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Rybelsus (oral semaglutide) is indicated for the treatment of adults with insufficiently controlled type 2 diabetes to improve glucose control. It contains the active ingredient semaglutide which has been approved for the treatment of obesity. Rybelsus belongs to the same family of GLP-1 Receptor agonist medications that are used for diabetes and weight loss treatment, including Saxenda, Ozempic and WeGovy.
Rybelsus (oral semaglutide) is a GLP-1 (Glucagon Like Peptide-1) Receptor agonist. GLP-1 is a hormone that regulates appetite, blood sugar and cardiovascular health- present in the brain, heart and gut. Rybelsus (oral semaglutide) reduces blood sugar levels by increasing insulin secretion, and reduces body weight and body fat mass by suppressing appetite, reducing craving for fatty foods. This allows the individual to sustain a caloric deficit that is necessary for weight loss.
Rybelsus (oral semaglutide) is safe and effective for the treatment of diabetes and weight loss, as proven by 8 multi-center, global randomised controlled clinical trials that looked at blood sugar levels (using Hba1c) and weight loss.
In the PIONEER 4 trial, 711 patients with diabetes were randomised to Rybelsus semaglutide 14mg, Saxenda liraglutide 1.mg and placebo. After 52 weeks of treatment, the patients in the Rybelsus semaglutide 14mg treatment group achieved a 1.2% reduction in Hba1c and 4.3kg weight loss. The results were more significant in the Rybelsus group compared to the Saxenda group.
In another double blind trial (PIONEER 6) which focused on cardiovascular outcomes, 3,183 patients with diabetes and obesity (mean BMI 32.3) were treated for 16 months. By end of treatment, 35% of patients had loss >5% of body weight, and 15% of patients had lost 10% of body weight in the Rybelsus (semaglutide) group.
Safety of Rybelsus (oral semaglutide) has been well studied in healthy subjects and patients with type 2 diabetes. Following oral administration, peak bloodstream concentration occurred 1 hour later. Steady state exposure is reached after 4-5 weeks of daily oral administration. Absorption of Rybelsus (oral semaglutide) decreases if taken with food or large volumes of water.
Rybelsus (oral semaglutide) is a tablet taken once daily in the morning with small sips of water. After taking the medication, it is recommended not to eat, drink or consume other medication for 30 minutes.
Rybelsus comes in 3mg, 7mg and 14mg dosages. Most patients start at 3mg dose for a month, before increasing to 7mg dose. Where required, 14mg dose may be prescribed.
If a dose is missed, the medication should be skipped for a day and the next dose taken the following day. Do not double dose by taking the medication at night and again on the morning the next day.
Rybelsus (oral semaglutide) is not recommended for patients who are pregnant, breastfeeding or below 18 years of age. Women of child bearing potential should avoid pregnancy and use contraception. No dosage adjustment is required for patients with kidney or liver disease.
Common but minor side effects include: nausea, bloating, vomiting, diarrhea or constipation. These effects are usually transient and improve in 3-4 weeks.
Rare but significant side effects include risk of acute pancreatitis, gallstone formation- hence this medications should be avoided in patients with a history of these conditions
Rybelsus, Ozempic and WeGovy are contain the same medication- semaglutide, and are manufactured by the same pharmaceutical company- Novo Nordisk (Denmark). Ozempic and WeGovy have recently been the subject of significant media attention, with celebrities such as Elon Musk and Oprah Winfrey sharing on social media their weight loss transformation after using these medications. As a result, there is a global shortage of Ozempic and WeGovy, with patients now resorting to off label usage of Rybelsus (oral semaglutide) for weight management
Due to global shortage of Ozempic and WeGovy, it is a common scenario where patients who managed to obtain a prescription (locally or overseas) suddenly find themselves out of supply and need to switch to a close alternative. Rybelsus (oral semaglutide) 14mg is approximately equivalent to injection semaglutide 0.5mg once weekly
Rybelsus is a prescription only medication and is available in medical clinics or hospitals. A doctor’s consultation and prescription is required. Rybelsus is not available for online purchase without prescription or over the counter.
