Rybelsus for weight loss

Rybelsus tablets are oral tablets used to treat type 2 diabetes. The active ingredient, semaglutide, belongs to a group of medications called glucagon-like-peptide 1 (GLP-1) receptor agonists. This medication group was mainly used for type 2 diabetes treatment for a long time before studies found that people were also losing weight and having a reduced appetite as a side effect. This led to doctors and scientists doing more research into them as a stand-alone weight loss medication.

Rybelsus is the only type of semaglutide tablet currently available and is manufactured by Novo Nordisk, the same company that manufactures Wegovy. Other GLP-1 receptor agonists include:

• Victoza, Ozempic, and Trulicity (injections for type 2 diabetes)
• Saxenda, Wegovy, and Mounjaro (injections for weight loss)

You can find more about the similarities and differences between Mounjaro, Wegovy and Ozempic and which is best for weight loss in our guide.

When are semaglutide tablets available for weight loss in the UK?

Although Rybelsus isn’t available yet for weight loss, Novo Nordisk have been carrying out clinical trials into its effectiveness for weight management in adults who are clinically obese or overweight, with one or more medical conditions that can be affected by weight, like prediabetes. These are the same requirements for approved medications like Wegovy and Mounjaro.

As the trials show promising results, Novo Nordisk is requesting a licence for semaglutide tablets for weight loss in the UK, but these will be in a different dose than currently offered for diabetes. This process can take a few years, so we can’t give a date they’ll be available yet.

Rybelsus is currently available for type 2 diabetes in 3 doses:

• 3mg
• 7mg
• 14mg

There isn’t a set weight loss dose like the Wegovy dosage schedule, so doctors will likely prescribe Rybelsus in the same way for weight loss as they do for diabetes.

Rybelsus 3mg is the lowest dose of semaglutide available. It’s the starting dose for everyone who takes it, whether you’ve taken a medication with semaglutide or another GLP-1 agonist before. The dose is increased slowly to reduce side effects,so your doctor can monitor your blood sugar levels to see which dose is most appropriate.

You’ll take Rybelsus 3mg once each day, for at least 30 days.

Rybelsus 7mg

If you tolerate Rybelsus 3mg well for 30 days, your doctor will increase your dose to 7mg, which is the recommended dose for blood sugar management. You’ll take Rybelsus 7mg for at least 30 days. If your doctor is happy with your blood sugar levels, you can stay at this dose and they’ll continue monitoring your progress throughout treatment.

If this dose isn’t controlling your blood sugar well enough, your doctor will increase your dose once more after 30 days.

Rybelsus 14mg

The highest dose of semaglutide, Rybelsus 14mg tablets, are taken once a day, for at least 30 days. If your blood sugar still isn’t controlled well enough at this dose after 30 days, they may recommend taking another medication alongside Rybelsus or changing your treatment.

You shouldn’t take more than one 14mg tablet per day, as this is the maximum daily dose and taking too much could increase your risk of side effects.

Semaglutide tablets work in a few different ways:

• For weight loss, it mimics the gut hormone GLP-1 usually released after eating, which sends signals to your brain saying you’re full. It also slows down how quickly your food is digested, meaning it can help you stay full for longer.
• For diabetes, it mimics the release of GLP-1, which signals the pancreas to release insulin. This causes your body to absorb sugar (glucose) from your blood into your cells to be stored for energy. It also stops your liver from secreting as much glucagon (a hormone that sends signals to release stored sugar from your cells). This prevents blood sugar spikes.

At the current doses, Rybelsus hasn’t been proven to be an overly effective medication for weight loss although there is evidence that it could be. Studies into Rybelsus usage at the available doses for 26 weeks found:

• 7mg caused an average loss of 2.3kg
• 14mg caused an average loss of 3.7kg
• a placebo caused an average loss of 1.4kg

Participants all followed a diet and exercise regime as prescribed by their doctor.

