What Endocrinologists Want You to Know About Rybelsus and Ozempic
"Hearst Magazines and Yahoo may earn commission or revenue on some items through these links."
Interest surrounding glucagon-like peptide 1 agonists (GLP-1), a class of type 2 diabetes drugs that help blood sugar management and may lead to weight loss, continues to grow. With more medications hitting the market that claim to lower blood sugars and help people lose weight, it can be difficult to discern which may be best for you—especially if some have the same active ingredient. Two that often come up? Rybelsus vs. Ozempic.
Though both are manufactured by Novo Nordisk and contain semaglutide as the main active ingredient, one is an oral tablet and the other is an injectable—that’s just the beginning of their differences.
Meet the experts: Betul Hatipoglu, M.D., professor of medicine, at Case Western Reserve University School of Medicine; Priya Jaisinghani, M.D., an endocrinologist at NYU Langone Health; and Akhil Shenoy, M.D., endocrinologist and medical advisor at Aeroflow Diabetes
Ahead, find out everything you need to know about Rybelsus vs. Ozempic for weight loss and type 2 diabetes, according to endocrinologists.
Rybelsus vs. Ozempic uses
Both drugs help people with type 2 diabetes manage blood sugar and slow gastric emptying. They do so by mimicking the naturally occurring GLP-1 hormone in the body. Both drugs help decrease A1Cs (a single blood test that indicates a three-month blood sugar average) in people with type 2 diabetes.
Rybelsus
As a type 2 diabetes drug, Rybelsus is a prescription oral tablet that, when used alongside diet and exercise, works to improve blood sugar in adults with type 2 diabetes. According to the drug’s website, it works to lower blood sugar by increasing insulin released from the pancreas, decreasing sugar released from the liver, and slowing food leaving the stomach after eating. Though not intended for weight loss, it may help you lose weight. According to the drug’s website, results from a six-month study with 703 adults with type 2 diabetes compared 7 mg and 14 mg Rybelsus with a sugar pill when both were taken with adjustments to diet and exercise. Those taking the medication lost around 8 lbs, while those who took a sugar pill lost around three. While many people in medical studies lost weight, some did gain weight.
Ozempic
Ozempic is a once-weekly injection used along with diet and exercise to improve blood sugar in adults with type 2 diabetes. The medication may help you lose weight, though that’s not its intent (Wegovy, which has the same active ingredient, is intended for weight loss). It has also shown heart-health benefits, even gaining approval from the U.S. Food and Drug Administration (FDA) to reduce the risk of heart attack, stroke, or death in adults with type 2 diabetes and known heart disease. According to a study from the drug’s manufacturer listed on its website, adults with type 2 diabetes taking the drug lost up to 14 lbs, whereas the placebo group lost three.
Rybelsus vs. Ozempic dosage
Rybelsus
Rybelsus comes in 3 mg, 7 mg, and 14 mg daily doses, explains Dr. Jaisinghani.
Ozempic
Ozmepic is available in 0.25 mg, 0.5mg, 1 mg, and 2 mg weekly doses, says Dr. Jaisinghani.
Rybelsus vs. Ozempic ingredients
Rybelsus
“Rybelsus has the active ingredient semaglutide and inactive ingredients including magnesium stearate, microcrystalline cellulose, povidone, and salcaprozate sodium (SNAC),” explains Dr. Jaisinghani.
Ozempic
“Ozempic has the active ingredient semaglutide and inactive ingredients including disodium phosphate dihydrate, propylene glycol, phenol, and water for injection,” Dr. Jaisinghani says.
Rybelsus vs. Ozempic differences
Rybelsus is an oral tablet taken daily, while Ozempic is a weekly injectable drug. The medications also have different potency and dosing, as listed above.
“They are similar in effectiveness overall. However rybelsus does not have a label as heart protective rather it is safe—currently,” explains Betul Hatipoglu, M.D., professor of medicine, at Case Western Reserve University School of Medicine.
Another difference can be found in the drugs’ price tags. Ozempic cost in the U.S. depends on insurance coverage. Without insurance, it can be upwards of $900 for a single 1.5 mL pen, according to the drug’s manufacturer. Meanwhile, 30 tablets of 7mg of Rebylsus may cost over $1,000, though the drug’s manufacturer is less explicit about Rybelsus pricing.
Rybelsus vs. Ozempic: Which is more effective?
