All About Rybelsus

What does Rybelsus cost? Are there savings options?

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.

If you have questions, including how to pay for your prescription or its price with insurance, ask your doctor or pharmacist. To save money on your Rybelsus prescription, explore the following coupon options.

Learn more about how much Rybelsus costs.

What are Rybelsus’s side effects?

Like most drugs, Rybelsus may cause mild or serious side effects. The following lists describe some of the more common side effects that Rybelsus may cause. These lists do not include all possible side effects.

Your doctor or pharmacist can tell you more about the potential side effects of Rybelsus. They can also suggest ways to help reduce side effects.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking Rybelsus and want to tell the FDA about it, visit MedWatch or call 800-332-1088.

Mild side effects

Here’s a short list of some of the mild side effects that Rybelsus can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read the Rybelsus prescribing information.

Mild side effects of Rybelsus can include:

• nausea
• abdominal pain
• diarrhea
• loss of appetite
• vomiting
• constipation
• weight loss

For information on weight loss, see the “Side effect focus” section.

You may have nausea, vomiting, and diarrhea when you first start taking Rybelsus. But mild side effects of many drugs may go away within a few days to a couple of weeks. If they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Rybelsus can occur, but they aren’t common. If you have serious side effects from Rybelsus, call your doctor right away. However, if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects can include:

• changes in eyesight
• low blood sugar
• kidney problems
• boxed warning: thyroid cancer
• inflammation in your pancreas
• severe digestive system side effects, such as severe diarrhea
• allergic reaction

For information on some of these side effects, including the boxed warning, see the next section.

Side effect focus

Learn more about some of the side effects Rybelsus may cause.

Boxed warning

Rybelsus has a boxed warning about the risk of thyroid cancer. A boxed warning is the most serious warning from the FDA.

It’s not known whether Rybelsus increases your risk of developing thyroid cancer. But in rat and mouse studies, there was an increase in thyroid cancer in animals that received semaglutide. (Semaglutide is the active ingredient in Rybelsus. An active ingredient is what makes a drug work.)

Keep in mind that studies in animals do not always show what will happen in people. But doctors do not recommend Rybelsus for people:

• who have had a type of thyroid cancer called medullary thyroid carcinoma (MTC)
• who have a rare genetic condition called multiple endocrine neoplasia syndrome type 2 (MEN 2)
• who have family members with MTC or a history of MTC

What might help

If you have a personal or family history of MTC or have MEN 2, talk with your doctor about treatment options other than Rybelsus. Your doctor can help you find a treatment that’s safe for you.

Weight loss

You may lose weight while you’re taking Rybelsus. However, this medication is not approved by the FDA as a weight loss drug.

In studies, people who weighed on average about 89 kilograms (kg), or about 196 pounds (lb), and took the lowest dose of Rybelsus lost about 2 kg (about 5 lb). This occurred over a period of 6 months.

But while some people in the study lost weight, others gained weight.

Keep in mind that Rybelsus should be used together with healthy eating and exercise habits to manage diabetes. Diet and exercise may help you lose weight. You may also lose weight because of other diabetes medications that you’re taking together with Rybelsus.

Additionally, Rybelsus can cause nausea, vomiting, diarrhea, and loss of appetite. And some people may lose weight because of these side effects.

What might help

Weight loss might be a desired side effect of Rybelsus. But weight loss from nausea, vomiting, and diarrhea may not be safe for you. If you have nausea and vomiting with Rybelsus, tell your doctor. To help ease these side effects, try eating small meals several times a day rather than eating three large meals.

If you have vomiting or diarrhea with Rybelsus, you may become dehydrated. (With dehydration, you have a low level of fluid in your body.) So be sure to tell your doctor about any vomiting or diarrhea.

To help replenish fluids in your body, drink plenty of fluids that contain electrolytes. For example, you could drink diluted fruit juice or sports drinks. Plain water won’t replace electrolyte losses from vomiting and diarrhea.

