Wegovy pill vs injection

The Wegovy pill and injection are created by the same manufacturer and contain the same active ingredient (semaglutide), so work in the same way. However, there are a few differences, which are summarised in this table:

Scroll to see the main differences between the Wegovy pill and injection.

Yes. The Wegovy pill has been proven in clinical trials to be effective at reducing appetite and helping with weight loss. The average percentage of weight loss from starting body weight is only about 3% less on the highest dose of the Wegovy pill compared to the highest injection dose. However, the injectable version of Wegovy has also been studied for longer (72 weeks vs 64 weeks) and currently has more clinical data available.

Either way, studies on Wegovy tablets have shown very promising results, and it makes a great alternative to injections for those who prefer.

How they work

The Wegovy pill and injection both contain semaglutide, a glucagon-like peptide 1 (GLP-1) receptor agonist. Semaglutide works by mimicking a natural hormone in your body called GLP-1. This hormone helps regulate your:

• appetite, by sending signals to your brain that you’ve eaten and are full
• digestion, by slowing down the digestion of food, keeping your stomach feeling fuller for longer
• blood sugar levels, by regulating how much insulin you produce to stop blood sugar spikes and prevent cravings

Effectiveness

The most recent clinical trial data on Wegovy injections, called STEP UP, found that people taking 7.2mg (the highest maintenance dose) once weekly for 72 weeks can lose on average 21% of their weight.

The most recent studies on the Wegovy pill, called the OASIS trials, found that people taking 25mg (the highest maintenance dose) once a day for 64 weeks can lose an average of up to 17% of their weight.

Other weight loss data from both trials are shown in this table:

Scroll to see the effectiveness data.

Why is the effectiveness different for the Wegovy pill and injection if they contain the same ingredient?

The main reason the Wegovy pill has a slightly different effectiveness, despite working the same and containing the same ingredient, is that it's taken by mouth. This means it has to travel to your stomach and be broken down before entering your bloodstream, while injections skip the digestive system.

The Wegovy injection has a bioavailability of 89%, which means 89% of the medication is absorbed into your bloodstream and becomes available for your body to use. In comparison, the bioavailability of semaglutide tablets is 0.4 to 1%.

To counter this, the manufacturer has added salcaprozate sodium (SNAC) into the Wegovy pill. This is also used in the semaglutide tablet Rybelsus, which is for type 2 diabetes.

“SNAC helps protect medications from stomach acid and digestive enzymes, which would normally break them down before they can be absorbed. It also helps more of the medication pass through the stomach lining and into your bloodstream.

This is also why you need to take the Wegovy pill on an empty stomach, with only a sip of water (no more than 120ml), and wait 30 minutes before eating or drinking anything else. This gives time for the pill to be absorbed and for SNAC to work. If you do not follow this guidance, such as if you eat and drink straight after, you may not get much effect from the Wegovy pill.” – Dr Kathryn Basford

The Wegovy injection is taken once weekly using a pre-filled injection pen, while the Wegovy pill is taken once daily as a tablet. Both treatments follow gradual dose increases to help reduce side effects and allow your body to adjust.

How to take Wegovy injections

Wegovy injections are taken once a week on the same day and time each week. You inject the medication under the skin of your:

• stomach
• thigh
• upper arm (with help)

We have a full guide on injecting Wegovy safely if you want to learn more, and all the information you need will also come with your medication.

Wegovy pen types

The injection is given using a Wegovy pen. Depending on the pen type, this may be:

• a multi-dose pen (contains 4 weeks of treatment) – doses up to 2.4mg come in a multi-dose pen, which you will need to prime on first use, and use a fresh needle for each injection
• a single-dose pen (contains 1 dose of treatment) – for Wegovy 7.2mg only

Wegovy 7.2mg is a new, higher dose of Wegovy and has been created as single-use pens. This means you do not need to attach a needle, as it’s built in. Each pen lasts for 1 injection before being discarded, so you’ll be given 4 pens for 1 month of treatment.

