Rybelsus side effects: What you should know

More common side effects of Rybelsus

Rybelsus can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took Rybelsus in clinical trials:

• nausea and vomiting*
• diarrhea
• constipation*
• abdominal pain
• reduced appetite

* For more information about this side effect, see the “Side effect specifics” section below.

Mild side effects of Rybelsus

Mild side effects can occur with Rybelsus treatment. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to the prescribing information for Rybelsus.

Mild side effects that have been reported with Rybelsus include:

• nausea and vomiting*
• diarrhea
• constipation*
• abdominal pain
• gas, bloating, and burping
• indigestion
• acid reflux*
• reduced appetite
• weight loss*
• mild allergic reaction*

* For more information about this side effect, see the “Side effect specifics” section below.

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking Rybelsus and want to tell the FDA about it, visit MedWatch.

Serious side effects of Rybelsus

Rybelsus may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to the prescribing information for Rybelsus.

If you develop serious side effects while taking Rybelsus, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

• Kidney problems, such as kidney failure. Symptoms can include:
  • dark-colored urine
  • urinating less than usual or not at all
  • swollen feet, ankles, or hands
  • confusion
• Pancreatitis (inflammation of the pancreas). Symptoms can include:
  • constant, stabbing abdominal pain that may spread toward your back
  • nausea and vomiting*
• Hypoglycemia (low blood sugar level), mainly if Rybelsus is used with insulin or sulfonylurea drugs, such as glipizide (Glucotrol XL). Symptoms can include:
  • dizziness
  • sweating
  • shaking
  • irritability
  • trouble concentrating
  • confusion
  • headache
• Gallbladder problems, such as gallstones or gallbladder inflammation. Symptoms can include:
  • severe abdominal pain below the ribs on the right side
  • pale stools
  • fever
  • nausea and vomiting*
  • jaundice
• Risk of thyroid cancer.†
• Severe allergic reaction.*

* For more information about this side effect, see the “Side effect specifics” section below.
† Rybelsus has a boxed warning for this side effect. This is a serious warning from the Food and Drug Administration (FDA). For more information, see the “Side effect specifics” section below

FAQ about the side effects of Rybelsus

Rybelsus may cause several side effects. Here are some frequently asked questions and answers about Rybelsus, including information about the drug’s side effects.

How much does Rybelsus cost? Are savings options available?

The price you’ll pay for Rybelsus can vary. Your cost may depend on your treatment plan, the pharmacy you use, and any insurance coverage you have. To save money on your Rybelsus prescription, explore the coupon options below.

Do side effects of Rybelsus vary by strength: 3 mg, 7 mg, and 14 mg?

Yes and no. All strengths of Rybelsus can cause the same mild and serious side effects. However, the risk of certain side effects may increase with higher doses.

The manufacturer doesn’t report how often side effects occurred with a dose of 3 milligrams (mg). It does note that digestive side effects tend to be more common when first starting treatment and after dose increases. You’ll start treatment with a 3-mg dose.

In clinical trials, digestive side effects were more common in people taking a 14-mg dose than in those taking a 7-mg dose.

If you have concerns about the risk of side effects with the Rybelsus dose you’re prescribed, talk with your doctor. To learn more about Rybelsus dosage, see this article.

Is hair loss a side effect of Rybelsus?

It’s not known to be. Hair loss wasn’t reported in clinical trials of Rybelsus. And it hasn’t been reported since the drug was approved. This side effect hasn’t been reported with other drugs from the same class as Rybelsus. (It belongs to a class of drugs called glucagon-like peptide-1 [GLP-1] receptor agonists.)

Hair loss can have many causes, including stress, certain medications, and diabetes. (Keep in mind that Rybelsus is prescribed to adults with type 2 diabetes.)

If you have hair loss while taking Rybelsus, talk with your doctor. They can try to determine the cause and recommend ways to manage your hair loss.

Are there any long-term side effects of Rybelsus treatment?

No, Rybelsus isn’t known to cause long-term side effects. And taking Rybelsus for a long period of time is not known to increase your risk of side effects.

Most side effects of Rybelsus are eased quickly, either with continued treatment or after you stop taking the medication.

