Rybelsus (semaglutide) and Ozempic (semaglutide) are prescription medications. They’re both approved by the Food and Drug Administration (FDA) to help control blood sugar levels in adults with type 2 diabetes.
Rybelsus and Ozempic contain the same active drug, semaglutide, but in different forms. Rybelsus comes as an oral tablet, while Ozempic is given as a subcutaneous injection.
Both Rybelsus and Ozempic are brand-name medications. Generic versions of the drugs aren’t currently available.
This article contains information about the main differences between Rybelsus and Ozempic. If you’re thinking about your treatment options, these details can help you consider whether one of these drugs may be right for you.
Both Rybelsus and Ozempic contain the active ingredient semaglutide. They belong to a class of drugs called glucagon-like peptide-1 (GLP-1) agonists. A class of drugs is a group of medications that act in a similar way.
What Rybelsus and Ozempic are used for
Rybelsus and Ozempic are both FDA-approved to help control blood sugar in adults with type 2 diabetes. The American Diabetes Association (ADA) guidelines recommend using the medications in combination with diet and exercise.
Rybelsus and Ozempic are not approved to treat type 1 diabetes, or a complication of diabetes called diabetic ketoacidosis. Also, the drugs haven’t been studied in people who have had a pancreas problem known as pancreatitis. If you’ve had this condition in the past, your doctor will likely recommend a different diabetes medication.
If diet and exercise alone aren’t helping your type 2 diabetes, Rybelsus shouldn’t be the first medication that you try.
Other uses of Ozempic
Ozempic is also FDA-approved to decrease the risk of major heart problems in people with type 2 diabetes and heart disease. The drug lowers the risk of heart attack, stroke, and death from heart disease. Rybelsus isn’t approved by the FDA for this use.
These drugs haven’t been directly compared in clinical studies. However, both Rybelsus and Ozempic have been found effective for helping improve blood sugar levels in people with type 2 diabetes when used with diet and exercise. For information about how these drugs performed in clinical studies, see the prescribing information for Rybelsus and Ozempic.
Rybelsus and Ozempic are both a type of drug called a glucagon-like peptide-1 (GLP-1) agonist. GLP-1 agonists such as Rybelsus and Ozempic are included in American Diabetes Association (ADA) guidelines for treating type 2 diabetes. These guidelines recommend GLP-1 agonists as an additional treatment option when metformin doesn’t lower blood sugar enough.
The ADA guidelines also recommend a GLP-1 agonist for people who have type 2 diabetes in addition to heart disease. However, the ADA recommends only drugs with proven heart benefits and FDA-approval for this use. Rybelsus is not FDA-approved for this purpose.
Mild side effects
The following lists contain some of the more common mild side effects of Rybelsus or Ozempic, and some that both drugs share.
- Can occur with Rybelsus:
- decreased appetite
- Can occur with Ozempic:
- reactions at the site of injection, such as redness or discomfort
- Can occur with both Rybelsus and Ozempic:
These side effects may be temporary, lasting a few days or weeks. If the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
Serious side effects
This list contains examples of serious side effects that can occur with Rybelsus and Ozempic when taken individually:
- allergic reaction
- pancreatitis (swelling or irritation of the pancreas)
- complications of diabetic retinopathy (a form of eye damage due to diabetes), such as worsened eyesight
- sudden kidney problems
- thyroid C-cell tumors*
If you have serious side effects while using Rybelsus or Ozempic, call your doctor immediately. If the side effects feel life threatening, or if you believe you’re having a medical emergency, call 911 or your local emergency number right away.
Note: For more information about mild and serious side effects, see our articles on Rybelsus and Ozempic side effects.
* Rybelsus and Ozempic have a boxed warning for the risk of thyroid C-cell tumors. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see the section below called “Warnings of Rybelsus and Ozempic.”
Rybelsus and Ozempic are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.
Rybelsus comes as an oral tablet that you swallow.
Dosage differences between Rybelsus and Ozempic
With Rybelsus, you’ll usually take 3 milligrams (mg) once per day for the first 30 days. After that, your doctor will typically increase your dose to 7 mg once per day. This is the dose that’s usually needed to help improve blood sugar management.
