Rybelsus for Weight Loss

Dr Babak Ashrafi Clinical Lead for Service Development

Medically reviewed by

Dr Babak Ashrafi

Last reviewed: 19 Jun 2024

Rybelsus is a prescription tablet for managing type 2 diabetes in adults. It is made by Novo Nordisk, the same pharmaceutical company that developed the weight loss injection, Wegovy.

Rybelsus contains the same active ingredient as Wegovy, semaglutide, which is available to buy with a prescription in the UK as a weight loss injection. Currently, Rybelsus is only available as an off-label medicine for weight loss, despite evidence that its active ingredient has been shown to help you lose weight. Superdrug Online Doctors don’t prescribe off-label medications, although we can prescribe approved weight loss treatments like Wegovy and Mounjaro.

What is Rybelsus used for and how does it work?

Rybelsus is an oral tablet that is prescribed to type 2 diabetes patients to control blood sugar levels. The active ingredient semaglutide is a type of medication known as glucagon-like-peptide 1 (GLP-1) receptor agonist. GLP-1 is a hormone naturally produced in the intestine after you have eaten. This hormone regulates your blood sugar levels by:

  • Increasing insulin production: The release of GLP-1 signals to the pancreas to release insulin, which helps the body absorb glucose (sugar) from the blood into cells, where it can be used for energy.
  • Reducing glucose production: GLP-1 reduces glucose production to prevent sudden spikes in blood sugar levels. It does this by reducing how much glucagon is secreted from your liver. Glucagon is a hormone that signals to your liver to release stored sugar.

Additionally, GLP-1 receptors can slow down the emptying of the stomach, making you feel fuller for longer and reducing your overall calorie intake. The medication should be taken alongside a healthy diet and exercise routine to control blood sugar levels.

How long does it take to work?

It takes at least 30 days after you start Rybelsus to see its effects on your blood sugar levels.When you first start taking Rybelsus, your doctor will prescribe a lower dose of 3mg once a day for 30 days, to help your body get used to Rybelsus and reduce the risk of side effects.

After 30 days, your doctor will increase your dose to 7mg once a day, which is a more effective dose for lowering blood sugar levels. This can be increased again to 14mg after 30 days if your blood sugar levels are still not controlled well enough.

How do you take Rybelsus?

You should always take Rybelsus as prescribed by your doctor.

Swallow your tablet whole with water (about half a cup), on an empty stomach, preferably when you first wake up. Do not break it in half, crush or chew it. Wait at least 30 minutes before eating or taking other medicines after taking Rybelsus to help your body absorb it better.

If you forget a dose, skip the missed dose and take your tablet the next day as usual. Do not take two tablets to make up for a missed dose.

Do not stop Rybelsus without speaking to your doctor as your blood sugar levels may suddenly increase.

Can you take Rybelsus long-term?

Taking Rybelsus for type 2 diabetes is supposed to be a long-term treatment. Once you and your doctor have established a dose that you tolerate well, you’ll likely take it long-term, alongside lifestyle changes, to manage your blood sugar levels.

What is the recommended dosage for Rybelsus?

Rybelsus tablets are available in the following doses:

  • 3mg
  • 7mg
  • 14mg

Your doctor will start you on the lowest dose of 3mg once a day for 30 days before increasing your dose to 7mg, an effective dose for reducing blood sugar levels.

Your dose can be increased again to 14mg if well tolerated after another 30 days, to help you reach your blood sugar level targets.

What are the possible side effects of Rybelsus?

As with many medications, you may experience some side effects when taking Rybelsus. Often the side effects are mild and will improve as your body adapts to the medication. Most people experience side effects when their dose is increased to 7mg or 14mg.

Some common Rybelsus side effects (may affect about 1 in 10 people) include:

  • feeling and being sick (nausea and vomiting)
  • diarrhoea
  • constipation
  • stomach pain
  • bloating
  • changes in your vision
  • hypoglycaemia (low blood sugar)
  • tiredness
  • heartburn
  • feeling dizzy
  • reduced appetite and weight loss

How can I manage the side effects of Rybelsus?

It is possible to manage the most common side effects at home. These side effects usually reduce after a few weeks, but you can use the following tips to help with nausea and vomiting:

  • Eat slowly and try eating smaller meal portions throughout the day.
  • Try bland foods like crackers or toast.
  • Stop eating when you feel full.
  • Avoid sweet and fatty foods.
  • Try drinking clear or ice-cold drinks.

Rybelsus may cause some serious side effects which you need to look out for. These include:

  • hypoglycaemia (low blood sugar)
  • anaphylactic reaction (breathing problems, swollen face and tongue, fast heartbeat, feeling weak, and dizzy)
  • pancreatitis (stomach pain from inflammation of the pancreas)
  • diabetic retinopathy (changes in your vision)

Seek urgent medical attention and inform your doctor if you experience any serious side effects when taking Rybelsus.

Is Rybelsus prescribed for weight loss?

Rybelsus is not a licensed treatment for weight loss, although it contains the active ingredient semaglutide which is also in the weight loss injection Wegovy. Rybelsus can be prescribed ‘off label’ as a weight loss treatment but we don’t offer this service.

Can I still take Rybelsus tablets even if I’m not diabetic?

In the UK and US, Rybelsus is currently only licensed to treat type 2 diabetes, but doctors can prescribe it ‘off label’ as a weight loss treatment for eligible patients who do not have diabetes.

Prescribing any medicine ‘off label’ means using it to treat a condition other than what it was originally licensed to treat. You may be able to take Rybelsus tablets if you’re not diabetic, but we recommend taking an approved weight loss treatment as it’s often cheaper, easier to get and comes in the right doses for weight loss.

