Rybelsus vs Ozempic: Differences and Similarities

By Jennifer Nadel, MD
Medically reviewed checkmarkMedically reviewed
August 19, 2022

Rybelsus and Ozempic are prescription medications containing the active drug semaglutide

The Food and Drug Administration (FDA) approved these medications for blood sugar control in people living with type 2 diabetes.

This article will explain the differences and similarities between Rybelsus and Ozempic.

I’ll discuss the uses, dosages, effectiveness, side effects, cost, and warnings, as well as an overall summary of which is best.

Rybelsus vs Ozempic 

Rybelsus and Ozempic are similar medications with slight differences. 

Both medications contain the active ingredient semaglutide and are in a class of drugs called glucagon-like peptide-1 (GLP-1) agonists. 

This class of drugs to work similarly to a naturally occurring hormone that helps the body: 

  • Slow digestion
  • Stimulate insulin release
  • Lower the amount the glucose released by the liver

Uses of Rybelsus and Ozempic

The FDA approved Rybelsus and Ozempic to help adults with type 2 diabetes lower their blood sugar levels.

The American Diabetes Association (ADA) recommends that people newly diagnosed with type 2 diabetes start with the medication metformin.

They encourage continuing metformin if tolerated, along with making lifestyle changes such as eating a balanced diet and regular exercise.

If further blood sugar management is needed, the ADA recommends adding insulin or another diabetes medication, which can include Rybelsus or Ozempic.

Rybelsus and Ozempic are not approved to treat type 1 diabetes.

Other uses of Ozempic

The FDA also approved Ozempic to reduce the risk of cardiovascular events like stroke and heart attack in people diagnosed with both type 2 diabetes and heart disease.

Dosage

Ozempic is a once-a-week subcutaneous injection that comes in a pre-filled injection pen.

Rybelsus comes in pill form that is taken by mouth once a day. 

Ozempic

The initial dose of ozempic is 0.25 milligrams (mg).

After four weeks, the dose increases to 0.5-1 mg once a week.

Rybelsus

The initial dose of Rybelsus is 3 mg once daily for 30 days.  

Then the dose increases to 7 mg for the next 30 days. 

After this, your medical provider will decide if this dose benefits you or if it needs to be increased to 14 mg for better blood sugar management. 

Effectiveness

Currently, no clinical studies directly compare the effectiveness of these medications. 

Rybelsus and Ozempic are effective in helping maintain blood sugar levels in people with type 2 diabetes when used with diet and exercise. 

Studies performed on this class of medication show that these drugs can lower a person’s A1c by about 1%

A1c measures a person’s blood sugar levels over the previous three months. 

Ozempic has additional labeled benefits. 

Clinical studies show it lowers the risk of heart attack, stroke, and death in certain people by 26%

Side Effects

Get emergency help for signs of an allergic reaction such as

  • Hives
  • Trouble breathing
  • Swelling of the lips, tongue, or throat

Because Rybelsus and Ozempic contain the same active ingredient, semaglutide, their side effects are similar. 

Mild side effects

Common side effects include:

Because of the effects on the digestive system, the initial dose of these medications is smaller to help your body adjust to the drug. 

Serious side effects

Call your doctor immediately if you experience:

  • Vision changes
  • Unusual mood changes
  • Thought about hurting yourself
  • Pounding heartbeats or fluttering in your chest
  • Lightheadedness
  • Lump in your neck or trouble swallowing
  • Hoarse voice
  • Pain in your upper stomach spreading to your back
  • Fever
  • Clay-colored stools
  • Yellow skin and eyes
  • Low blood sugar symptoms
  • Lower back pain
  • Urinating less often
  • Stomach flu symptoms

If you believe your symptoms are life-threatening, seek emergency care.

Cost

The cost of the medications depends on several factors, including your insurance plan and pharmacy.

Rybelsus oral tablets 3mg cost around $949 for 30 tablets. 

Ozempic subcutaneous solution (2mg/1.5 mL (0.25 mg or 0.5 mg dose)) costs around $949 for a supply of 1.5 mL.

Patient assistant programs can help cover the cost of these medications. 

Warnings and Interactions

Both Rybelsus and Ozempic come with a black box warning for the risk of a thyroid tumor. 

In studies, semaglutide increased the risk of thyroid C-cell tumors in mice. 

However, it is unknown if this risk also applies to humans. 

Do not take Rybelsus or Ozempic if you or a family member have had medullary thyroid carcinoma. 

Also avoid these medications if you have endocrine neoplasia syndrome type 2. 

Call your medical provider if you have signs of a thyroid tumor, such as

  • Swelling or a lump in your neck
  • Difficulty swallowing
  • A hoarse voice
  • Shortness of breath 

Both medications have drug interactions that you should discuss with your medical provider. 

Avoid drinking alcohol while taking Rybelsus and Ozempic.

Rybelsus and Ozempic are not approved to treat type 1 diabetes or diabetic ketoacidosis.  

Which Is Best?

Talk with your medical provider if you have type 2 diabetes and are looking at possible treatments or switching medications. 

They will review your medical history and help you decide which medication may be best for you or if there is another more suitable option. 

Some key points to remember include:

  • Both Rybelsus and Ozempic contain the same active ingredient, semaglutide. 
  • Rybelsus is an oral tablet you take once a day.
  • Ozempic is a subcutaneous injection you take once a week. 
  • Before trying these medications, the ADA recommends you take metformin first.
  • Both of these drugs are for use with diet and exercise.
  • Ozempic is approved for reducing the risk of heart attack, stroke, and death in people with type 2 diabetes and heart disease. 

How K Health Can Help

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Frequently Asked Questions

Does Rybelsus work as well as Ozempic?
Currently, no studies compare the effectiveness of these medications. Both approved for treating type 2 diabetes. Ozempic is also approved for reducing the risk of heart attack and stroke, while Rybelsus is not.
Is Ozempic cheaper than Rybelsus?
The cost of Ozempic and Rybelsus depends on your health insurance plan and the pharmacy where you purchase your medicines. If needed, there are programs to help cover the cost of either medication.
Can I switch from Rybelsus to Ozempic?
If you want to switch from Rybelsus to Ozempic, speak with your medical provider. The transition is possible, but you need to be monitored by your medical provider.
Does Rybelsus have the same side effects as Ozempic?
Because Rybelsus and Ozempic have the same active ingredient, semaglutide, both have side effects on the digestive system and can cause an upset stomach. The dose is initially started as a small dose and then increased over time.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Jennifer Nadel, MD

Dr. Jennifer Nadel is a board certified emergency medicine physician and received her medical degree from the George Washington University School of Medicine. She has worked in varied practice environments, including academic urban level-one trauma centers, community hospital emergency departments, skilled nursing facilities, telemedicine, EMS medical control, and flight medicine.

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