Certain serious side effects may take a long time to get better after stopping treatment. (Examples include pancreatitis and kidney problems.) They shouldn’t cause long-lasting problems.

If you have concerns about long-term side effects with this medication, talk with your doctor.

Where can I find reviews from people who have had side effects with Rybelsus?

Reviews from people who’ve taken Rybelsus are available on the manufacturer’s website. It’s important to note that the reviewers have been paid by the manufacturer to share their stories. You’ll also be able to find other reviews about this medication on other websites.

That said, not everyone’s experience with Rybelsus will be the same. You should not rely on reviews of Rybelsus when deciding whether this drug is a good option for you.

Many factors can affect the experience you have with Rybelsus. These include your age, other medical conditions you have, other medications you take, and the dose of Rybelsus you take. Your doctor can best advise you on possible side effects of Rybelsus and recommend whether the drug is right for you.

Should I expect headaches during Rybelsus treatment?

No, you shouldn’t. You’re unlikely to have headaches from taking Rybelsus. Headaches weren’t reported in clinical trials of this medication.

Headaches have been reported with some other medications from the same drug class as Rybelsus, called GLP-1 receptor agonists. An example is liraglutide (Saxenda, Victoza). However, headaches are not known to be a side effect of Rybelsus.

Headaches can have many different causes, including stress, lack of sleep, low blood sugar, and overuse of pain relievers. If you have frequent headaches while taking Rybelsus, talk with your doctor. They can help you determine the cause and recommend ways to manage your headaches.

Side effect specifics

Learn more about some of the side effects that Rybelsus may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Rybelsus.

Risk of thyroid cancer

Rybelsus has a boxed warning for the risk of thyroid cancer. A boxed warning is a serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about side effects that may be harmful.

In animal studies, semaglutide (the active ingredient in Rybelsus) caused thyroid tumors in mice and rats. Animal studies don’t always predict what will happen in people. And no cases of thyroid cancer have been reported in people taking Rybelsus. However, it’s not known whether Rybelsus raises the risk of thyroid cancer in humans.

Thyroid cancer has been reported in some people taking a medication from the same drug class as Rybelsus. This medication is called liraglutide (Saxenda, Victoza). It’s unclear how often this has happened or whether liraglutide was the cause. It’s not known whether drugs in this drug class (glucagon-like peptide-1 [GLP-1] receptor agonists) raise the risk of thyroid cancer.

As a precaution, your doctor will likely not prescribe Rybelsus if you have ever had:

• medullary thyroid carcinoma (MTC)
• a rare type of cancer known as multiple endocrine neoplasia syndrome type 2 (MEN 2)

As well, your doctor will likely not prescribe Rybelsus if a member of your family has ever had MTC.

What you can do

While taking Rybelsus, you should see your doctor if you develop symptoms of thyroid cancer. These can include:

• ongoing hoarseness
• lump in the throat
• trouble swallowing
• shortness of breath

Nausea and vomiting

You may have nausea and vomiting while taking Rybelsus. These side effects may occur with Rybelsus because the medication causes food to stay in your stomach longer than usual. In clinical trials, nausea and vomiting were common with Rybelsus.

You’re most likely to have nausea and vomiting when you first start taking Rybelsus and after dose increases. These side effects usually get better within a couple of weeks as your body gets used to the medication.

If you have nausea with Rybelsus, you may not feel like drinking as much as usual. And if you have vomiting, you may lose more fluids than usual. These situations can lead to dehydration. If you become dehydrated while taking Rybelsus, this can increase your risk of kidney problems, such as kidney failure.

Though rare, Rybelsus may cause pancreatitis (inflammation of the pancreas) or gallbladder problems. These conditions cause nausea and vomiting and other symptoms, such as severe abdominal pain.

If you have nausea and vomiting with other symptoms, see your doctor right away. If you have pancreatitis or gallbladder problems, you’ll need to stop taking Rybelsus.

What you can do

If you have nausea and vomiting with Rybelsus, it’s important to drink plenty of fluids to avoid becoming dehydrated. If you have nausea, you may find it helpful to take frequent sips of ice-cold drinks. If you have vomiting, it’s helpful to drink sports drinks, such as Gatorade, or eat soups or broths. These items replace electrolytes, such as sodium and potassium, that you can lose through vomiting.

