your blood sugar levels and weight:It helps control your blood sugar: Rybelsus helps your pancreas release the right amount of insulin when you eat, which keeps your blood sugar more stable throughout the day. It slows down your digestion: it slows down how quickly food moves through your stomach, which means you feel fuller for longer after eating. It reduces your appetite: Rybelsus affects the appetite signals in your brain, so you naturally feel less hungry and may find it easier to eat smaller portions. You may also find you're not thinking about food as much (food noise), feel satisfied with less, or don't have the same urge to snack between meals.
Doesn’t require needles or sharps bins: Pills may be preferred by people who are uncomfortable with injections, potentially making this type of weight loss treatment accessible to a wider group.
Daily routine: Some people find it easier to stick to their treatment with a daily tablet over a weekly injection.
This is where pills may have more appeal for some. There’s no need for needles, sharps bins, or keeping the medication refrigerated. If the idea of self-injecting puts you off, tablets could be a better option.
However, whereas Ozempic or other injectables can be administered with or without food, Rybelsus must be taken on an empty stomach.
Wegovy and Rybelsus are both oral tablet versions of Semaglutide from the same manufacturer, Novo Nordisk.
However, they are licensed for different things.
Rybelsus:
licensed for type 2 diabetes
available in doses of 1.5mg, 4mg, and 9mg (formally 3mg, 7mg and 14mg)
Wegovy pills:
licensed for weight management
available in doses of 1.5mg, 4mg, 9mg, and 25mg
Because they're different products with different licences, using Rybelsus for weight loss would be off-label use. This is common, safe, and legal, if it’s appropriate for you.
Yes, Rybelsus can be prescribed off label for weight management in the UK. Off-label prescribing simply means using a medicine for a different condition than it was originally licensed for. This is common, legal, and safe when done under proper medical supervision.
Whether Rybelsus is right for you depends on:
your BMI
your overall health
any medical conditions
what other medicines you’re taking.
We can assess this before deciding if Rybelsus is suitable for you. If our clinicians recommend Rybelsus for weight loss, they’ll monitor you throughout your treatment journey to ensure it’s working well and you’re not experiencing any concerning side effects.
Weight loss with Rybelsus is gradual, happening over weeks and months rather than immediately.
Research showed that after 26 weeks, people taking Rybelsus lost an average of 2.3kg on the 7mg dose and 3.7kg on the 14mg dose.
However, everyone is different, and your results may vary. For example, some people may notice changes sooner if they have a higher starting weight.
Remember, like all weight loss treatments, they work best alongside healthy lifestyle changes, like maintaining a balanced diet and staying active.
Due to it's success, Rybelsus has undergone rigorous testing and clinical trials to be licensed for weight loss as the new Wegovy Pill.
Rybelsus tablets may be suitable for adults who have:A Body Mass Index (BMI) of 30 or above, orA BMI of 27 or above with at least one weight-related health condition, such as type 2 diabetes, high blood pressure or abnormal cholesterol levels.However, the medication can be used for those with a BMI over 25 (if new to the medication) as we take into account a range of factors such as:BMIMedical HistoryCurrent MedicationBody measurementsEating habitsPast dietsCurrent exercise levelsThe programme is not suitable for:Under 18'sLadies who are breastfeeding, pregnant or actively trying to get pregnant.Type 1 diabeticsAnyone with a history of pancreatitis or thyroid tumoursAnyone with direct family members who have had thyroid cancerBefore treatment begins, a healthcare professional will review your medical history, current medications, and overall health to determine whether Rybelsus is safe and appropriate for you.
Novo Nordisk recently developed and released a new formulation that's absorbed more effectively by your body, the strengths of Rybelsus tablets have changed. This means the medicine now works better at lower doses.
The new Rybelsus strengths are:
1.5mg
4mg
9mg
The old Rybelsus strengths were:
3mg
7mg
14mg
Treatment begins at a low dose and is increased gradually over several months.
This process, known as dose titration, helps reduce the likelihood of side effects while allowing your body to adjust.
Below is an example dosing schedule. Not everyone will need the highest dose to achieve meaningful weight loss, and you can stay at each dose as long as you need to:
1.5mg starting dose
The 1.5mg dose is the starting strength for the new formulation. Like the original 3mg, it's designed to help your body adjust to the medicine gradually.
You'll typically stay on this dose for about a month before your prescriber increases it to 4mg, assuming you're tolerating it well.
4mg ongoing dose
The 4mg dose is usually where you'll start to notice the main effects of Rybelsus, including reduced appetite and better blood sugar control.
Many people find this strength is enough to meet their treatment goals. Your prescriber will review your progress and decide whether you need to move up to the 9mg dose.
