Semaglutide has become a prominent name in the realm of diabetes and weight management. While injectable forms like Ozempic and Wegovy have garnered significant attention, Rybelsus, an oral formulation of semaglutide, offers an alternative approach. This article delves into the effectiveness of Rybelsus for weight loss, its usage, potential side effects, and how it compares to other semaglutide medications.
Understanding Rybelsus
Rybelsus is a prescription medication containing semaglutide, a GLP-1 receptor agonist. GLP-1 receptor agonists mimic the effects of a naturally occurring hormone in the gut, stimulating insulin secretion and reducing glucagon release in response to food. This mechanism helps lower blood sugar levels, making it an effective treatment for type 2 diabetes. Additionally, GLP-1 RAs promote weight loss by inducing satiety, leading to decreased caloric intake by delaying gastric emptying.
Rybelsus and Weight Loss: What the Studies Say
While Rybelsus is primarily approved for managing type 2 diabetes, studies have demonstrated its potential for weight loss. Weight losses of 2kg to 4kg may occur in people taking Rybelsus for type 2 diabetes. The weight loss benefit of semaglutide in patients with diabetes is well-documented.
One study of real-world data found similar results. Oral semaglutide demonstrated “similar effectiveness” to injectable semaglutide.
A meta-analysis of randomized controlled trials (RCT) evaluated the efficacy and safety of subcutaneous semaglutide in obese patients without type 2 diabetes. The study, which included 4 RCTs with a total of 3,613 individuals, revealed a mean weight reduction of 11.85% in the semaglutide group compared to placebo [95% confidence interval (CI) (-12.81,-10.90), p<0.00001]. This supports the use of semaglutide for weight management in obesity.
Read also: Using Rybelsus for Weight Loss: A Guide
Rybelsus vs. Ozempic and Wegovy
Rybelsus, Ozempic, and Wegovy all contain semaglutide as their active ingredient but differ in their formulation and approved uses. Ozempic is an injectable medication intended for people with type 2 diabetes, while Wegovy is also an injectable form of semaglutide, but it is specifically approved for the treatment of obesity. Rybelsus is the only approved oral form of semaglutide.
Clinical trials show that the two doses have a comparable metabolic effect: Rybelsus 14 mg daily pill and Ozempic 0.5 mg weekly injection both resulted in a 1.3 percentage point drop in A1C and around 9.5 - 10 pounds weight loss.
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 15 pounds. Rybelsus can’t match these results - at least not at the approved doses. Wegovy is available in an even higher dose, 2.4 mg per week.
In the coming years, higher doses of Rybelsus may become available. In 2023, Novo Nordisk announced that it would seek FDA approval for larger doses of oral semaglutide for the treatment of type 2 diabetes.
How to Take Rybelsus
Rybelsus is taken orally in tablet form. According to the FDA label, Rybelsus should be taken on an empty stomach every morning, 30 minutes before eating, drinking, or taking any other oral medications. During this time, you may only have up to 4 ounces of plain water. 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).
Read also: Rybelsus: A Weight Loss Option?
By contrast, Ozempic is a single weekly injection and can be taken at any time of day, with or without meals.
Rybelsus Side Effects
Like other medications, Rybelsus may cause side effects. The most common side effects are gastrointestinal disorders, including nausea, abdominal pain, diarrhea, and vomiting.
Clinical trials suggest that 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.
The meta-analysis also showed that the risk of developing gastrointestinal adverse events was 1.59 times more likely with semaglutide treatment (RR 1.59, 95%CI [1.34, 1.88], p< 0.00001, I2 81%).
Rybelsus’ FDA label also warns of some of the same rare, serious side effects as Ozempic, including pancreatitis (inflammation of the pancreas) and acute kidney injury (a sudden decrease in kidney function).
Read also: Rybelsus and Its Effects
Important Considerations
Off-Label Use
Some doctors may prescribe Rybelsus off-label as a weight loss therapy for people without diabetes, especially those who cannot tolerate Wegovy or who are unable to use needles.
Lifestyle Modifications
Rybelsus is most effective when used in conjunction with a healthy diet and lifestyle. Clinical trials on semaglutide have found that the drug reduces appetite which decreases food intake and leads to fewer cravings. As well as following a healthy diet and exercise routine, getting enough sleep will help you to avoid weight gain.
Compounded Oral Semaglutide
Some online compounding pharmacies are now advertising “oral semaglutide,” but some of these products are not, in fact, equivalent to Rybelsus. 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.
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