Certain over-the-counter (OTC) antidiarrheal medications may also help stop diarrhea. But always talk with your doctor before taking any medications with Rybelsus.

In addition, a bland diet that includes low fiber foods may help relieve diarrhea. Foods that can help make your stools firmer include:

• toast
• bananas
• oatmeal
• white rice
• applesauce
• soup or broth

Eating plenty of nutritious calories can help you prevent weight loss. If you’re trying to regain weight that you’ve lost, avoid eating empty calories. Instead, try to choose foods that are high in calories and nutrients. And talk with your doctor about your weight loss concerns.

Inflammation of the pancreas

It’s possible to develop inflammation in your pancreas while you’re taking Rybelsus. This condition is called pancreatitis. Often, pancreatitis caused by medications is mild to moderate in severity. But some people may have severe pancreatitis that can be fatal.

If you develop pancreatitis, you may have severe abdominal pain, nausea, and vomiting. Depending on how severe your pancreatitis is, you may feel only mild tenderness or you may have severe pain. But the pain will be constant and feel like a stabbing sensation. It may even feel like it’s moving toward your back.

To feel less of this abdominal pain, you may tend to bend forward or bring your knees to your chest while lying down.

What might help

When you start taking Rybelsus, your doctor will check to see whether you have pancreatitis. If you’ve had it in the past, your doctor may not prescribe Rybelsus for you.

If you have persistent and severe abdominal pain, with or without vomiting, stop taking Rybelsus and call your doctor right away. They’ll likely check to see whether you have pancreatitis.

If your doctor diagnoses pancreatitis, you won’t be able to take Rybelsus again. Instead, your doctor will prescribe another diabetes medication for you to replace Rybelsus. And they’ll treat your pancreatitis as needed.

Allergic reaction

Some people may have an allergic reaction to Rybelsus. But it’s not known how often allergic reactions occurred with Rybelsus use during studies.

You should be aware of the possible symptoms of an allergic reaction. Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause difficulty breathing.

Call your doctor right away if you have an allergic reaction to Rybelsus. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Does Rybelsus have alternatives?

You may wonder if there are alternatives to Rybelsus. Like Rybelsus, many other drugs are used to treat type 2 diabetes.

Read on to learn about a couple of alternative medications. Also, talk with your doctor about the diabetes treatment plan that’s right for you.

Rybelsus vs. metformin

Rybelsus is a brand-name medication that contains the active ingredient semaglutide. Metformin is an active ingredient that comes as a generic medication.

Both drugs help manage blood sugar in adults with type 2 diabetes as part of a treatment plan that includes healthy eating and exercise habits. Unlike Rybelsus, metformin is also approved for this use in some children.

Rybelsus and metformin come as tablets that you swallow. (Metformin also comes in other oral forms.)

It’s possible to take metformin with Rybelsus. Your doctor can discuss whether taking both or one of these drugs might be the right treatment for you.

Rybelsus vs. Ozempic

Rybelsus and Ozempic are both brand-name medications that contain the active ingredient semaglutide. Both are prescribed to help manage blood sugar in adults with type 2 diabetes when taken with a balanced diet and exercise. Ozempic also has other uses, which your doctor can tell you about.

Unlike Rybelsus, which is taken by mouth, Ozempic is administered by injection. Rybelsus is taken once per day, while Ozempic is taken once per week.

These drugs should not be taken together, but it is possible to switch from Ozempic to Rybelsus with your doctor’s guidance. Your doctor can discuss which of these drugs is a better option for your type 2 diabetes.

What’s the dosage of Rybelsus?

Your doctor will recommend the dosage of Rybelsus that’s right for you. The following text describes commonly used dosages, but always take the dosage that your doctor prescribes.

Form and strengths

Rybelsus comes as tablets that you’ll take by mouth. It’s available in two formulations, which come in the following strengths:

• Formulation R1 comes in 3 milligrams (mg), 7 mg, and 14 mg.
• Formulation R2 comes in 1.5 mg, 4 mg, and 9 mg.