“Ozempic is one of the strongest medications for diabetes and weight loss that we have ever had in the history of medicine,” says Akhil Shenoy, M.D., endocrinologist and medical advisor at Aeroflow Diabetes. “Rybelsus is weaker and has similar efficacy to other oral anti-diabetes medications (very generally speaking).”
But, it really depends on the intended use and the patient. Looking at data from the drugs’ manufacturer shows that both are effective. In a study with patients living with type 2 diabetes, patients were randomized to take Ozempic 0.5 mg, 1.0 mg weekly, or a placebo. The study noted an A1c difference at weel 30 of -1.2 in those that took 0.5 mg of Ozempic, and -1.4 I those that took 1.0 mg weekly, when compared to the placebo group. The study also showed that those taking Ozempic lost more weight than the placebo group. Participants who took 0.5 mg of Ozempic weekly lost 2.6 kg and those who took 1.o mg lost 3.5 kg, explains Dr. Jaisinghani.
For Rybelsus, in a study with patients living with type 2 diabetes, patients were randomized to take 3, 7, or 14 mg daily tablets or a placebo. “The study noted a hemoglobin A1c difference from placebo of -0.9 and -1.1 at week 26 for Rybelsus 7 mg or 14 mg daily respectively. The study also noted differences in weight from placebo - 0.9 kg and -2.3 kg for Rybelsus 7 mg or 14 mg daily respectively,” Dr. Jaisinghani says.
These two drugs have yet to be compared in a single study. So, with the given data, it appears that those taking Ozempic showed a greater reduction in A1Cs and weight compared to the participants in the Rebylsus study.
Rybelsus vs. ozempic safety
Rybelsus side effects
The most common side effects may include, according to the drug’s website:
Nausea
Stomach pain
Diarrhea
Decreased appetite
Vomiting
Constipation
More serious side effects may include:
Possible thyroid tumors, including cancer
Pancreatitis (inflammation of the pancreas)
Change in vision
Low blood sugar (hypoglycemia)
Kidney problems (kidney failure)
Allergic reactions
Gallbladder problems
Ozempic side effects
The most common Ozempic side effects may include:
Gastrointestinal upset (upset stomach)
Nausea
Reflux
Vomiting
Diarrhea
Constipation
Stomach pain
More serious side effects may include:
Pancreatitis
Appendicitis
Thyroid cancer
Decreased kidney function
Allergic reactions
Angioedema
Rybelsus vs. Ozempic: Which should I take?
The indications for diabetes management are similar for both, explains Dr. Hatipoglu. When looking at the studies available, Ozempic appears to be stronger, but it also comes with more anecdotal side effects (Ozempic face, Ozempic butt, Ozempic personality, etc.)
If you’re looking for a medication that also offers FDA-approved heart health benefits, Ozempic may be your choice. “Ozempic is approved for heart benefits, versus Rybelsus is described as safe for the heart,” Dr. Hatipoglu says.
“Our primary goal for our patients is to ensure they are prescribed medications that they feel comfortable with and can consistently take to maintain adherence to their treatment plan,” says Dr. Jaisinghani. “For patients that find subcutaneous medications inconvenient or unsuitable, they may prefer taking an oral alternative.”
Can someone switch between Rybelsus vs. Ozempic?
Yes, this can be considered if patients prefer one over the other, says Dr. Hatipoglu. Dr. Shenoy agrees, saying that someone taking one can switch between the two. Just be sure you do so under the supervision of your prescriber.
“Patients who are taking Rybelsus 14mg daily can transition to Ozempic 0.5 mg weekly,” says Dr. Jaisinghani. “Patients can transition to Ozempic the day after the last dose of Rybelsus.”
On the other hand, for patients taking Ozempic 0.5 mg weekly, they can transition to Rybelsus 7 mg or 14 mg daily, Dr. Jaisinghani says. “Patients can transition to Rybelsus up to one week after their last Ozempic administration,” she explains.
When to see a doctor
If you’re considering these medications, or even switching to one from the other, Dr. Jaisinghani says to speak to a professional. “Communicate your goals to your doctor, whether they involve managing blood sugar levels, managing weight, improving heart health, or a combination of these objectives,” she says.
Dr. Hatipoglu says, “If you have diabetes mellitus, definitely bring them up during your visit and discuss them to understand if it will work for you.”
You Might Also Like
