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Jul 20, 2023

Diabetes

Rybelsus Tablet vs Ozempic Injection

Semaglutide for Type 2 Diabetes

Understanding the difference between Rybelsus and Ozempic is important for effectively managing your type 2 diabetes. While both medications contain the same active ingredient, semaglutide, they offer unique features that may impact your treatment journey. By learning the distinctions between Rybelsus and Ozempic, you'll be able to engage in meaningful discussions with your healthcare provider and make informed decisions about your diabetes management.

How Does Semaglutide Work?

Semaglutide is a medication that belongs to a class of drugs called glucagon-like peptide-1 receptor agonists (GLP-1 RAs). It is used for the treatment of type 2 diabetes. Semaglutide works by mimicking the action of a natural hormone called glucagon-like peptide-1 (GLP-1) in the body.

GLP-1 Hormone in Our Body

GLP-1 is produced in the intestine and helps regulating blood sugar levels. When we eat a meal, GLP-1 is released and stimulates the release of insulin from the pancreas. Insulin helps to lower blood sugar by facilitating the uptake of glucose from the bloodstream into the body's cells.

IAdditionally, GLP-1 slows down the emptying of the stomach, reducing the rate at which carbohydrates are absorbed from the intestines into the bloodstream. It also suppresses the release of glucagon, a hormone that increases blood sugar levels. By these actions, GLP-1 helps to control blood sugar levels and maintain them within a normal range.

Semaglutide Mimics GLP-1

Semaglutide works by binding to GLP-1 receptors in the body and activating them. This leads to increased insulin secretion from the pancreas, reduced glucagon release, and slowed stomach emptying. As a result, blood sugar levels decrease, and the risk of hyperglycemia (high blood sugar) is reduced.

In addition to its blood sugar-lowering effects, semaglutide has been shown to promote weight loss. It acts on the hypothalamus in the brain, increasing feelings of fullness and reducing appetite.

It's important to note that semaglutide, like other GLP-1 RAs, is not a substitute for a healthy lifestyle. It is typically used in conjunction with diet and exercise to optimize diabetes management. Always follow your healthcare provider's instructions and regularly monitor your blood sugar levels while taking semaglutide or any other medication for type 2 diabetes.

7 most questions about Ozempic

Differences Between Rybelsus and Ozempic

Since they contain the same active ingredient, Rybelsus and Ozempic work the same way. In what ways are they different? The main differences are their dosage forms (convenience), some side effects, and cost, depending on your dose.

Formation and Administration
  • Rybelsus: Oral tablet formulation Taken once daily.
  • Ozempic: Injectable formulation. Aministered once a week via subcutaneous injection.
Dosage
  • Rybelsus: The recommended starting dose is 3 mg once daily. After 30 days, the dose may be increased to 7 mg once daily if additional blood sugar control is needed.
  • Ozempic: The recommended starting dose is 0.25 mg once weekly for four weeks. After that, the dose is increased to 0.5 mg once weekly, which is the maintenance dose for most individuals. In some cases, the dose may be further increased to 1 mg once weekly for additional blood sugar control.
Efficacy

Both Rybelsus and Ozempic have been shown to effectively lower blood sugar levels in people with type 2 diabetes. They can also help with weight loss and reducing the risk of cardiovascular events.

Side Effects

The two medications have similar side effects, most of which are gut related.

  • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal pain
  • Decreased appetite
  • Weight loss

    Weight loss is a unique and sometimes desired side effect of Ozempic. Certain studies have shown that Rybelsus may also reduce weight, but not to the same extent as Ozempic.

Ozempic has an additional side effect of injection site pain.

Weight Loss: A Desirable Side Effect of Ozempic

Weight loss is a common side effect of Ozempic. While it is generally considered a “side effect”, it’s often a factor to consider when choosing a medication for your type 2 diabetes. While the medication is not specifically approved by the FDA for weight loss, many healthcare providers will prescribe Ozempic “off-label” for weight loss even in individuals who do not have type 2 diabetes.

How this weight loss occurs is not exactly known but is thought to be related to a decrease in appetite. With less desire to eat, and increased fullness after eating there are less calories consumed and weight is lost.

What about Rybelsus? Since it has the same ingredient it could be assumed that this medication has a similar effect. While this is true, it is not quite to the same extent as the injectable medication. Studies directly comparing the two medications against eachother, and other diabetes drugs have indicated the following levels of weight loss after 26-40 weeks of taking the medication:

  • Rybelsus 14 mg by mouth daily: weight loss of 8.2 – 9.7 lbs
  • Ozempic 1.0 mg injection weekly: weight loss of 9.9 – 14.0 lbs

This variation is due to a number of factors, including the starting weight as well as other medications taken during the studies, such as Jardiance and metformin.

It is also important to note that these studies specifically noted this weight loss at the doses provided, and lower doses are known to have less weight reduction. The studies were also completed on individuals who have diagnosed type 2 diabetes, so it is not entirely certain is this same data remains true if you do not have diabetes.

Cost

The prices of Rybelsus and Ozempic generally comparable. At the typical doses of both Rybelsus and Ozempic, a one-month supply would cost you roughly $1100. However, since Ozempic pens come in set-volumes, if you use an increased dose (greater than 0.5mg per week) you may pay double this price for a monthly supply.

Prices mentioned in this article are based on average retail price at major box chain pharmacy in the U.S. as of July 12, 2023.

References

  1. Rybelsus (semaglutide) tablets, for oral use. Food and Drug Administration. (09/2019). Retrieved July 11, 2023, from https://www.accessdata.fda.gov
  2. Ozempic (semaglutide) injection, for subcutaneous use. Food and Drug Administration. (12/2017). Retrieved July 12, 2023, from https://www.accessdata.fda.gov
  3. Meier JJ. Efficacy of Semaglutide in a Subcutaneous and an Oral Formulation. Front Endocrinol (Lausanne). 2021 Jun 25; 12:645617. doi:10.3389/fendo.2021.645617. PMID: 34248838; PMCID: PMC8269445.
  4. Blundell, J., Finlayson, G., Axelsen, M., Flint, A., Gibbons, C., Kvist, T., & Hjerpsted, J. B. (2017). Effects of once-weekly semaglutide on appetite, energy intake, control of eating, food preference and body weight in subjects with obesity. Diabetes, obesity & metabolism, 19(9), 1242–1251. https://doi.org/10.1111/dom.12932
  5. Diabetes Canada Clinical Practice Guidelines Expert Committee. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes. 2018;42(Suppl 1): S1-S325. Retrieved July 12, 2023, from https://guidelines.diabetes.ca

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