Dr Babak Ashrafi Clinical Lead for Service Development
Dr Babak Ashrafi Clinical Lead for Service Development

Is it possible to lose weight if you take Rybelsus for type 2 diabetes?

Yes, this 6-month study showed a reduction in blood sugar levels when taking Rybelsus doses of 7mg and 14mg. Participants also reported weight loss of up to 8 pounds (3.6kg) in the same period. The participants of the study took Rybelsus in addition to a healthy diet and exercise.

How effective is Rybelsus for weight loss?

Rybelsus has not been officially approved as a weight loss treatment but people who take it for type 2 diabetes have reported weight loss in addition to reduced blood sugar levels.

Novo Nordisk is currently testing Rybelsus’s effectiveness as a weight loss treatment as part of several clinical trials. Their latest results showed study participants taking an oral 50mg daily dose achieved weight loss of 17.4% after 68 weeks compared to a 1.8% reduction with placebo. They intend to begin the process for regulatory approval soon.

Are there any alternatives to Rybelsus?

Weight loss alternatives

There are different types of available and approved weight loss treatments. They may work differently and are available in several forms, including oral tablets and injections. Your doctor will help you decide the right weight loss treatment for you.

  • Wegovy: A weekly weight loss injection that contains the active ingredient semaglutide. Wegovy works by making you feel fuller for longer by mimicking a hormone that targets areas of the brain that regulate your appetite.
  • Mounjaro: A weekly injectable weight loss treatment that contains the active ingredient tirzepatide. It works in a similar way to semaglutide by making you feel fuller from less food. Mounjaro is also prescribed to treat type 2 diabetes.
  • Saxenda: A daily weight loss injection that reduces your appetite, helping you to feel less hungry and lose weight. Saxenda contains the active ingredient liraglutide which is a glucagon-like-peptide (GLP-1). Due to ongoing shortages in the UK, Saxenda is out of stock long-term.
  • Orlistat: Available to buy over the counter orlistat is a weight loss tablet that should be taken up to three times a day with meals. It works by reducing the amount of fat your body digests.
  • Mysimba: A prescription weight loss medication that is in the form of a tablet and contains naltrexone and bupropion. It works in a similar way to Rybelsus by affecting the part of the brain that controls your appetite.
  • alli: An over-the-counter weight loss tablet that helps you lose weight by reducing how much fat your body absorbs from meals. It contains the active ingredient orlistat.
  • Ozempic: A once-weekly injection that contains the same active ingredient, semaglutide, a synthetic form of the natural GLP-1 hormone in the body. Ozempic is licensed for the treatment of type 2 diabetes but may also be prescribed ‘off label’ as a weight loss treatment.

Type 2 diabetes alternatives

There are a number of effective alternative treatments to Rybelsus for type 2 diabetes including:

Rybelsus vs Trulicity

Both Rybelsus (semaglutide) and Trulicity (dulaglutide) contain synthetic forms of the GLP-1 hormone and are licensed to treat type 2 diabetes. Both medicines might also be prescribed ‘off label’ as weight loss treatments but Superdrug Online Doctor doesn’t provide this service for Trulicity either.

Rybelsus is an oral tablet taken daily while Trulicity is an injection taken once weekly.

Rybelsus vs Metformin

Metformin is a prescription oral medication that is commonly prescribed to treat type 2 diabetes. Metformin tablets can help your body produce more insulin and reduce the amount of sugar produced by your liver.

Rybelsus FAQs

Can you get Rybelsus over the counter?

No. Rybelsus is a prescription-only medicine licensed for treating type 2 diabetes. It is not available to buy over the counter without a doctor’s prescription.

Is Rybelsus the same as Wegovy?

Not exactly. Both Rybelsus and Wegovy contain the active ingredient semaglutide and are manufactured by the pharmaceutical company, Novo Nordisk. They are both licensed to treat different conditions and are available in different doses.

While Rybelsus comes in a tablet form taken daily to treat type 2 diabetes, Wegovy is a weekly injection for weight loss.

Is Rybelsus the same as Saxenda?

No. Rybelsus contains semaglutide while Saxenda contains liraglutide. Both active ingredients work similarly to the natural GLP-1 hormone in the body. This hormone works for weight loss by reducing your appetite and making you feel full for longer.

Both Ryblesus (oral tablets) and Saxenda (injections) are taken daily but Ryblesus is used ‘off label’ for weight loss while Saxenda is a licensed weight loss treatment.

Can you drink alcohol with Rybelsus?

There is no known direct interaction between Rybelsus and alcohol, but alcohol may worsen Rybelsus side effects like nausea and stomach pain.

Alcohol can also affect your blood sugar levels, so you should avoid drinking alcohol if you have type 2 diabetes, especially when you are taking Rybelsus for regulating blood sugar.

Does Rybelsus affect sleep?

There is no clear report about Rybelsus affecting sleep, but tiredness and dizziness are listed Rybelsus side effects which may cause increased sleepiness.

On the flip side, in addition to blood sugar control, Rybelsus can help with weight loss which is known to generally improve sleep quality.

Do you have to drink a lot of water when taking Rybelsus?

No. You should swallow the Rybelsus tablet whole, on an empty stomach, with 4oz (120ml) of water. You should also wait at least 30 minutes before taking any other medicine or food.

If you experience nausea, vomiting, or diarrhoea while taking Rybelsus, it is important to stay hydrated to reduce your risk of dehydration. If you have any of these side effects and they are severe or do not go away, speak to your doctor.


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