Wegovy injection dosage schedule

The standard Wegovy injection dosage schedule increases gradually over several months:

• Weeks 1 to 4: 0.25mg
• Weeks 5 to 8: 0.5mg
• Weeks 9 to 12: 1mg
• Weeks 13 to 16: 1.7mg
• Weeks 17 to 20: 2.4mg
• Week 21+: 7.2mg

You may remain on lower doses if side effects are persistent or stronger at higher doses. You can also choose to stay on a lower dose if you want to lose weight more slowly or are happy with your results at the current dose. 2.4mg and 7.2mg are the standard maintenance doses.

How to take the Wegovy pill

The Wegovy pill is taken once daily. You need to:

• take it on an empty stomach
• swallow it whole with a small amount of water (no more than 120ml)
• wait 30 minutes before eating, drinking, or taking any other medication

This helps improve how much semaglutide your body absorbs. Unlike injections, the tablet must be taken every day for the medication levels to remain effective in your body.

Wegovy pill dosage schedule

The Wegovy pill also follows a gradual dose increase to reduce side effects:

• Weeks 1 to 4: 1.5mg
• Weeks 5 to 8: 4mg
• Weeks 9 to 12: 9mg
• Weeks 13+: 25mg

Higher tablet doses are needed compared to injections because semaglutide taken by mouth is absorbed less effectively through the stomach. As with the injection, you can discuss staying on a lower dose of the Wegovy pill if you have side effects, or are happy with your results and do not want to increase your dose. You can always increase it later.

The Wegovy pill and injection have very similar side effects because they contain the same active ingredient. However, stomach-related side effects may happen slightly more often with tablets because the medication passes through the digestive system first and is taken on an empty stomach.

The most common side effects of Wegovy pills and injections include:

• nausea (feeling sick)
• diarrhoea
• vomiting (being sick)
• constipation
• stomach pain
• changes in skin sensations
• headache
• tiredness (fatigue)
• upset stomach
• dizziness
• feeling bloated
• burping or gas
• low blood sugar in people with type 2 diabetes
• stomach flu
• heartburn
• hair loss

Typically, common side effects are reported at the start of treatment for both the pill and injection, or after a dose increase. They tend to be mild to moderate and get better over time. You should let your doctor know if you get side effects, especially if they are severe or do not get better.

People using injections may also experience injection site reactions, such as:

• redness
• bruising
• itching
• mild pain where the injection was given

These side effects are usually temporary, and it helps to rotate your injection site and leave the injection out of the fridge for 30 minutes before injecting it. Very cold injections can sting more.

For a full list of side effects, you can also read the patient information leaflet for Wegovy injections. The Wegovy pill has not been released in the UK yet. An up-to-date, full list of side effects will be available once it is.

Are there any safety differences between the Wegovy pill and injection?

For the most part, side effects of the Wegovy pill and injection are very similar, as the active ingredient is the same. In side effect information from the manufacturer, the type of side effect and how often they happened were similar for Wegovy 25mg tablets and Wegovy 2.4mg injections.

However, the newest dose of Wegovy injections, 7.2mg, has been shown to cause certain side effects more often. This is likely because 7.2mg is stronger than the other doses. In clinical trials, about 10% more people on 7.2mg had gastrointestinal side effects, such as nausea, vomiting, diarrhoea, constipation, or stomach pain, compared to 2.4mg.

Around 23% of patients in clinical trials for Wegovy 7.2mg also reported changes in skin sensations, including:

• burning
• tingling
• skin pain
• sensitive skin

To compare, around 1 to 6% of people taking 25mg Wegovy tablets or Wegovy 2.4mg injections reported changes in skin sensations.

Inactive ingredients

The pill and injection are made with different inactive ingredients, so it’s important that you check that you are not allergic or sensitive to any ingredients in the pill or injection.