9mg maintenance dose
The 9mg dose is the highest strength of the new formulation and can be used for longer-term treatment when needed.
While it's not identical to injectable semaglutide products like Wegovy, Mounjaro or Ozempic, it provides an effective dose for ongoing weight management or diabetes control in tablet form.
Take one tablet first thing in the morning.
Take it on an empty stomach.
Swallow the tablet whole - do not crush, split or chew.
Wait at least 30 minutes before eating, drinking anything other than water, or taking other oral medicines.
Try to take it at approximately the same time every day.
If you forget a dose, skip it and take your next tablet the following morning as usual. Do not take two tablets together.
If you miss several consecutive doses, contact us before restarting treatment.
Rybelsus has been approved following extensive clinical research and are considered safe and effective for eligible adults when prescribed appropriately.As with all prescription medicines, they are not suitable for everyone and that is why a health screening must occur before any medication can be safely prescribed.
Most side effects occur when starting treatment or increasing the dose and often improve as your body adjusts. They are usually mild and can be managed at home with some simple home-based remedies.Everyone is different. You may not experience any side effects, you may experience one side effect or several side effects.Common side effects include:NauseaDiarrhoeaConstipationIndigestionBloating or windSulphur burps / acid refluxHeadacheTirednessWe will send you aftercare information on how to deal with any potential side effects, along with the Patient Information Leaflet which goes into greater detail. We can also provide advice on managing side effects and adjusting treatment if necessary.Please do not hesitate to contact us if you need any support on dealing with side effects. We are more than happy to advise you.Contact 111 or seek urgent medical help if you experience any of the following:Pancreatitis: Severe stomach pain that won't go away, with or without nausea or vomiting. The pain may also spread to your back.Gallbladder problems (like gallstones): Pain in your upper stomach, fever, yellowing of the skin or eyes, or clay-coloured stools.Low blood sugar (hypoglycaemia): Particularly if you also take insulin or sulfonylureas. Signs include dizziness, blurred vision, anxiety, sweating, slurred speech, shakiness, confusion, a fast heartbeat or feeling jittery.Dehydration and kidney problems: Persistent nausea, vomiting, or diarrhoea can lead to dehydration, which can affect your kidneys. Make sure you're drinking plenty of fluids.Severe stomach problems: Stomach issues that are severe or won't go away.Serious allergic reaction: Swelling of the face, lips, tongue or throat, difficulty breathing or swallowing, severe rash or itching, fainting, or a very rapid heartbeat.Changes in vision: If you have type 2 diabetes and notice any changes in your vision, speak to your GP.Increased heart rate: Your heart feels like it's racing or pounding at rest, and it lasts for several minutes.Anaphylaxis:There have been no documented cases of an anaphylactic reaction to Liraglutide, Dulaglutide or Semaglutide but as this is a new medication being introduced to your body, we want to make you aware of the possible signs of anaphylaxis.If you experience swelling of the lips/tongue/throat, difficulty breathing, tightness in the chest, a severe rash or severe itching, discontinue use immediately and call 999.
Rybelsus is not suitable for everyone.You should not take Rybelsus if:you're allergic to semaglutide or any of the other listed ingredientsyou've previously had a serious allergic reaction to semaglutide or any of the ingredients in Rybelsusyou or a close family member has ever had medullary thyroid carcinoma (MTC), a type of thyroid canceryou have multiple endocrine neoplasia syndrome type 2 (MEN 2)Please tell us before starting treatment if you:have or have had problems with your pancreas or kidneyshave type 2 diabetes with a history of diabetic retinopathyare due to have surgery or a procedure involving anaesthesiaare pregnant or planning to become pregnant. Semaglutide, the active ingredient in Rybelsus, may harm your unborn baby, so you should stop taking it at least two months before trying to conceiveare breastfeeding or planning to breastfeed. Breastfeeding isn't recommended while taking RybelsusTell us about all medications you take, including prescription medicines, over-the-counter treatments, vitamins and supplements. Wegovy can affect how some medicines work, and some medicines can affect how Wegovy works.This is especially important if you take diabetes medications like insulin or sulfonylureas, as using Rybelsus alongside these treatments increases your risk of hypoglycaemia.
Will I need ongoing monitoring?Yes. Regular reviews allow your clinician to monitor your progress, manage any side effects, adjust your dose if needed, and provide support with nutrition and lifestyle changes to maximise long-term success.Are Wegovy tablets a long-term treatment?Diabetes and obesity is a long-term medical condition. Your healthcare professional will regularly review whether continuing treatment remains appropriate based on your weight loss, overall health, and individual goals.
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