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Drug vs. Drug

Rybelsus vs. Wegovy: Differences, similarities & side effects

Learn why you might be prescribed Rybelsus or Wegovy to treat your condition
Karen Berger medical writer and reviewer headshot
By | Sep. 3, 2024
An injection and a pill with "vs." between them: Rybelsus vs. Wegovy

Key takeaways

  • Rybelsus and Wegovy both contain the active ingredient semaglutide. Rybelsus is used to manage blood sugar levels in Type 2 diabetes, while Wegovy is prescribed for chronic weight management and reducing cardiovascular risk.

  • Rybelsus is an oral medication taken as a tablet once daily, whereas Wegovy is injected under the skin once a week.

  • Both medications can cause nausea, vomiting, and other gastrointestinal issues, with Wegovy having a higher incidence of these side effects compared with Rybelsus.

  • Both drugs can interact with insulin and sulfonylureas, which can increase the risk for hypoglycemia (low blood sugar).

In this article:

Rybelsus and Wegovy are two brand-name medications that both contain the active ingredient semaglutide. While Rybelsus is used to manage blood sugar levels in people with Type 2 diabetes, Wegovy is prescribed for weight management and reducing cardiovascular risk. Rybelsus is taken by mouth once a day, whereas Wegovy is injected under the skin once a week. Despite containing the same active ingredient, these medications differ in other areas, such as their administration methods, dosing schedules, and approved Food and Drug Administration (FDA) indications. Continue reading to learn more about Rybelsus and Wegovy.

Rybelsus vs. Wegovy: Key differences

Rybelsus and Wegovy are both medications containing semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist. Rybelsus is approved by the FDA  to manage blood sugar (blood glucose) levels in people with Type 2 diabetes. Wegovy is FDA approved for weight management and to reduce cardiovascular risk. Rybelsus is taken orally once daily, and Wegovy is a weekly injection. Both medications are available only as brand-name drugs, with no generics currently available.

Compare Rybelsus vs. Wegovy key differences
Rybelsus Wegovy
Drug class GLP-1 receptor agonist GLP-1 receptor agonist
Brand/generic status Brand Brand
What is the generic name? The active ingredient is semaglutide, but there is not a generic available The active ingredient is semaglutide, but there is not a generic available
What form(s) does the drug come in? Oral tablet: 3 mg, 7 mg, and 14 mg Injection: 0.25 mg per injection, 0.5 mg per injection, 1 mg per injection, 1.7 mg per injection, and 2.4 mg per injection 
What is the standard dosage? The starting dose is 3 mg by mouth once a day for 30 days. After that, the dose may be increased to a higher dose of 7 mg by mouth once a day. After at least 30 days, the dose may stay the same or be increased to 14 mg daily if needed to control blood sugar.  The starting dose is 0.25 mg, injected once a week for 4 weeks under the skin of the upper arm, stomach, or thigh. The dose will be gradually increased to 1.7 mg or 2.4 mg injected weekly. 
How long is the typical treatment? Long-term Long-term
Who typically uses the medication? Adults  Weight management: Adults and pediatric patients 12 years and older

Cardiovascular risk reduction: Adults 

Rybelsus vs. Wegovy: Conditions treated

Rybelsus is FDA approved to improve blood sugar control in adults with Type 2 diabetes mellitus. It is often recommended along with lifestyle changes such as a reduced-calorie diet and exercise. Some healthcare providers may prescribe Rybelsus off-label for weight loss, although it is not specifically FDA approved for this use. 

Wegovy has two FDA-approved uses and is also generally recommended along with diet and exercise: 

  • To reduce body weight and maintain weight loss in:
    • Adults and pediatric patients 12 years and older with a body mass index (BMI) of 30 or higher (obesity)
    • Adults with a BMI of 27 or higher (overweight) and at least one weight-related condition, such as high blood pressure or high cholesterol
  • To lower the risk of major adverse cardiovascular events (heart attack, stroke, and death) in adults with cardiovascular disease who either have obesity or are overweight

RELATED: Who can take Rybelsus for weight loss?

Is Wegovy better than Rybelsus?

Because they have different FDA-approved uses, it can be difficult to compare the two drugs. Rybelsus is FDA approved to control blood sugar levels in people with Type 2 diabetes, while Wegovy is used for weight loss and cardiovascular risk reduction. 

In clinical trials, once-weekly semaglutide (Wegovy) at a dose of 2.4 milligrams (mg) led to significant weight loss in adults with overweight or obesity. Participants lost an average of 14.9% of their body weight compared with just 2.4% in those receiving a placebo (inactive medicine). 

In contrast, although oral semaglutide has been studied for weight loss, it is currently only available in a maximum dose of 14 mg daily, not the 50 mg dose used in trials. The 50 mg dose used in research resulted in a 15.1% average weight loss, but since 50 mg is more than three times the current maximum dose and not available, these results are not directly applicable to real-world use with the current oral formulation of Rybelsus.

Certain factors may impact which semaglutide product your healthcare provider recommends, such as insurance coverage and personal preferences (e.g., weekly injection versus daily oral tablet). While you might see advertisements for inexpensive compounded versions of semaglutide, the FDA has raised safety concerns about these products because they may contain different forms of the active ingredient and are not FDA approved. The FDA advises using only FDA-approved semaglutide products and consulting with a healthcare provider for safe and effective treatment options.

