Rybelsus vs Ozempic: Are They the Same?

Deciding between Rybelsus vs Ozempic? Both are GLP-1 medications with the same active ingredient, semaglutide, and are FDA-approved for type 2 diabetes. They can also support weight loss, but the biggest difference is how you take them. 

Rybelsus is a daily pill, while Ozempic is a weekly injection. This guide explains how they compare in effectiveness, side effects, cost, and more, so you can make the best choice with your doctor.

What Is Rybelsus? 

Rybelsus (semaglutide) is the oral form of semaglutide, taken once daily with a healthy diet and exercise program to control blood sugar levels in people with type 2 diabetes. The convenience of Rybelsus's daily oral form can provide a sense of ease in managing your condition. It comes in tablet form and must be taken in the morning on an empty stomach, at least 30 minutes before eating, drinking, or taking any other medications. 

What Is Ozempic?

Ozempic (semaglutide) is the injectable form of semaglutide, given once weekly under the skin (subcutaneously), used with a healthy diet and exercise to manage blood sugar in people with type 2 diabetes. 

Ozempic is also FDA-approved to lower the risk of heart attack, stroke, and death in people with type 2 diabetes who have heart disease or blood vessel disease.

How Do They Work?

Both Rybelsus and Ozempic work similarly by mimicking GLP-1. This hormone helps lower blood sugar by increasing insulin release, decreasing glucagon, and slowing digestion, which promotes weight loss by curbing appetite.

FDA-Approved Uses

Both Ozempic and Rybelsus, when used in conjunction with a healthy diet, increased exercise, and other oral medications and insulin, improve glycemic control (blood glucose levels) in adults with type 2 diabetes mellitus. 

Ozempic is also FDA-approved to lower the risk of major adverse cardiovascular events (heart attack, stroke) in adults with type 2 diabetes mellitus and established cardiovascular disease.

Rybelsus and Ozempic do not have approval for use in children aged 17 or younger.

How Do They Differ?

Below is a breakdown of the key differences between Rybelsus and Ozempic:

Is Rybelsus or Ozempic More Effective?

No current studies compare oral semaglutide (Rybelsus tablets) with subcutaneous semaglutide (Ozempic injections). However, separate studies have found that both Rybelsus and Ozempic are equally effective in achieving blood sugar control and weight reduction. 

A 2021 study found that in people with type 2 diabetes controlled with diet and exercise:

• The maximum dose of Ozempic (1 mg once weekly) led to a hemoglobin A1c (HbA1c) reduction of 1.5% in 30 weeks.

• The maximum dose of Rybelsus (14 mg) led to a HbA1c reduction of 1.4% in 26 weeks. 

Rybelsus vs Ozempic for Weight Loss

Rybelsus (oral semaglutide) and Ozempic (semaglutide injection) are both GLP-1 drugs that lower blood sugar levels. However, they also slow down digestion and reduce appetite, promoting weight loss.

Weight loss results are similar between Ozempic and Rybelsus. During clinical studies, people lost an average of 3.7 kg or 8.2 lbs in 26 weeks (6.5 months). You may not notice significant weight loss during the initial dose escalation. However, neither is FDA-approved for weight management. 

If you do not have diabetes and want to take medication for weight loss, talk to your doctor about a treatment plan with Wegovy, which also contains the same active ingredient, semaglutide. Wegovy has FDA approval for chronic weight management. 

Which Is More Expensive?

GLP-1 drugs are expensive because they are brand-name only, and lower-cost generics are not yet available. These medications can cost upwards of $1,000 per month without insurance.

Both Rybelsus and Ozempic have the same retail price of $997.58 for a month’s supply of all doses. However, eligible patients with private or commercial insurance may pay as little as: 

• $10 for a 1-, 2-, or 3-month prescription of Rybelsus. 

• $25 for a 1-, 2-, or 3-month prescription of Ozempic.

Your out-of-pocket costs will depend on your specific health insurance plan, whether Rybelsus vs Ozempic is on your plan’s Preferred Drug List, and your copay. Also, out-of-pocket costs are higher before you’ve met your annual deductible amount.

Side Effects and Safety Comparison

Common Side Effects

Common side effects of Rybelsus and Ozempic include heartburn, abdominal pain, burping or belching, nausea, vomiting, diarrhea, constipation, and decreased appetite. These side effects typically subside within a few days as the body adjusts to the medicine.

Ozempic injections can cause local reactions such as redness, swelling, and itching. To lower the risk of injection site reactions, you should inject Ozempic at a different site every week.

Serious Side Effects

Rybelsus and other GLP-1 drugs, including Ozempic, can increase the risk of acute pancreatitis (inflammation of the pancreas).

Other serious side effects of Ozempic and Rybelsus include:

• Acute kidney injury and decreased kidney function

• Gallbladder problems

• Diabetic retinopathy complications (blurred vision and vision problems)

• Hypoglycemia (low blood sugar)

• Hypersensitivity (allergic reactions)

Rybelsus and Ozempic carry a boxed warning for thyroid cancer. They are contraindicated for people with a personal or family history of thyroid cancer (medullary thyroid carcinoma or multiple endocrine neoplasia type 2).

Ozempic vs Rybelsus: Which Is Right For You?

The key differences between Rybelsus and Ozempic are the method of administration (oral vs injection) and the frequency of dosing (daily vs weekly).

Both are equally effective at managing type 2 diabetes, promote similar weight loss benefits, and are comparable in cost.  

Rybelusus may be best for people who find it difficult to inject Ozempic, as Ozempic can cause injection site reactions like swelling, redness, and itching.

However, Ozempic has additional proven benefits for people who have both type 2 diabetes mellitus and cardiovascular disease (blood vessel and heart disease).

The choice between Rybelsus vs Ozempic comes down to personal preference, your health history, and other medical conditions. That’s why it’s important to discuss the pros and cons of Ozempic vs Rybelsus with your healthcare provider. 

FAQs on Ozempic vs Rybelsus

Is Rybelsus More Effective Than Ozempic?

There are no studies comparing Rybelsus vs Ozempic. However, separate studies have found that both medications are equally effective and achieve similar reductions in average blood glucose levels. 

Can You Switch From Rybelsus To Ozempic?

Yes, you can switch from Rybelsus to Ozempic and vice versa under the supervision of your healthcare provider. 

Why Is Rybelsus Not As Popular?

Rybelsus is not as popular as Ozempic because:

• Rybelsus is available in smaller doses than Ozempic. The maximum dose of Rybelsus (14 mg) is equivalent to 0.5 mg of Ozempic..

• Oral semaglutide does not have approval for weight loss. 

• Rybelsus needs to be taken every day on an empty stomach, while Ozempic is once-weekly, which makes Rybelsus less convenient for some.