Rybelsus vs. Ozempic: Effective Diabetes Treatment Without Injections?
Everyday Health Special Report: Weight Loss Reframed

Rybelsus Is Ozempic in a Pill — Is It Just as Good?

Rybelsus Is Ozempic in a Pill — Is It Just as Good?
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Updated on January 7, 2026
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The diabetes and weight loss drug semaglutide is a popular and powerful treatment option. While the injectable forms, Ozempic and Wegovy, have gotten plenty of coverage, there’s been much less hype for Rybelsus, an oral form of the exact same drug.

Is Rybelsus as effective as the Ozempic? How can you tell which one is right for you? We’re covering everything you need to know about oral semaglutide for type 2 diabetes.

What Is Rybelsus?

Rybelsus is essentially Ozempic in the form of a pill rather than an injection. Ozempic and Rybelsus are made by the same manufacturer, Novo Nordisk, and have the same active ingredient, semaglutide. Semaglutide, when sold under the brand name Ozempic or Rybelsus, is intended for people with type 2 diabetes. The same drug is also sold as Wegovy in injection and pill form for the treatment of obesity.

Semaglutide is a GLP-1 receptor agonist, a type of drug that mimics the effect of a hormone that stimulates insulin secretion and prompts feelings of fullness. Semaglutide was originally developed and approved to treat type 2 diabetes, and it remains a powerful glucose-lowering therapy, it also has a profound effect on body weight. Many semaglutide users find themselves losing weight without having to consciously cut calories.

Rybelsus is approved by the U.S Food and Drug Administration (FDA) to treat type 2 diabetes. It’s a daily pill, and it has been shown to result in clinically significant weight loss and blood sugar improvements, both alone and in combination with other diabetes drugs.

Diabetes 101: What Is Ozempic?

Diabetes 101: What Is Ozempic?

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Is Rybelsus as Effective as Ozempic?

Rybelsus can also be an effective type 2 diabetes treatment, like Ozempic, but it’s important to note each are absorbed differently, and are therefore available different doses.

According to the FDA, the maximum 14 milligram (mg) daily dose of Rybelsus is equivalent to the 0.5 mg weekly dose of Ozempic; one can be switched for the other without the need for a dose adjustment.

 (Rybelsus uses higher amounts of semaglutide than Ozempic, because only a fraction of the semaglutide that enters the stomach is properly absorbed.)

A study of real-world data found oral semaglutide demonstrated “similar effectiveness” to injectable semaglutide for blood sugar control.

While these results suggest that Rybelsus and Ozempic could be similarly effective for people with type 2 diabetes, the two drugs are not equivalent, practically speaking, because Ozempic is available in more powerful dosages.

Ozempic is additionally available in 1 and 2 mg doses. The maximum dose, when tested in people with type 2 diabetes using metformin, led to an A1C drop of 2.2 percentage points, and weight loss of just over 15 pounds.

 Rybelsus can’t match these results — at least not at the approved doses. Wegovy is approved in even higher doses, a 2.4 mg per week injection and a 25 mg per day pill.

Is Rybelsus Approved for Weight Loss?

The Rybelsus brand is approved to treat type 2 diabetes, but in 2025, Novo Nordisk announced the FDA approval of the 25 mg Wegovy pill, the first oral GLP-1 drug approved for weight management.

In clinical trials, researchers found study participants lost an average of 16.6 percent of their total body weight while taking 25 mg of oral semaglutide. That amount of weight loss was about equal to that achieved by people using the maximum dose of injectable semaglutide, suggesting that an oral semaglutide weight loss pill could be just as effective as the injectable.

How to Take Rybelsus

If there’s another reason that Rybelsus hasn’t quite caught on, it’s that taking the drug is arguably something of a hassle.

According to the instructions on the FDA label, you need to take Rybelsus on an empty stomach every morning, 30 minutes before eating, drinking, or using any other oral medications. You may only have up to 4 ounces of plain water during this time. If you have your breakfast too early, the pill will be less effective. But if you wait longer than 30 minutes to eat, the pill’s absorption may be enhanced (which could also lead to more significant side effects).

