Rybelsus is one of the new trending weight loss medications gaining attention online. After Ozempic peaked in popularity, more pharmaceutical drugs began gaining attention for their ability to help suppress appetite and assist people on their weight loss journeys. Rybelsus is an oral medication that has the same active ingredient as Ozempic and Wegrovy: semaglutide.

Before we dive into the details, it is important to note that there is no such thing as a miracle weight loss drug. Even though pharmaceutical interventions can help you lose weight, diet and exercise still play an important role in leading a healthy life and maintaining your results.

For those who dislike or cannot tolerate the idea of weight loss injections, Rybelsus could one day be a future oral alternative to Wegovy and Ozempic. For now, however, it’s currently only approved by Health Canada to treat type 2 diabetes.

Rybelsus Uses

Rybelsus is Health-Canada-approved as a type 2 diabetes treatment. Semaglutide acts as a GLP-1 agonist (glucagon-like peptide-1 receptor agonist), which helps lower the amount of blood sugar (glucose) in the body. Rybelsus helps manage type 2 diabetes by signalling the pancreas to produce more insulin. Insulin is a regulatory hormone that helps the body maintain stable blood sugar levels.

Given that many people who are overweight also develop type 2 diabetes, they may be prescribed Rybelsus to manage their condition. While Rybelsus may be approved for weight loss in the future, it is currently only approved as a type 2 diabetes treatment.

The only comparable Rybelsus alternatives are Ozempic and Wegovy. Wegovy is the only injectable semaglutide treatment Health Canada has approved for weight loss. The organization recently published an update regarding Ozempic shortages and other weight-loss medication shortages in the country.

As of January 18, 2024, the Ozempic shortage has ended. However, to combat future shortages, manufacturers are encouraging pharmacists to only fill 30-day supplies. Remember, because these are primarily used to treat type 2 diabetes, it is important for patients who need the medications to maintain healthy blood sugar levels to receive them first.

Weight Loss

More clinical research is needed to determine if Rybelsus is a suitable weight loss treatment. The company that created Rybelsus, Novo Nordisk, recently announced the completion of a 68-week clinical trial to test its efficacy as a weight-loss drug. They report that 15.1% weight loss of participants achieved weight loss with a 50mg dose of semaglutide when taken in conjunction with eating a healthy diet and following an exercise routine. They also report the weight loss figure would have been 17.4% of participants if all had adhered to their treatment regime.

Semaglutide can help weight loss by suppressing appetite. It delays gastric emptying (something all GLP-1 medications do), which causes food to move slower through the digestive tract. This creates a sensation of fullness that lasts longer, which reduces snacking and overeating.

At the same time, GLP-1 medications like Rybelsus also activate the GLP-1 receptor. This makes you feel fuller for much longer than you normally might.

How Long Does It Take for Rybelsus to Start Working?

In the clinical study, patients began to show weight loss consistently within a week of starting treatment. By week 26, weight loss tapered off. Semaglutide will affect each person differently, and more studies are needed to develop an exact timeline on what to expect from treatment. Factors such as dosage, metabolic rate, starting weight, and the level of lifestyle modifications you make will influence how fast the drug begins to deliver noticeable results.

Rybelsus Side Effects

As with any medication, Rybelsus has side effects to know about and carefully consider. Common Rybelsus side effects may include:

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

Nausea is the most common Rybelsus side effect with 20% of people reporting it as a symptom when taking 14 mg daily. According to the drug’s label, about 8% of patients discontinue use at a higher dose due to the side effects.

It is important to be open with your doctor about any side effects you notice, so they can help you manage them effectively. This may involve lowering your dose or monitoring symptoms to see if they improve with time. In many cases, side effects from Rybelsus do improve as your body adapts to the medication.

Rybelsus Interactions

Because Rybelsus affects how quickly your body digests food, it can affect how your body absorbs other medications as well. For those who take other oral medications, it is important to consider the impact Rybelsus could have on your health and whether it is an appropriate treatment for you.

The effect of Rybelsus on other medications has been noticed on patients taking Synthroid (levothyroxine), which treats hypothyroidism. You can still take Rybelsus with Synthroid, but you should be monitored by a doctor to ensure the right dosage and prescription to ensure you are getting the maximum benefit from both medications.

Another potential interaction of Rybelsus is hypoglycemia, a condition marked by excessively low blood sugar levels, when taken with other medications that lower blood-glucose levels. For example, patients who also take insulin will need to discuss whether Rybelsus is safe for them to take to avoid complications.

Rybelsus Warnings

Rybelsus has a black box warning (the most serious advisory for any medication) for patients with a family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN2).

Patients with diabetic retinopathy, pancreatitis, acute kidney injury, and an allergic history to semaglutide or other ingredients in Rybelsus should also avoid the medication.

Rybelsus Dosing

Rybelsus can be prescribed as 3 mg, 7 mg, or 14 mg tablets. Research has shown that even higher doses of Rybelsus are modest, though it does seem to be most effective when taken at a higher dose. Currently, Novo Nordisk is studying the effects of Rybelsus for weight loss at 25 and 50 mg doses.

Alternatives to Rybelsus for Weight Loss

Because Rybelsus is not currently approved as a weight-loss drug or available for use as one off-label, you will have to explore Rybelsus alternatives if you’re interested in using GLP-1 agonists.

Wegovy is Health-Canada-approved and expected to be available in spring 2024. It is the form of Ozempic specifically approved for weight loss and weight management. Saxenda (liraglutide) is another approved drug for weight loss, but it is not available as an oral form.

The only way to take GLP-1 agonists is a subcutaneous injection. The needle is very small and thin, so it is not likely to cause any discomfort. Currently, more research is needed to see how Rybelsus could compare to Wegovy or Saxenda.

While Rybelsus is the only GLP-1 agonist you can take orally, there are several other oral weight loss medications to consider:

• Qsymia (phentermine/topiramate)
• Contrave (naltrexone/bupropion)
• Xenical, Alli (orlistat)

Is Rybelsus as Good as Ozempic?

Because they have the same active ingredient, Rybelsus and Ozempic can both be used as effective type 2 diabetes treatment. However, Rybelsus appears to be more effective at regulating blood sugar levels, and Ozempic has shown to be more effective as a weight-loss treatment.

As time goes on, more information about Rybelsus for weight loss will be revealed. At higher doses, it may someday be comparable or more effective than Ozempic. Currently, we need more research to definitively say which one is better.

In any case, you should always work with a licensed doctor you can trust. Remember, just because a medication is better in a study does not always mean it is best for you. The only way to find the right treatments for your unique body is to work with a physician who will take the time to understand you, your medical history, needs, and preferences.

Additional Considerations

Semaglutide may help you lose weight, but it is not a cure-all for obesity or chronic weight struggles. Individuals are encouraged to exercise, follow a healthy diet, and lower other risk factors (such as smoking) to improve their outcomes. Leading a healthy life is about so much more than instantly losing extra weight. True freedom and wellness come from learning how to take care of your body and give it the nourishment and movement it needs to thrive.

Sources

• Rybelsus (semaglutide): Side effects, dosage, uses, and more
• Novo Nordisk A/S: Oral semaglutide 50 mg achieved 15.1% weight loss (17.4% if all people adhered to treatment) in adults with obesity or overweight in the OASIS 1 trial
• Rybelsus: Uses, Dosage, Side Effects, Warnings - Drugs.com
• HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use RYBELSUS® safely and ef
• Effect of Oral Semaglutide Compared With Placebo and Subcutaneous Semaglutide on Glycemic Control in Patients With Type 2 Diabetes: A Randomized Clinical Trial | Diabetes | JAMA | JAMA Network

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