Rybelsus vs. Wegovy: Insurance coverage and cost comparison

Insurance and Medicare prescription coverage vary by plan, with some covering these medications and others requiring prior authorization.

Without insurance, a typical prescription for Rybelsus (30, 7 mg tablets) costs about $1,348. However, you can use a SingleCare coupon to pay $844, saving about $500 per month.

Wegovy’s cost without insurance is about $1,820 per month. However, using a SingleCare coupon can lower the price to $1,197, saving about $600 per month. 

According to the manufacturer’s website, most insurance and Medicare prescription plans pay for Rybelsus. But since Wegovy is a weight loss drug, coverage varies by plan, so it is advisable to check your specific plan’s coverage details for an exact amount.

RELATED: How to save on Wegovy for weight loss

Compare Rybelsus vs. Wegovy cost & coverage
Rybelsus Wegovy
Typically covered by insurance? Yes  Varies 
Typically covered by Medicare Part D? Yes  Varies 
Quantity 30, 7 mg tablets 1 box of 4 single-use injection pens
SingleCare cost $844 $1,197

 

Rybelsus vs. Wegovy side effects

The most common side effects of Rybelsus and Wegovy are related to the digestive system and may include nausea, vomiting, abdominal pain, and constipation or diarrhea.

Serious side effects can also occur. Seek emergency medical help right away if you experience symptoms of an allergic reaction, such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat. Other serious side effects may involve the gallbladder, pancreas, or kidneys. 

This is not a complete list of side effects. Consult your healthcare provider or pharmacist for more detailed information about potential side effects.

Compare Rybelsus vs. Wegovy side effects
Rybelsus Wegovy
Side effect Applicable? Frequency Applicable? Frequency
Nausea  Yes  11–20% Yes  44%
Vomiting  Yes  6–8% Yes  24%
Stomach pain  Yes  10–11% Yes  20%
Diarrhea  Yes  9–10% Yes 30%
Constipation  Yes  5–6% Yes 24%
Flatulence (gas) Yes  1–2% Yes  6%
Source: Rybelsus (DailyMed), Wegovy (DailyMed)

Rybelsus and Wegovy drug interactions

Semaglutide, the active ingredient in Rybelsus and Wegovy, can lower blood sugar levels and may cause hypoglycemia (low blood sugar). This risk is higher when semaglutide is used in combination with insulin or certain diabetes medications known as sulfonylureas. If you are prescribed both, your healthcare provider may lower your dose of insulin or oral diabetes medication to reduce the risk of low blood sugar episodes.

Additionally, semaglutide slows stomach emptying, which can affect the absorption of other medications taken around the same time. In drug interaction studies, no clinically relevant interactions were found. However, it is a good idea to consult your healthcare provider to determine if you need to adjust the timing of any other medications you are taking, especially if you take certain medications that require careful monitoring, such as levothyroxine or warfarin. 

This is not a full list of drug interactions, and others may occur. Consult your healthcare provider for more information about drug interactions and how they may affect you.

Compare Rybelsus vs. Wegovy drug interactions
Drug Drug class Interacts with Rybelsus? Interacts with Wegovy?
Lantus

Novolog

Tresiba

 Insulin  Yes  Yes 
Glimepiride

Glipizide

Glyburide

 Sulfonylureas Yes  Yes 

Rybelsus and Wegovy drug warnings

Rybelsus and Wegovy have a boxed warning, also called a black box warning. This is the most serious warning required by the FDA. In animal studies, semaglutide has caused thyroid tumors. It is not known if this occurs in humans. Call your healthcare provider right away if you take Rybelsus or Wegovy and notice symptoms of thyroid cancer, which include difficulty swallowing or breathing, a hoarse voice, or a lump in the neck. Additionally, you should not take Rybelsus or Wegovy if you have a personal or family history of medullary thyroid carcinoma (MTC) or if you have multiple endocrine neoplasia syndrome type 2 (MEN 2). 

Before taking Rybelsus or Wegovy, tell your healthcare provider about all of your medical conditions and medical history, including if you are pregnant or breastfeeding. These medications can cause harm to an unborn baby and should not be used during pregnancy. If you are planning to become pregnant, you will need to stop taking Rybelsus or Wegovy at least two months before trying to become pregnant. Also, be sure to tell your healthcare provider if you have ever had any of the following:

  • Kidney problems
  • Pancreas problems
  • Type 2 diabetes and related vision problems 
  • Mental health conditions, including depression or suicidal thoughts

Potentially serious problems that require immediate or emergency medical attention include:

  • Inflammation of the pancreas (pancreatitis)
  • Gallbladder disease
  • Low blood sugar
  • Kidney problems
  • Allergic reactions
  • Increased heart rate
  • Complications related to diabetic retinopathy in people with Type 2 diabetes
  • Suicidal thoughts or behaviors

Consult your healthcare provider for more detailed information and medical advice about side effects, precautions, and warnings.

Can you take Rybelsus and Wegovy together?

No, Rybelsus and Wegovy should not be taken together. The prescribing information indicates that semaglutide products, including Rybelsus, Wegovy, and Ozempic, should not be combined. Additionally, semaglutide should not be used with other medications in the GLP-1 receptor agonist class, such as Victoza (liraglutide), Saxenda (liraglutide), or Trulicity (dulaglutide).

Consult your healthcare provider for personalized advice and more detailed information about which medication might be best for you.