Recommended dosage

You’ll take 1 tablet of Rybelsus once per day. It needs to be taken at least 30 minutes before your first meal of the day. And be sure to take Rybelsus with no more than 4 ounces of plain water.

Do not take Rybelsus with food, beverages (besides water), or other medications that are taken by mouth.

Your doctor will start you on the lowest dose of Rybelsus for the first 30 days of treatment. After 30 days, your doctor will likely raise your dose to help you achieve your blood sugar goals. If you haven’t reached your goals after another 30 days, your doctor may raise your Rybelsus dose again.

The dose you take will depend on the formulation your doctor recommends. If your doctor prescribes formulation R1, you’ll take a dose of 3 mg once per day for the first 30 days. Then you’ll take 7 mg once per day. After another 30 days, if your blood sugar isn’t well-managed, your doctor may increase your daily dose to 14 mg.

Likewise, if your doctor prescribes formulation R2, you’ll take 1.5 mg once per day for 30 days, followed by 4 mg once per day. If needed, they may raise your dose again to 9 mg once per day.

The formulations of Rybelsus aren’t interchangeable. If your doctor recommends switching between formulations, they will give you instructions on how to do so.

Questions about Rybelsus’s dosage

Here’s a list of some common questions related to the dosage of Rybelsus.

• What if I miss a dose of Rybelsus? If you miss a dose of Rybelsus, take your next dose the following day as usual. Then go back to your regular schedule. But do not take an extra dose to make up for the missed dose.
• Will I need to use Rybelsus long term? Diabetes is a long-lasting condition, so you may need to take Rybelsus long term. Talk with your doctor about how long you’ll need to take this drug.
• How long does Rybelsus take to work? Your blood sugar levels may start to be managed with Rybelsus after 30 days of taking the drug. But it may take several months before major improvements occur. In studies, Rybelsus made significant improvements in people’s blood sugar levels after 26 weeks of treatment.

What are some frequently asked questions about Rybelsus?

Here we answer common questions about Rybelsus.

Do Rybelsus 3-mg doses cause different side effects from 7-mg doses?

The manufacturer of Rybelsus didn’t report how often side effects occurred in people taking 3-milligram (mg) doses of this drug. But there were differences reported between people taking 7-mg doses and 14-mg doses.

For example, nausea and vomiting were more common in people taking 14-mg doses than in people taking 7-mg doses. And constipation was more common in people taking 7-mg doses.

If you have bothersome or concerning side effects from taking Rybelsus, talk with your doctor. They can tell whether your side effects may be related to your dosage of this drug.

Is Rybelsus used for weight loss?

Rybelsus is not approved by the Food and Drug Administration (FDA) as a weight loss aid. Instead, it’s used together with healthy eating and exercise habits to manage blood sugar levels in adults with type 2 diabetes.

It’s possible that you’ll lose weight during Rybelsus treatment, but the drug is not approved for this specific use. To learn about therapies for weight management, talk with your doctor.

Will I have hair loss with Rybelsus?

It may be possible. While hair loss wasn’t seen in people during studies of Rybelsus, this side effect was reported after the drug became available. Keep in mind that Rybelsus is used in people with type 2 diabetes. And this condition may cause hair loss in some people.

If you’re having hair loss with Rybelsus, tell your doctor. They can recommend ways to help manage this side effect.

Are Rybelsus and Januvia taken together?

Rybelsus may be used with other drugs for diabetes, but Januvia isn’t commonly used with it.

Januvia is an alternative treatment for type 2 diabetes. This means that it might be used instead of Rybelsus for some people.

To learn more about Januvia, talk with your doctor. They can recommend the treatment plan that’s best for you.

What should I know about stopping Rybelsus?

If your doctor recommends it, you can stop taking Rybelsus. But be sure to discuss it with your doctor.

