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Rybelsus vs Ozempic

Drug facts and comparison

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Medically reviewed by  Jamie Winn, PharmD

Uses

  • Type 2 diabetes
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  • Type 2 diabetes
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Summary

Brand name: Rybelsus
Brand name: Ozempic
Manufacturer: Novo Nordisk
Manufacturer: Novo Nordisk
Active ingredient: semaglutide
Active ingredient: semaglutide
Indication: Type 2 diabetes
Indication: Type 2 diabetes

Side Effects

Most common

  • Feeling sick
  • Being sick (vomiting)
  • Diarrhea
  • Stomach (abdominal) pain
  • Constipation
  • Decreased appetite

More serious

  • Thyroid tumors and a type of thyroid cancer called medullary thyroid carcinoma
  • Changes in your vision
  • Very low blood sugar (hypoglycemia)
  • Inflammation of the pancreas (pancreatitis)

Most common

  • Feeling sick
  • Being sick (vomiting)
  • Diarrhea
  • Stomach (abdominal) pain
  • Constipation

More serious

  • Thyroid tumors and a type of thyroid cancer called medullary thyroid carcinoma
  • Kidney problems, including kidney failure
  • Inflammation of the pancreas (pancreatitis)
  • Severe allergic reactions
  • Changes in vision
  • Very low blood sugar (hypoglycemia)

Drug Interactions

Severe Interactions
  • Antibiotics for bacterial infections such as gatifloxacin
  • Bexarotene used to treat skin cancer
Serious interactions
  • Any other diabetes medications, like insulin or sulfonylureas
  • Diuretics, taken to make you lose water and salt, usually to treat high blood pressure – bumetanide, furosemide
  • Corticosteroids such as cortisone and prednisolone
  • Beta 2-stimulants, taken to treat asthma – salmeterol
  • Antipsychotics – clozapine
  • Estrogen containing drugs including birth control and hormone replacements
Moderate Interaction
  • Steroids used topically (on the skin) such as betamethasone, clobetasol, hydrocortisone, and mometasone
Severe Interactions
  • Antibiotics for bacterial infections such as gatifloxacin
  • Bexarotene used to treat skin cancer
Serious interactions
  • Any other diabetes medications, like insulin or sulfonylureas
  • Diuretics, taken to make you lose water and salt, usually to treat high blood pressure – bumetanide, furosemide
  • Corticosteroids such as cortisone and prednisolone
  • Fenofibrate, taken to lower blood triglyceride levels
  • Beta 2-stimulants, taken to treat asthma – salmeterol
  • Antidepressants, including monoamine oxidase inhibitors and selective serotonin reuptake inhibitors – phenelzine, selegiline, sertraline
  • Disopyramide, taken to treat heart rhythm problems
  • Estrogen containing drugs including birth control and hormone replacements
Moderate Interaction
  • Steroids used topically (on the skin) such as betamethasone, clobetasol, hydrocortisone, and mometasone

Warnings

You should not use Rybelsus if you:

  • Are allergic to the active ingredient semaglutide
  • Are allergic to any of the other ingredients in Rybelsus
  • Have had a type of thyroid cancer called medullary thyroid carcinoma (MTC), or if anyone in your family has
  • Have an endocrine system condition called multiple endocrine neoplasia syndrome type 2 (MEN 2)
  • Have pancreatitis (inflammation of your pancreas)
  • Have type 1 diabetes (Rybelsus is for type 2 diabetes only)
  • Are under 18 years of age

You should talk to your doctor before using Rybelsus if you:

  • Are taking any of the medications that could interact with Rybelsus
  • Have had any problems with your pancreas
  • Have had any problems with your kidneys
  • Have or have ever had any problems with your eyes, including cataracts or glaucoma
  • Are pregnant or are planning to become pregnant
  • Are breastfeeding or are planning to breastfeed

You should not use Ozempic if you:

  • Are allergic to the active ingredient semaglutide
  • Are allergic to any of the other ingredients in Ozempic
  • Have Type 1 diabetes (Ozempic is for Type 2 diabetes only)
  • Have an endocrine system condition called multiple endocrine neoplasia syndrome type 2 (MEN 2)
  • Have or anyone in your family has had a type of thyroid cancer called medullary thyroid carcinoma (MTC)
  • Have diabetic ketoacidosis
  • Are under 18 years of age

You should talk to your doctor before using Ozempic if you:

  • Are taking any of the medications that could interact with Ozempic
  • Have or have had any problems with your pancreas
  • Have or have had any problems with your kidneys
  • Have a history of diabetic retinopathy
  • Are pregnant or are planning to become pregnant
  • Are breastfeeding or are planning to breastfeed

Dosage

Once daily

0.25mg once weekly
0.5mg once weekly
1mg once weekly

Cost

30, 3 mg Rybelsus oral tablet will cost around $950

2 mg/1.5 ml pre-filled Ozempic Pen costs $899 on average for 1.5 milliliters

FAQs

Rybelsus and Ozempic are brand names of semaglutide, a glucagon-like peptide-1 receptor agonist used for diabetes treatment. Rybelsus is an oral tablet and Ozempic is an injection and both are FDA (U.S. Food and Drug Administration) approved drugs.

If you have Type 2 diabetes and metformin is not achieving glycemic control, your healthcare professional may prescribe either Rybelsus or Ozempic. In clinical trials, both Rybelsus and Ozempic were effective at treating Type 2 diabetes and lowering blood sugar levels but Ozempic has shown to reduce cardiovascular events, unlike Rybelsus.

Both drugs contain the same active ingredient. Read on to find out about their similarities and differences.

What is Rybelsus?