The Wegovy pill contains only 2 inactive ingredients: salcaprozate sodium (SNAC) and magnesium stearate.

The Wegovy injection contains:

• disodium phosphate dihydrate
• propylene glycol
• phenol
• sodium hydroxide/hydrochloric acid (for pH adjustment)
• water for injection

In the US, where the Wegovy pill and injection are both available, the pill starts at a lower price than the injection. Prices increase for the pill and injection as you follow the dosage schedule, as stronger doses contain more medication.

In general, tablets are usually cheaper than injections as injectable pens need to be made for each dose, while tablets come in a much smaller, easier form to make. Cost information in the UK will be announced when it becomes available, and will depend on where you get it from. The manufacturer makes the final decision on price.

The Wegovy injection and pill both have their advantages and disadvantages.

The injection is often more convenient for people who prefer weekly treatment, while the tablet may suit people who dislike needles or prefer taking medication by mouth. The best option depends on your routine, lifestyle, and personal preferences.

Which is the right treatment for you?

Scroll to see the benefits and considerations of Wegovy pill and injection.

The prescribing guidelines for the Wegovy pill and injection are the same, as they contain the same active ingredient. This means you are eligible for Wegovy if you:

• have a body mass index (BMI) over 30
• have a weight-related health condition, like pre-diabetes, high blood pressure, or high cholesterol and a BMI between 27 and 30

You must not be:

• allergic to any of the ingredients
• pregnant, planning a pregnancy, or breastfeeding

Can I switch from the Wegovy injection to the pill?

Yes, the Wegovy injection and pill have the same eligibility and prescribing guidelines. The manufacturer recommends stopping Wegovy injections for 1 week before starting tablets. Which dose you switch to depends on which dose you are currently taking, but if you’re taking a high dose of Wegovy injections, you should be able to switch to the highest tablet dose.

At Asda Online Doctor, we already have a switching service for weight loss injections, and we will be able to help you switch from the Wegovy injection to the Wegovy pill when it’s available.

Do the pill and the injection work in the same way?

Yes, the pill and injection both contain semaglutide, so they act on the same GLP-1 receptors and work in the exact same way. They are just taken in a different form and route. They both:

• regulate appetite
• increase feelings of fullness
• manage blood sugar levels

Do I need to keep the Wegovy pill in the fridge?

No. Unlike the injection, Wegovy pills do not need to be kept in the fridge. Store them in their original bottle, away from direct sunlight or moisture.

How long does it take to see results with the Wegovy pill?

In clinical trials, people saw an average 2% weight loss by week 4 of treatment, which means most people will see results within 4 weeks. However, the best results on the Wegovy pill were shown after 64 weeks of daily treatment at the maximum dose of 25mg. It takes time to lose a significant amount of weight, and everyone has a different weight loss experience.

➤ See how Wegovy injection week by week results compare.

What happens if I miss a dose of Wegovy?

If you miss a Wegovy injection dose, and it has been less than 5 days, you can take it as soon as you remember. If more than 5 days have passed, you should skip the missed dose and continue your normal schedule when your next dose is due.

If you miss a Wegovy pill, you can continue with treatment the next day.

Do not take a double dose of either medication to make up for a missed one, as this can increase the chances of side effects. Missing regular doses may reduce the effectiveness of Wegovy.

What are alternatives to the Wegovy injection or pills?

The main alternative to the Wegovy injection is Mounjaro, another GLP-1 weekly injection containing tirzepatide. This mimics a second hormone that is thought to enhance its effects. The effectiveness of both is very similar. There’s also Nevolat, but it's injected once daily rather than once weekly. This also contains a GLP-1 medication, called liraglutide.

➤ Check our Wegovy vs Mounjaro vs Ozempic guide for more information and to see how they compare.

There are no other GLP-1 weight loss pills available yet, but a few are in clinical trials or waiting for approval from regulatory bodies, such as orforglipron.