If you stop taking this drug, your blood sugar levels won’t be managed by it any longer. Your doctor can recommend whether diet and exercise are enough to manage your blood sugar levels or if you’ll need to take a different diabetes medication.

Is Rybelsus used for type 2 diabetes?

If you have type 2 diabetes, your doctor may prescribe Rybelsus for you.

This drug is used together with healthy eating and exercise habits in adults with type 2 diabetes. Rybelsus can help you manage your blood sugar levels.

With type 2 diabetes, your body either doesn’t make enough insulin or doesn’t respond as usual to insulin. Your pancreas makes insulin. It’s a hormone that helps lower your blood sugar levels.

Rybelsus is a glucagon-like peptide-1 (GLP-1) receptor agonist. GLP-1 is a protein that’s found naturally in your body. It has a role in helping manage your blood sugar levels. For more information, see the “How does Rybelsus work?” section.

Note: Rybelsus isn’t meant as a treatment for people with type 1 diabetes because it would not be effective for this condition.

How does Rybelsus work?

If you have type 2 diabetes, Rybelsus can help you manage your blood sugar.

Rybelsus is a glucagon-like peptide-1 (GLP-1) receptor agonist. GLP-1 is a protein that’s found naturally in your body. Rybelsus works to lower your blood sugar levels by:

• Increasing your body’s release of insulin: When you take Rybelsus, your pancreas releases more insulin. Insulin helps move sugar out of your blood and into your cells, lowering your blood sugar level.
• Blocking your body’s release of glucagon: When you take Rybelsus, your pancreas releases less glucagon. Glucagon activates your liver to make sugar, raising your blood sugar level.

For more information about how Rybelsus works to manage blood sugar, talk with your doctor or pharmacist.

How is Rybelsus taken?

Your doctor will explain how you should take Rybelsus. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions.

Taking Rybelsus

Rybelsus comes as tablets that you’ll take by mouth.

It needs to be taken at least 30 minutes before your first meal of the day. Be sure to take Rybelsus with no more than 4 ounces of plain water.

You cannot take Rybelsus with food, beverages (besides water), or other medications that are taken by mouth. If you do not have an empty stomach when you take this drug, the amount of Rybelsus that your body absorbs will be lower than it should be.

Taking Rybelsus with other drugs

You may need to take other diabetes medications with Rybelsus to help manage your blood sugar levels. For example, your doctor may have you take the diabetes drug metformin with Rybelsus.

Your doctor will recommend whether using other drugs with Rybelsus is something you should do.

Keep in mind that you cannot take Rybelsus at the same time as you take other diabetes medications by mouth. Instead, you must wait at least 30 minutes between taking Rybelsus and taking other medications by mouth. You should take Rybelsus before, instead of after, you take other medications by mouth.

The effectiveness and safety of taking Rybelsus alone and with other diabetes drugs have been studied. The studies have shown that taking other diabetes medications together with Rybelsus can help you achieve your blood sugar goals.

Questions about taking Rybelsus

You may have questions about taking Rybelsus. Here we answer some questions related to the dosage of this drug.

• Can Rybelsus be chewed, crushed, or split? No, you should not chew, crush, or split Rybelsus pills. Instead, you must swallow them whole. If you have difficulty swallowing whole pills, talk with your doctor or pharmacist. They’ll help you find a solution to take your medication safely.
• Should I take Rybelsus with food? No, you should not take Rybelsus with food. Instead, you should take Rybelsus 30 minutes before your first meal of the day with no more than 4 ounces of plain water. If you take Rybelsus with food or beverages besides water, you may absorb less of the drug than you’re meant to. And waiting less than 30 minutes before eating or taking other medications by mouth can also alter the effectiveness of Rybelsus.

Questions for your doctor

You may have questions about Rybelsus and your treatment plan. It’s important to discuss all of your concerns with your doctor.

Here are a few tips that might help guide your discussion:

• Before your appointment, write down questions like:
  • How will Rybelsus affect my body, mood, or lifestyle?
• Bring someone with you to your appointment if doing so will help you feel more comfortable.
• If you do not understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So do not be afraid to ask questions or offer feedback on your treatment.

