Rybelsus vs. Wegovy: 5 Differences You Should Know About
Key takeaways:
Rybelsus and Wegovy are two medications that contain semaglutide. But Rybelsus is an oral pill that you take every day and Wegovy is a once-weekly injection.
Rybelsus is only approved to treat Type 2 diabetes in adults. Wegovy is approved for chronic weight management in certain adults and adolescents ages 12 and older. Rybelsus and Wegovy are not considered interchangeable.
Rybelsus isn’t approved for weight loss, but higher doses are being studied for this purpose. Initial results suggest it may cause weight loss that’s comparable to Wegovy.
Rybelsus and Wegovy are only available as brand-name medications. Copay savings cards from their manufacturer can help make your prescription more affordable.
Table of contents
Wegovy (semaglutide), an injectable weight loss medication, has grown in popularity as people search for new ways to manage their weight. But did you know that there’s an oral medication with the exact same active ingredient? Almost 2 years before Wegovy was approved, an oral pill called Rybelsus first hit the market.
Both Rybelsus and Wegovy belong to the same medication class: glucagon-like peptide-1 (GLP-1) agonists. But they’re approved for different uses and are not considered interchangeable. Why is that, and how else are they different? We explore five differences between Rybelsus and Wegovy below.
1. Wegovy and Rybelsus have different approved uses
Wegovy and Rybelsus contain the same active ingredient: semaglutide. And even though the two medications work the same way in the body, they’re approved for different uses.
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Wegovy is a higher-dose semaglutide product that’s approved for chronic weight management. It’s intended for certain adults and adolescents ages 12 and older based on their initial body mass index (BMI):
Adults: A BMI that’s at least 30, or a BMI of 27 or higher with one or more weight-related health conditions (e.g., Type 2 diabetes, high blood pressure, high cholesterol)
Adolescents ages 12 and older: A BMI that’s at least in the 95% percentile for their sex and age
Rybelsus is approved to treat Type 2 diabetes in adults. Its injectable counterpart, Ozempic, is also approved to lower the risk of heart attack and stroke if you have diabetes and heart disease. But this benefit hasn’t been proven with Rybelsus yet. More on this later.
Good to know: Rybelsis isn’t approved for weight loss, but it’s currently being studied for this purpose. It’s thought that higher doses may result in weight loss that’s comparable to Wegovy.
2. Wegovy is available as an injection, while Rybelsus comes as an oral pill
Most GLP-1 agonists, including Wegovy, are available as injections. This is because they’re usually not absorbed very well if you take them by mouth. However, Rybelsus is the first and only medication in this class that comes as an oral pill.
Rybelsus contains a special ingredient that helps improve absorption in the stomach. Even so, there are specific instructions you need to follow when taking it. Take Rybelsus at least 30 minutes before your first food, drink, and medications of the day, with no more than 4 oz of water. This helps to ensure that you absorb as much of your dose as possible.
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3. You need to take Rybelsus every day, but you only inject Wegovy once weekly
No matter how you take semaglutide, it lasts a long time in your system. This is why injectable versions, such as Wegovy and Ozempic, only need to be injected weekly.
But when you take semaglutide by mouth, you only absorb a small amount. And there can be variability in how much you absorb each time you take it. This is why you need to take Rybelsus every day to build up a consistent level of medication in your body. If you take it less often, you may not get the same benefit.
4. Wegovy may also help lower the risk of heart attack, stroke, and heart-related death
Wegovy and Rybelsus haven’t been compared in head-to-head studies. But topline results from a recent trial suggest that Wegovy may also lower the risk of heart-related death, heart attack, and stroke. This hasn’t been confirmed with Rybelsus.
The SELECT trial followed people receiving Wegovy over a period of 5 years. Topline results have shown a 20% decrease in major adverse cardiovascular events (MACE) with Wegovy compared to placebo (an injection without medication). MACE includes heart-related death, heart attack, and stroke.
The PIONEER 6 trial followed people receiving Rybelsus for a little over a year, on average. Rybelsus was found to lower the risk of heart-related death and death from all causes by nearly 50% compared to placebo. But its reduction in MACE wasn’t statistically significant. Longer studies are ongoing to confirm potential cardiovascular benefits.
5. Insurance coverage for Wegovy and Rybelsus may be different
Since Wegovy is only approved for chronic weight management, it may be not covered under your insurance plan. So it pays to check your coverage and estimated out-of-pocket costs ahead of time. It’s possible that Wegovy is covered, but you may have a higher copay or coinsurance.
When it’s used to treat Type 2 diabetes, Rybelsus is covered by most insurance plans. But it’s still a good idea to check your coverage. It’s possible that other GLP-1 agonists may be preferred. Or your healthcare provider may need to show your insurance that you’ve tried other diabetes medications first.
Can you switch from Wegovy to Rybelsus (and vice versa)?
No. Wegovy and Rybelsus are not considered interchangeable. And there isn’t currently a Rybelsus dose that’s comparable to the typical Wegovy maintenance dose either.
However, your healthcare provider may decide to switch you to Wegovy if you’ve been prescribed Rybelsus off-label for weight loss. In this case, they may have you start with a lower Wegovy dose and work your way up, if needed.
But if you’ve been prescribed Rybelsus for Type 2 diabetes and want to switch to an injection, Ozempic would be the best option.
How to save on Rybelsus and Wegovy
Rybelsus and Wegovy are available as brand-name medications. A few ways to make your prescription more affordable include using a manufacturer copay savings card or patient assistance program.
If you’re eligible, you could pay as little as $10 for up to a 90-day supply of Rybelsus with a manufacturer copay savings card. A patient assistance program is also available, providing Rybelsus at no cost to those who qualify.
A manufacturer copay savings card is available for Wegovy. If you’re eligible, you could pay as little as $0 for a 28-day supply of Wegovy.
The bottom line
Wegovy and Rybelsus are medications that both contain semaglutide. But Wegovy is a once-weekly injection, and Rybelsus is a once-daily pill. While they work the same way in the body, Wegovy is approved for chronic weight management and Rybelsus is approved for Type 2 diabetes.
If you think Wegovy or Rybelsus may be right for you, speak with your healthcare provider about your options.
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References
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