After you’ve been taking 7 mg of Rybelsus for 30 days, your doctor will decide whether to increase the dose. If you could benefit from better blood sugar management, they may increase your dose to 14 mg, once per day.
With Ozempic, you’ll usually start with a 0.25-mg injection once a week. After 4 weeks, your doctor will likely increase your dose to a 0.5-mg injection once a week. If you could benefit from better blood sugar management, your doctor may increase your dose to a 1-mg injection once a week.
Rybelsus and Ozempic may not be right for you if you have certain medical conditions or other factors that affect your health. Here, these are referred to as warnings. The two drugs share some of the same warnings, but they also have different ones. Some of these warnings are mentioned below. Before you start using Rybelsus or Ozempic, be sure to talk with your doctor to see if these warnings apply to you.
Boxed warning: Risk of thyroid tumors
Both Rybelsus and Ozempic have a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.
In animal studies of Rybelsus and Ozempic, semaglutide increased the risk of thyroid C-cell tumors. (Semaglutide is the active drug in both Rybelsus and Ozempic.) It’s not known if these medications increase the risk of thyroid tumors in humans.
You shouldn’t take Rybelsus or Ozempic if you or a family member have ever had a type of thyroid cancer called medullary thyroid carcinoma. You also shouldn’t take these drugs if you have a rare form of cancer called multiple endocrine neoplasia syndrome type 2.
If you develop symptoms of thyroid cancer while taking Rybelsus or Ozempic, see your doctor right away. Symptoms may include trouble swallowing, hoarseness that doesn’t get better, shortness of breath, and a lump in your neck.
In addition to boxed warnings, Rybelsus and Ozempic have other warnings.
Before using Rybelsus or Ozempic, talk with your doctor if any of the following conditions or health factors apply to you:
- if you’ve had an allergic reaction to either drug or any of its ingredients
- if you’re pregnant or breastfeeding
- if you have a history of pancreatitis
- if you have kidney problems, such as kidney failure
- if you have ever been diagnosed with diabetic retinopathy (an eye condition caused by diabetes)
Your doctor may switch you to Rybelsus from Ozempic if you prefer taking medication by mouth instead of having subcutaneous injections. Or they may switch you to Ozempic from Rybelsus if you prefer taking a drug once a week instead of once per day.
If you have heart disease, your doctor may recommend Ozempic instead of Rybelsus. Ozempic is approved to decrease the risk of major heart problems in people with type 2 diabetes and heart disease. Rybelsus isn’t approved for this use.
If you’re taking 14 milligrams (mg) of Rybelsus once per day, your doctor may switch you to a 0.5-mg injection of Ozempic once a week. You can start having your Ozempic injections the day after your last dose of Rybelsus.
If you’re taking a 0.5-mg injection of Ozempic once a week, your doctor may switch you to either a 7-mg or 14-mg dose of Rybelsus once per day. You can start taking Rybelsus up to 7 days after your last injection of Ozempic.
If you’re taking 1-mg injections of Ozempic once a week, keep in mind that there’s no equal dose of Rybelsus.
If you’re interested in switching between Rybelsus and Ozempic, talk with your doctor. You shouldn’t switch your medications without your doctor’s approval and guidance.
If you’re considering starting Rybelsus or Ozempic treatment for type 2 diabetes, or switching from one drug to the other, talk with your doctor. They can advise you on which of these drugs may be best for you, or if another diabetes treatment may be more suitable. They’ll review your personal health history, as well as the potential positives and negatives of both drugs.
Some of the key points to consider when comparing the drugs include:
- Both Rybelsus and Ozempic contain the same active drug (semaglutide).
- Rybelsus comes as an oral tablet that you’ll likely take once per day. Ozempic is given as a subcutaneous injection that you’ll likely give yourself once a week.
- If your blood sugar isn’t well controlled with other diabetes drugs, your doctor may look at adding Rybelsus or Ozempic to your treatment regimen. Either drug would be used in combination with diet and exercise.
- Ozempic is approved to reduce the risk of heart attack or stroke in people with type 2 diabetes and heart disease. Rybelsus is not approved for this use.
If you’d like to learn more about Rybelsus or Ozempic, talk with your doctor or pharmacist. They can help answer any questions you have about similarities and differences between the drugs.
Note: For more information on type 2 diabetes, see our list of diabetes articles.
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 other 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.