Oral Semaglutide (Wegovy Pill) for Weight Loss: 6 Things You Should Know

For decades, researchers have been looking for an effective weight-loss pill. But the recent success of glucagon-like peptide-1 (GLP-1) weight-loss injections has sparked new hope — especially for those frustrated with existing oral options.

But for many, injections aren’t the most convenient or preferred choice. The possibility of achieving similar weight-loss results with a daily pill is appealing — and is now a reality. Wegovy (semaglutide), a popular injectable GLP-1 for weight loss, is now FDA approved in pill form.

Here’s what you should know about oral semaglutide (Wegovy) for weight loss — how it works, how to take it, and more.

1. Wegovy pills work the same way in the body as the injections

Both injectable and oral Wegovy contain the same active ingredient: semaglutide. Semaglutide is a GLP-1 receptor agonist that helps people lose weight by:

• Activating the brain’s appetite centers to reduce hunger and food cravings

• Slowing how quickly food leaves the stomach, which can help you feel full sooner and for longer

• Managing blood glucose (blood sugar) levels to prevent spikes after eating

The main difference between oral and injectable semaglutide is how it enters the body, not what it does once it’s there.

Good to know: Oral semaglutide is also available in lower doses for Type 2 diabetes as Rybelsus. Its injectable counterpart is sold as Ozempic.

2. Oral Wegovy has shown weight loss similar to Wegovy injections

Wegovy injections and pills haven’t been compared directly in a study. But separately, both forms appear to result in similar amounts of weight loss.

The OASIS 4 trial studied the 25 mg oral semaglutide dose. The study included adults considered obese, or considered overweight with at least one weight-related health condition. At 64 weeks (almost 15 months), people in the semaglutide group lost almost 14% of their starting body weight on average. Those who remained on treatment for the full duration lost about 17% on average.

The OASIS 4 results are comparable to the results from the largest injectable Wegovy trial. Participants had about 15% average weight loss with the highest dose (2.4 mg) within a similar timeframe.

EXPERT PICKS: WHAT TO READ NEXT

• Picking needle-free options: In addition to weight-loss injections, several oral medications can also help you lose weight. Experts review which weight-loss pills actually work.

• Knowing the risks: Compounded products can help people access certain medications. But before giving compounded semaglutide a try, it’s a good idea to understand the potential risks.

• How to save: Glucagon-like peptide-1 (GLP-1) medications like Wegovy (semaglutide) don’t need to break the bank. Explore ways to save on your prescription with this GLP-1 savings guide.

However, it’s important to keep in mind that higher injectable Wegovy doses may be approved in the near future. During studies, the 7.2 mg dose resulted in nearly 21% average weight loss.

3. Oral Wegovy is taken every day to build up consistent levels in the body

Wegovy injections are administered once a week. This is because most of the dose reaches your bloodstream, and it takes your body about 1 week to remove half of it. The Wegovy pill, on the other hand, isn't absorbed as well. So it’s taken daily to help build and maintain a steady level of the medication in your bloodstream.

Taking Wegovy pills every day as directed helps you get the most from the medication. If you find that you’re missing doses, there are medication reminder apps and other strategies that can help keep you on track.

4. Wegovy pills need to be taken on an empty stomach — and timing really matters

Because they are absorbed differently than the injections, Wegovy pills have specific instructions to follow. This helps ensure that you’re absorbing as much of your dose as possible. You’ll need to:

• Take your dose first thing in the morning, before eating or drinking anything else.

• Swallow it with no more than 4 oz of plain water (no coffee, juice, or other drinks).

• Wait at least 30 minutes before eating, drinking other liquids, or taking other medications.

Skipping or shortening this wait time can reduce how much semaglutide your body absorbs.

5. You’ll start with a low oral Wegovy dose and work your way up

If you’re new to treatment with Wegovy, you’ll follow a specific dosage schedule when starting Wegovy pills. This involves starting with a low dose tablet that’s gradually increased every month or so until you reach a target maintenance dose, similar to Wegovy injections. Following this schedule helps your body get used to the medication and minimizes side effects. 

But if you’re switching directly from Wegovy injections, you may start with a comparable oral dose right away. Your prescriber will give you instructions for dose and timing the transition.

6. Oral Wegovy can cause side effects similar to injectable Wegovy

Since both forms contain semaglutide, they can cause similar side effects. The main difference is that Wegovy injections can cause injection site reactions (such as irritation), while the pills do not.

Common side effects

These side effects are most likely to occur when starting Wegovy treatment or after your dose is increased. They’re usually mild to moderate in severity and tend to improve over time.

• Nausea

• Vomiting

• Diarrhea

• Stomach pain

• Constipation

• Indigestion

Serious risks to know about

More serious but less common risks include:

• Gallbladder problems, such as gallstones

• Pancreatitis (inflammation of the pancreas)

• Gastroparesis (slowed stomach emptying)

• Kidney problems, often related to dehydration

• Potential risk of thyroid C-cell tumors (boxed warning)

Because of potential thyroid risks, people with a personal or family history of medullary thyroid carcinoma, or with multiple endocrine neoplasia syndrome type 2, shouldn’t take semaglutide. You may also be advised to avoid semaglutide if you have a history of pancreatitis or severe gastroparesis.

Can you switch from Wegovy injections to Wegovy pills (and vice versa)?

Yes, it’s possible to switch between Wegovy injections and Wegovy pills. 

If you’re currently using the 2.4 mg Wegovy injection dose, you can switch to the 25 mg pill. You’ll wait 1 week after your last injection before starting the pill. And if you’re taking the 25 mg Wegovy pill dose, you can switch to the 2.4 mg injection (or 1.7 mg if you can’t tolerate the 25 mg pill). You’ll start the injection the day after stopping the pill.

Your healthcare professional can help determine the most appropriate dose and timing based on your current treatment, side effects, and personal preference.

How to save on the Wegovy pill

There are ways to save on the Wegovy pill, which is available as a brand-name medication. GoodRx coupons and manufacturer copay cards can help make your prescription more affordable.

• Save with GoodRx. If you're new to using GoodRx for Wegovy savings, pay an introductory price of $149 per month for the first two fills of the Wegovy pill (only available for certain doses). For future fills and for other Wegovy doses, pay $299 per month. Subscribers to GoodRx for Weight Loss can also access FDA-approved, brand-name GLP-1 medications.

• Save with a copay savings card: If you have commercial insurance, you could pay as little as $25 per month with the card.

Why trust our experts?

Written by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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