Rybelsus vs. Ozempic

Authored by The Rx Advocates, / Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS


Patients with Type 2 Diabetes often need prescription medications to help manage their blood sugar levels. After talking with their doctors, many consider Rybelsus and Ozempic and have difficulty deciding which is right for them.

Both Rybelsus and Ozempic work well to treat Type 2 Diabetes. But if you are weighing your options, it helps to learn as much as possible to make an educated decision.

What is Rybelsus?

Rybelsus is a medication many doctors prescribe for Type 2 Diabetes when other medications have not worked. It is classified as a GLP-1 receptor agonist. But some doctors may opt for this medication in newly diagnosed patients if the benefits outweigh the risks.

Rybelsus is available in generic form under the name semaglutide. It is taken orally once daily; most patients start with 3 mg. After 30 days, most patients increase to 7 mg. Depending on how this medication works, some patients need to increase to 14 mg.

Rybelsus controls blood glucose levels with two mechanisms of action. It increases how much insulin is released while simultaneously decreasing glucagon secretion. This medication works well in many patients when combined with exercise and a healthy diet.

Common Side Effects

The most common side effects patients experience when taking Rybelsus include:

  • Diarrhea
  • Nausea
  • Vomiting
  • Constipation
  • Stomach pain
  • Decreased appetite

Rybelsus may slow digestion, which can make you feel fuller longer.

Some patients experience serious side effects when taking Rybelsus. Talk with your doctor if you have any of the following:

  • Pain in your abdomen that doesn’t go away. This could indicate pancreatitis.
  • Changes in your vision.
  • Kidney problems.
  • Gallbladder problems.
  • Serious allergic reactions.
  • Signs and symptoms of hypoglycemia (low blood sugar).

Many patients experience side effects when they first begin taking Rybelsus, but they go away with continued use.

If you begin taking Rybelsus and have questions about its side effects or experience any dangerous side effects, talk with your doctor. They may want you to try a different medication instead.

Benefits of Rybelsus for Type 2 Diabetes

Many patients taking Rybelsus and other glucagon-like peptide-1 receptor agonists have found that it decreased their A1C levels by about 1%.

This medication may also help with weight loss because it causes you to not feel as hungry. Your doctor may use it in combination with insulin, or with other medications that are approved to treat Type 2 Diabetes.

When combined with a healthy diet and exercise, most patients experience a positive outcome when taking Rybelsus.

What is Ozempic?

Ozempic is similar to Rybelsus in many ways. The same pharmaceutical company, Novo Nordisk, manufactures both medications. This medication is not approved to treat Type 1 Diabetes.

The main difference between these two medications is that Ozempic is available as a self-administered injection. Your initial dose of Ozempic will be 0.25 mg weekly for four weeks. After that, your doctor will prescribe 0.5 mg once weekly for four weeks. They may increase your dose to 1 mg once a week if needed to control your glucose levels.

Ozempic comes as a pre-filled, single-use, disposable injection pen. Your doctor may try other medications for Type 2 Diabetes before trying this one.

Your doctor may consider prescribing Ozempic if you have known heart disease. This medication has been shown to reduce the risk of stroke, heart attack, or death in patients diagnosed with Type 2 Diabetes and heart disease.

Common Side Effects

Most patients taking Ozempic will experience some side effects that should go away or decrease with continued use.

Side effects of Ozempic include:

  • Symptoms of stomach flu
  • Appetite loss
  • Heartburn
  • Bloating
  • Low blood sugar
  • Headaches
  • Dizziness
  • Feeling tired

Serious Ozempic side effects that need to be reported to your doctor right away include:

  • Vision changes
  • Pounding heartbeat
  • Changes in your mood
  • Thoughts of self-harm or suicide
  • Kidney issues
  • Gallbladder problems
  • Pancreatitis symptoms
  • Signs of a thyroid tumor, such as swelling in your neck or problems swallowing

Ozempic Benefits

Like Rybelsus, Ozempic offers many of the same benefits. When taken according to doctor recommendations, you may experience a decrease in your A1C by up to 1%. You may also lose weight due to slower digestion with this medication.

Your doctor may prescribe Ozempic if you have been diagnosed with heart disease. Clinical studies have shown that it lowers the risk of stroke, heart attack, and death in some patients by 26%.

Rybelsus vs. Ozempic: Warnings

Your doctor will discuss the pros and cons of each medication if they are considering which one to prescribe for you. If you take any other medications or supplements, be sure your doctor knows them.

Both Rybelsus and Ozempic typically do not cause low blood sugar on their own. But that risk increases if you are also taking insulin or sulfonylureas.

Your doctor will advise you on how to take your thyroid medication. Because these medications cause slower digestion, they may affect how your body absorbs other medications. For example, if you also take levothyroxine for your thyroid, Rybelsus may lower its absorption by 33%.

Switching Your Medications

If managing your Type 2 Diabetes requires a dose of 14 mg of Rybelsus, your doctor may want you to switch to a once-weekly injection of Ozempic instead.

If you begin taking Ozempic and would instead take an oral medication, your doctor may switch you to Rybelsus without incident.

Talk with your doctor if you have concerns about either Ozempic or Rybelsus.

Rybelsus vs. Ozempic: Which is Right for You?

Your doctor may base their medication recommendations on your personal preference and medical history. If you have a history of heart disease, Ozempic may be recommended. Both have similar side effects and have proven similarly effective in lowering A1C levels.

The Rx Advocates Can Make Your Medication More Affordable

At The Rx Advocates, we understand that some medications are less affordable than others. Both Rybelsus and Ozempic are costly, and your copay could still be very high even if you have health insurance.

We offer financial assistance to patients who qualify for our program. Contact us today to determine your eligibility.

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  3. National Library of Medicine. Glucagon-like Peptide-1 Receptor Agonists. November 26, 2022. Available at ncbi.nlm.nih.gov.
  4. National Library of Medicine. Effects of semaglutide on risk of cardiovascular events across a continuum of cardiovascular risk: combined post hoc analysis of the SUSTAIN and PIONEER trials. September 30, 2020. Available at ncbi.nlm.nih.gov.
  5. Drugs.com. Ozempic. June 8, 2022. Available at Drugs.com.
  6. The New England Journal of Medicine. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. November 10, 2016. Available at NEJM.org.
  7. Drugs.com. Sulfonylureas. December 2022. Available at Drugs.com.
  8. Drugs.com. Drug Interactions between levothyroxine and Rybelsus. December 2022. Available at Drugs.com.
  9. MedicalNewsToday. Rybelsus vs. Ozempic. February 3, 2021. Available at MedicalNewsToday.com.
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