Here are a few other tips for reducing nausea with Rybelsus:

• Avoid eating large main meals and try eating smaller amounts more often instead.
• Avoid greasy, spicy, or overly sweet foods.
• Avoid lying down after eating.
• Get plenty of fresh air.

If you have nausea or vomiting that’s severe, doesn’t lessen, or occurs with abdominal pain, talk with your doctor right away. They may recommend switching from Rybelsus to a different medication.

Constipation

You may have constipation while taking Rybelsus. This side effect was common in clinical trials of Rybelsus.

Constipation is usually mild. However, if it’s not managed, it can lead to problems, such as hemorrhoids, rectal bleeding, and nausea. It could even lead to a blockage in your bowel.

What you can do

If you have constipation with Rybelsus, it may help to:

• drink more water
• eat more high fiber foods, such as fruits, vegetables, and whole grains
• exercise regularly

Sticking with these lifestyle changes can also help prevent constipation from happening again.

If these measures don’t ease your constipation, ask your pharmacist to recommend a suitable over-the-counter laxative. Examples include:

• stool softeners, such as docusate sodium
• stimulant laxatives, such as senna
• bulk-forming laxatives, such as methylcellulose

If you have constipation that’s severe, bothersome, or doesn’t get better, talk with your doctor. They may prescribe a different laxative. Or they may recommend switching from Rybelsus to a different medication.

Weight loss

You may have weight loss while taking Rybelsus. However, Rybelsus is not FDA approved for weight loss.

The medication causes food to stay in your stomach longer than usual, so it can make you feel fuller after eating. As a result, you may consume fewer calories, which can lead to weight loss.

In clinical trials, reduced appetite and weight loss were commonly reported with Rybelsus.

Note that Rybelsus is meant to be part of a treatment regimen that includes a balanced diet and increased exercise. These factors can also lead to weight loss.

As well, Rybelsus commonly causes digestive side effects, such as diarrhea, nausea, and vomiting. These side effects may sometimes lead to weight loss.

What you can do

If you have type 2 diabetes, weight loss generally has beneficial effects on your blood sugar levels and overall health. However, Rybelsus should not be taken for weight loss alone. Remember that it’s used to manage blood sugar levels in adults with type 2 diabetes.

If you have a reduced appetite with Rybelsus, talk with your doctor about your diet. It’s important to make sure you’re still getting enough essential nutrients.

Additionally, it’s not healthy to lose weight due to digestive side effects, such as vomiting and diarrhea. These side effects can make you lose excessive amounts of fluid and electrolytes, which can lead to dehydration. Dehydration increases your risk of kidney problems, including while taking Rybelsus. If you’re having trouble eating or drinking because of digestive side effects, talk with your doctor.

Acid reflux

You may have acid reflux while taking Rybelsus. With acid reflux, stomach acid travels from your stomach back up into your esophagus (a tube connecting your mouth to your stomach). This side effect may occur with Rybelsus because the medication causes food to stay in your stomach longer than usual. That said, in clinical trials acid reflux was rare with Rybelsus.

Symptoms of acid reflux can include:

• heartburn (a painful burning sensation in your esophagus that you may feel behind your breastbone or throat)
• sour or bitter taste in your mouth
• indigestion

These symptoms may get worse after eating or if you bend over or lie down. If you frequently have symptoms of acid reflux, your doctor may diagnose this as gastroesophageal reflux disease (GERD).

What you can do

If you have symptoms of acid reflux while taking Rybelsus, the following may help:

• Eat smaller amounts more often, instead of fewer larger meals.
• Avoid spicy and greasy foods.
• Avoid lying down soon after eating.
• Improve your posture, by sitting and standing up straighter, for example.
• Raise the head of your bed if your symptoms are worse at night.