Does Rybelsus have any interactions?

Taking medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions.

Before taking Rybelsus, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions with Rybelsus these items may cause.

Note: The following lists do not contain all types of drugs that may interact with Rybelsus. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with use of Rybelsus.

Interactions with drugs or supplements

Rybelsus slows down digestion in your body. So it can affect how other drugs are absorbed if you take them at the same time as you take Rybelsus.

To ensure correct absorption of other drugs, you must follow the recommendations given for when to take Rybelsus. For more information, see the “How is Rybelsus taken?” section.

Your doctor may need to monitor how much of other certain drugs you have in your bloodstream if you’re taking them with Rybelsus. Some of these drugs include:

• the anticoagulant warfarin (Jantoven)
• the thyroid medication levothyroxine (Synthroid)
• the antiseizure medications carbamazepine (Tegretol) and phenytoin (Dilantin)
• the antipsychotic medication lithium (Lithobid)
• the heart medication digoxin (Lanoxin)
• the immune system blocker tacrolimus (Prograf)

Interactions with other diabetes medications

You may need to take Rybelsus with other diabetes medications that help lower your blood sugar level. But certain drug combinations may lower your blood sugar too much.

For example, using Rybelsus with insulin or insulin secretagogues may make your blood sugar level too low. (Insulin secretagogues are drugs that help your body release insulin.)

Examples of insulin secretagogues include:

• sulfonylureas, such as glimepiride, glipizide (Glucotrol XL), and glyburide (DiaBeta)
• meglitinides, such as repaglinide and nateglinide

If your blood sugar level drops too low while using insulin or insulin secretagogues with Rybelsus, your doctor may lower your dosage of insulin or insulin secretagogues.

Other interactions

It’s unknown whether any herbs or natural products interact with Rybelsus. Talk with your doctor or pharmacist if you have questions about taking anything with Rybelsus.

There aren’t any foods known to interact with Rybelsus. However, if you take Rybelsus with food, the amount of the drug your body absorbs will be lowered. So you should always take Rybelsus on an empty stomach, at least 30 minutes before your first meal of the day.

Does Rybelsus have precautions for its use?

Before taking Rybelsus, talk with your doctor about whether this drug is right for you. Precautions and considerations for its use are described here.

Boxed warning

Rybelsus has a boxed warning regarding the risk of thyroid cancer. A boxed warning is a serious warning from the FDA.

In mice and rats, semaglutide can cause thyroid cancer. Semaglutide is the active ingredient in Rybelsus. (An active ingredient is what makes a drug work.) But animal studies do not always show what will happen in people.

Due to the risk of thyroid cancer, doctors typically won’t prescribe Rybelsus to certain people. For more information, see the “Rybelsus side effects” section.

Other warnings

Before taking Rybelsus, discuss your health history with your doctor. Rybelsus may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

• diabetic retinopathy
• an allergic reaction to Rybelsus or any of its ingredients
• low blood sugar
• kidney problems, such as kidney failure
• inflammation in your pancreas
• delayed emptying of the stomach
• planned surgery

Can alcohol be consumed with Rybelsus?

Some medications interact with alcohol, but Rybelsus isn’t one of them. However, if you drink alcohol, ask your doctor or pharmacist whether it’s safe for you to consume alcohol before starting treatment with Rybelsus.

And remember that Rybelsus should be taken at least 30 minutes before you drink anything other than 4 ounces of plain water. You should avoid drinking alcohol before you take your Rybelsus dose.

Can I take Rybelsus while I’m pregnant or breastfeeding?

If you can become pregnant, are breastfeeding, or are using birth control, it’s important to consider whether Rybelsus is a safe choice for you.

It’s possible for Rybelsus to cause fetal harm if taken during pregnancy. Also, it’s not recommended to breastfeed during Rybelsus treatment.