By contrast, Ozempic is a single weekly injection and can be taken at any time of day, with or without meals.

Rybelsus and Side Effects

A substantial minority of Ozempic users experience gastrointestinal side effects. For some, the nausea, vomiting, or diarrhea subsides as the body gets acclimated to the drug. But others don’t feel better and end up quitting the drug entirely.

Clinical trials suggest Rybelsus has similar side effects. A roughly similar proportion of Rybelsus study participants reported experiencing the most common side effects, including nausea, abdominal pain, diarrhea, and vomiting.

Rybelsus’ FDA label also warns of some of the same rare, serious side effects as Ozempic, including thyroid c-cell tumors, pancreatitis (inflammation of the pancreas), and acute kidney injury (a sudden decrease in kidney function).

Compounded Oral Semaglutide

Some online compounding pharmacies are now advertising “oral semaglutide,” but some of these products are not, in fact, equivalent to Rybelsus or the Wegovy pill. These semaglutide pills are taken sublingually (dissolved under the tongue) rather than swallowed, and therefore have an entirely different mechanism for absorption.

Buyers should be wary of such products, as there has never been any published study of sublingual semaglutide, and the safety and efficacy of such substances may be questionable.

The Takeaway

  • Rybelsus, an oral form of semaglutide, appears to be just as effective as Ozempic and Wegovy for diabetes management and weight loss, but it is only available in less powerful doses.
  • Rybelsus remains an effective therapy for type 2 diabetes, and may be especially useful for people with needle phobia or those who cannot take Ozempic for any other reason.
  • Rybelsus is a pill you swallow, so avoid any compounding pharmacies selling sublingual semaglutide as there isn’t data on the safety and efficacy of this form.

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Adam Gilden, MD, MSCE

Medical Reviewer
Diplomate of American Board of Obesity Medicine Foundation

Adam Gilden, MD, MSCE, is an associate director of the Obesity Medicine Fellowship at University of Colorado School of Medicine and associate director of the Colorado University Medicine Weight Management and Wellness Clinic in Aurora. Dr. Gilden works in a multidisciplinary academic center with other physicians, nurse practitioners, registered dietitians, and a psychologist, and collaborates closely with bariatric surgeons.

Gilden is very involved in education in obesity medicine, lecturing in one of the obesity medicine board review courses and serving as the lead author on the Annals of Internal Medicine article "In the Clinic" on obesity.

He lives in Denver, where he enjoys spending time with family, and playing tennis.

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Ross Wollen

Ross Wollen

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Ross Wollen joined Everyday Health in 2021 and now works as a senior editor, often focusing on diabetes, obesity, heart health, and metabolic health. He previously spent over a decade as a chef and craft butcher in the San Francisco Bay Area. After he was diagnosed with type 1 diabetes at age 36, he quickly became an active member of the online diabetes community, eventually becoming the lead writer and editor of two diabetes websites, A Sweet Life and Diabetes Daily. Wollen now lives with his wife and children in Maine's Midcoast region.

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Resources
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  2. Kim JC et al. Gastrointestinal Permeation Enhancers for the Development of Oral Peptide Pharmaceuticals. Pharmaceuticals. December 19, 2022.
  3. Klobucar S et al. Effectiveness of Oral versus Injectable Semaglutide in Adults with Type 2 Diabetes: Results from a Retrospective Observational Study in Croatia. Diabetology. February 2, 2024.
  4. Frías JP et al. Efficacy and Safety of Once-Weekly Semaglutide 2.0 mg Versus 1.0 mg in Patients With Type 2 Diabetes (SUSTAIN FORTE): A Double-Blind, Randomised, Phase 3B Trial. The Lancet Diabetes & Endocrinology. September 2021.
  5. Novo Nordisk A/S: Wegovy® pill approved in the US as first oral GLP-1 for weight management. Novo Nordisk. December 22, 2025.