Rybelsus is a diabetes medication manufactured by Novo Nordisk. It is given to adults with Type 2 diabetes to help lower blood sugar (glucose) when used with exercise and changes in diet.

Rybelsus is a non-insulin medication that causes your pancreas to produce more insulin, helping to lower your blood glucose levels.

Rybelsus is taken in tablet form, usually once a day when you first wake up. Make sure you always use your Rybelsus as directed by your doctor or pharmacist.

What is Ozempic?

Ozempic is a diabetes medication given to adults with Type 2 diabetes to:

  • Lower blood sugar (glucose) levels, when used alongside exercise and changes in diet
  • Reduce the risk of major cardiovascular events, like heart attacks and strokes, in people who have heart disease

Ozempic can help you lower your blood sugar levels when used alongside dietary and lifestyle changes. It causes you to secrete more insulin, helping to lower your blood sugar and reduce your risk of major cardiovascular events, like heart attacks and strokes, if you have heart disease.

Ozempic is taken as a weekly injection. It is injected under your skin (subcutaneous injection), using a pre-filled pen. As it is a non-insulin medication, your doctor may prescribe Ozempic alongside insulin. Make sure you always use your Ozempic as directed by your doctor.

How do Rybelsus and Ozempic work?

The active ingredient in Rybelsus and Ozempic is called semaglutide. It is a non-insulin drug that can help lower your blood glucose levels by stimulating the cells in your pancreas that produce insulin (called beta cells).

When you take Rybelsus or Ozempic, semaglutide molecules attach to beta cells in your pancreas at sites called glucagon-like peptide-1 (GLP-1) receptors. The semaglutide stimulates these receptors, which makes the beta cells produce more insulin, helping to lower your blood sugar after you’ve eaten.

Semaglutide also encourages the growth of more beta cells in your pancreas, allowing your pancreas to produce higher levels of insulin, reversing any declines in your body’s insulin production.

Other common brands of GLP-1 agonists are Trulicity (dulaglutide), Byetta (exenatide), Bydureon Bcise (exenatide extended-release), and Victoza (liraglutide).

Dosing of Rybelsus and Ozempic

The prescribing information for both drugs recommends the following dosing:

Rybelsus is an oral medication normally started with 3 mg once daily for 30 days. After 30 days on the 3 mg dose, increase the dose to 7 mg once daily. The dose may be increased to 14 mg once daily if additional glycemic control is needed after at least 30 days on the 7 mg dose. Rybelsus should be taken on an empty stomach.

Ozempic is normally started with 0.25 mg once weekly. After 4 weeks, the dose may increase to 0.5 mg once weekly. If after at least 4 weeks additional glycemic control is needed, an increase to 1 mg once weekly may be given. Ozempic is to be taken once weekly at any time of day, with or without meals.

The maximum dose available of injected Ozempic is 1mg whereas the maximum dose of Rybelsus is 14mg. This difference in doses suggests that a lot of Rybelsus is still broken down in the gut before being absorbed.

Rybelsus and Ozempic side effects

The most common side effects of Rybelsus include:

  • Nausea (feeling sick)
  • Vomiting (being sick)
  • Abdominal pain
  • Constipation
  • Diarrhea
  • Decreased appetite

For some people, Rybelsus and Ozempic can cause more serious side effects. These are rarer but can include:

  • An increased risk of thyroid tumors, including cancerous tumors. You should not use Rybelsus or Ozempic if you have a personal or family history of thyroid cancer (see the boxed warning)
  • Inflammation of your pancreas (pancreatitis)
  • Changes in your vision
  • Very low blood sugar (hypoglycemia)
  • Severe allergic reactions to the medication that can cause itching, rashes, swelling, and difficulties breathing

RELATED: Rybelsus side effects, Ozempic side effects

Rybelsus and Ozempic drug interactions

Tell your prescribing physician if you take any of the following as they can interact with Rybelsus and Ozempic:

  • Insulin – Rybelsus and Ozempic can be used alongside insulin, but your doctor may change the dose of insulin you take and/or how often you take it
  • Any other medications used for the treatment of type 2 diabetes, like sulfonylureas
  • Any medications you take by mouth to reduce the risk of blood clots (oral anticoagulants) like warfarin

Always speak to your healthcare provider for medical advice regarding drug interactions, taking supplements, over-the-counter medications, and drinking alcohol when using Rybelsus or Ozempic. Healthcare professionals are the most reliable and accurate source of drug information.

Rybelsus and Ozempic warnings & precautions

Don’t take Rybelsus or Ozempic if you:

  • Are allergic to the active ingredient semaglutide
  • Are allergic to any of the other ingredients in Rybelsus or Ozempic
  • Have had a type of thyroid cancer called medullary thyroid carcinoma (MTC), or if there is a family history (see the boxed warning)
  • Have an endocrine system condition called multiple endocrine neoplasia syndrome type 2 (boxed warning)
  • Have pancreatitis (inflammation of your pancreas)
  • Have type 1 diabetes (Rybelsus and Ozempic are for type 2 diabetes only)
  • Are under 18 years of age

Talk to your doctor before taking Rybelsus or Ozempic if you:

  • Are taking any of the medications that could interact with Rybelsus or Ozempic
  • Have had any problems with your pancreas
  • Have kidney problems, including kidney failure
  • Have or have ever had any problems with your eyes, including cataracts or glaucoma
  • Are pregnant or are planning to become pregnant
  • Are breastfeeding or are planning to breastfeed

It is possible that you may lose body weight while taking Rybelsus or Ozempic, however, the medication isn’t intended to be used for weight loss.

The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.
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