Rybelsus was created for type 2 diabetes, so weight loss was only noted as a side effect during these trials. Since then, Novo Nordisk has been studying semaglutide tablets as a weight loss drug, but at a higher dose of 50mg a day. This 68-week study has shown more promising results, including:

• the average body weight change from starting weight was 15.1%
• 85% of patients lost at least 5% of their body weight
• 69% of patients lost 10% or more of their body weight
• 54% of patients lost 15% or more of their body weight
• 34% of patients lost 20% or more of their body weight

Novo Nordisk will use this study to apply for regulatory approval in the UK to release semaglutide tablets for weight loss as a stand-alone product. These will be available at a higher dose of 50mg if approved, and will likely follow a slowly-increasing dosage schedule like Wegovy and Mounjaro do.

According to clinical trials into the doses currently available for Rybelsus vs other approved weight loss medications, we found the following data:

Rybelsus, like all medications, can cause side effects. As the medication is currently only studied in diabetes patients, the side effects could be different for people taking it for weight loss. For information on semaglutide side effects for weight loss, check our Wegovy side effects page.

Serious Rybelsus side effects

• Common: Speak to your doctor if you notice eye problems and have been diagnosed with a condition called diabetic eye disease (retinopathy).
• Rare: Call 999 or get to A&E straight away if you notice signs of an inflamed pancreas (acute pancreatitis), such as stomach and back pain that is persistent, fever, jaundice, nausea or vomiting.
• Rare allergic reaction: Call 999 or get to A&E straight away if you notice signs of a serious allergic reaction, such as breathing problems, swelling, wheezing, fast heartbeat, dizziness or weakness.

Although the frequency cannot be estimated from current data, Rybelsus tablets can cause bowel obstruction (severe constipation). If you’ve got symptoms such as stomach ache, bloating, vomiting, and constipation, see a doctor straight away. If your symptoms are severe, call 999 or go to A&E.

Very common Rybelsus side effects

• diarrhoea
• nausea
• low blood sugar when taking Rybelsus alongside diabetes medications that contain a sulfonylurea or insulin

Common Rybelsus side effects

• low blood sugar when used with oral diabetes medication other than sulfonylurea or insulin
• vomiting
• stomach ache or indigestion
• constipation
• inflamed stomach (gastritis) – symptoms include stomach ache, feeling sick or being sick
• reflux or heartburn – also called gastroesophageal reflux disease
• stomach pain
• bloating
• tiredness
• reduced appetite
• gas (flatulence)
• increase of pancreatic enzymes (such as lipase and amylase) shown in blood tests
• dizziness

Uncommon Rybelsus side effects

• weight loss
• gallstones
• burping
• fast pulse
• allergic skin reactions such as rash, itching or hives
• a delay in the emptying of the stomach
• change in the way food or drink tastes

If you get side effects, speak with your doctor or pharmacist. Most can be managed at home, but persistent or severe side effects should be discussed with a healthcare professional straight away.

For diabetes, Rybelsus can be prescribed for free from the NHS. It’s also available from private services and prices vary.

Rybelsus for weight loss is only prescribed off-label by some private services in the UK. Prices vary from £150 to £400, depending on the number of tablets you order. There may also be further charges for off-label prescribing and delivery.

Weight loss injections containing a GLP-1 receptor agonist are the most popular Rybelsus alternatives in the UK. These require a prescription from our doctors and include:

• Wegovy, the same active ingredient semaglutide in a weekly injectable pen. Works like Rybelsus to reduce appetite and delay stomach emptying, so you can follow a diet plan more easily.
• Mounjaro, containing a similar active ingredient called tirzepatide, this medication mimics GLP-1 and a second hormone that further enhances appetite suppression and feelings of fullness. Also a weekly injectable pen.

We also provide other weight loss treatments, such as tablets and capsules, if you’d prefer an oral medication over an injectable pen. These include:

• Orlistat, a fat-enzyme blocker that contains orlistat. Works differently than Rybelsus and GLP-1 medications as it reduces the amount of fat absorbed from each meal instead. It’s taken up to 3 times per day, and around a third of the fat from your meal will be passed out through your stools.
• Xenical, branded orlistat. Works the same way in the same dose but is manufactured by a different company.
• alli, over-the-counter orlistat that works in the same way, but in a lower dose of 60mg, so it can be bought without a prescription.
• Mysimba, also works on the parts of your brain responsible for appetite and cravings. Contains 2 active ingredients, naltrexone and bupropion to reduce hunger and food cravings, so you can reduce your calorie intake more easily.