If these measures don’t help, several over-the-counter medications are available to relieve heartburn. Ask your pharmacist to recommend a suitable product. Examples include:

• antacids that neutralize stomach acid, such as calcium carbonate (Tums) and calcium carbonate/magnesium hydroxide (Rolaids)
• H2 blockers that reduce stomach acid production, such as famotidine (Pepcid)
• proton pump inhibitors that reduce stomach acid production, such as esomeprazole (Nexium)

If you have symptoms of acid reflux that last longer than 2 weeks, see your doctor. They may prescribe medication to treat your symptoms. Or they may recommend switching from Rybelsus to a different medication.

Allergic reaction

As with most drugs, Rybelsus can cause an allergic reaction in some people. This side effect wasn’t reported in clinical trials of Rybelsus. However, serious allergic reactions have been reported since the drug was approved.

Symptoms can be mild or serious and can include:

• skin rash
• itching
• flushing
• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should continue taking Rybelsus. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Precautions for Rybelsus

Rybelsus may not be safe for everyone with type 2 diabetes. Some warnings and precautions to consider are discussed below.

Boxed warning: Risk of thyroid cancer

This drug has a boxed warning for the risk of thyroid cancer. This is a serious warning from the Food and Drug Administration (FDA). For details, see the “Side effect specifics” section above.

Other precautions

Be sure to talk with your doctor about your health history before you take Rybelsus. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. These are considered drug-condition or drug-factor interactions. The conditions and factors to consider include:

Diabetic retinopathy. If you have diabetic retinopathy (problems with your eyesight caused by diabetes), Rybelsus might worsen your condition. Your doctor will likely monitor your eyes closely while you take Rybelsus. If you have any vision-related side effects while taking Rybelsus, tell your doctor right away.

Kidney problems. Rybelsus can sometimes cause or worsen kidney failure, especially if you become dehydrated while taking the drug. Dehydration occurs when your body loses too much fluid. This can happen if you have diarrhea, nausea, or vomiting while taking Rybelsus. To learn more about nausea and vomiting, see the “Side effect specifics” section above. If you have kidney problems, your doctor may monitor your kidney function more often while you’re taking Rybelsus.

Pancreatitis. Though rare, Rybelsus may cause pancreatitis (inflammation of the pancreas). It’s not known whether Rybelsus is safe for people who’ve had pancreatitis in the past. If you’ve ever had pancreatitis, your doctor will likely not prescribe Rybelsus. Ask them what other medications may be better options for you.

Allergic reaction. If you’ve had an allergic reaction to Rybelsus or any of its ingredients, your doctor will likely not prescribe Rybelsus. Ask your doctor what other medications may be better options for you.

Alcohol with Rybelsus

Alcohol isn’t known to interact with Rybelsus. However, drinking alcohol while taking this medication may increase digestive side effects, such as nausea and diarrhea.

If you drink alcohol, talk with your doctor about how much is safe to drink with Rybelsus.

Pregnancy and breastfeeding while taking Rybelsus

It isn’t known whether Rybelsus is safe to take during pregnancy. If you’re pregnant or able to become pregnant, talk with your doctor about the risks and benefits of taking Rybelsus.

Your doctor will likely recommend a medication other than Rybelsus to manage blood sugar levels during your pregnancy. (Keep in mind that this drug is prescribed for adults with type 2 diabetes.) Having blood sugar that isn’t managed well during pregnancy can be harmful to both a pregnant person and their fetus.

It’s also not known whether Rybelsus passes into breast milk. Breastfeeding is not recommended if you’re taking Rybelsus. Talk with your doctor about other healthy ways to feed your child. If you’re breastfeeding or plan to breastfeed, talk with your doctor about other treatment options.

When to talk with your doctor

Rybelsus commonly causes mild digestive side effects at the start of treatment and after dosage increases. These side effects are typically easily managed and resolve quickly. As with many medications, some serious side effects are also possible, but these are rare.

To learn more about Rybelsus, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug.

Besides talking with your doctor, you can do some research on your own. These articles might help:

• More information about Rybelsus. For details about other aspects of Rybelsus, refer to this article.
• Drug comparison. Learn how Rybelsus compares with Ozempic and metformin.
• Drug costs. To find out about the price of Rybelsus, see this article.
• A look at type 2 diabetes. For details about type 2 diabetes, see our diabetes hub.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.