Can Rybelsus Be Taken at Night? Plus, 6 More Pharmacist-Backed Tips for Taking Rybelsus

When you receive your Rybelsus (semaglutide) prescription, there are several important instructions to follow. This includes when to take it and how to time food, drinks, and other medications around your dose. And there are specific storage instructions, too.

All of these recommendations are in place to help you get the most benefit from Rybelsus. But there may be situations where these instructions don’t fit with your schedule due to work or other reasons. In this case, can you take Rybelsus at a different time? We cover this topic and six more below.

1. The best time to take Rybelsus is first thing in the morning on an empty stomach

To get the most benefit from Rybelsus, it’s best to take it on an empty stomach. This is because Rybelsus isn’t absorbed very well. It’s also easily broken down by enzymes in the stomach. Taking it with food can almost completely limit its absorption.

You’ll absorb more of your Rybelsus dose if you’ve fasted overnight, which is why it’s best to take it first thing in the morning. Make sure to swallow the tablet whole with up to 4 oz (120 mL) of water. Wait at least 30 minutes before eating, drinking, or taking other medications.

2. It may be OK to take Rybelsus at night in certain situations

But what happens if you can’t take Rybelsus in the morning? There may be certain situations where you may be told to take it at a different time, such as at night. It’s best to discuss your situation with your prescriber before adjusting your Rybelsus timing. But here are a few tips to help with your discussion.

• Shift work: If you work the night shift, you may need to take Rybelsus later in the day if a morning dose isn’t feasible. The general guidance is to fast at least 6 hours before taking Rybelsus, then wait at least 30 minutes before eating.

• Fasting: If you’re fasting from sunrise to sunset for religious reasons, such as during Ramadan, experts recommend taking Rybelsus after sunset. Then, wait 30 minutes before eating the fast-breaking evening meal. Another option is to take Rybelsus at least 30 minutes before your pre-dawn meal, but only if you’ve been fasting at least 6 hours beforehand.

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Keep in mind that taking Rybelsus differently from what’s recommended may affect how much you absorb. Your prescriber can monitor your response to treatment and make adjustments as needed.

Good to know: Semaglutide, the main ingredient in Rybelsus, is also available as a weekly injection called Ozempic. If timing your Rybelsus dose is an issue, Ozempic may be an alternative to consider since you can inject it at any time of day.

3. Rybelsus may also affect how you absorb other medications

As mentioned earlier, it’s important to take Rybelsus before any food, drink, or other medications. This is because they can reduce how much Rybelsus you absorb. However, it’s possible for Rybelsus to affect other medications, too. While it’s not a comprehensive list, below are a few examples.

Thyroid medications

One of the ways Rybelsus works is by slowing down how quickly food leaves your stomach. This effect can potentially interfere with how your body absorbs certain oral medications. One example is levothyroxine (Synthroid). When it’s taken with Rybelsus, you may be exposed to greater amounts of levothyroxine.

Rybelsus and levothyroxine are both recommended to be taken first thing in the morning on an empty stomach. So you may need to adjust your dosing schedule to manage this interaction. For example, you may be told to take levothyroxine at night, at least 3 hours after your last meal of the day, instead. Your prescriber may also want to monitor your thyroid levels more frequently.

Bisphosphonates

Another potential Rybelsus interaction is with oral bisphosphonates, such as alendronate (Fosamax). These medications should also be taken first thing in the morning on an empty stomach for best absorption. And taking them at bedtime isn’t recommended. That’s because oral bisphosphonates can damage the esophagus, especially if you lie down after taking them.

In this case, your prescriber may recommend switching to an injectable bisphosphonate, such as ibandronate or zoledronic acid (Reclast). These forms wouldn’t interact with Rybelsus.As mentioned earlier, it’s important to take Rybelsus before any food, drink, or other medications. This is because they can reduce how much Rybelsus you absorb. However, it’s possible for Rybelsus to affect other medications, too. While it’s not a comprehensive list, below are a few examples.

EXPERT PICKS: WHAT TO READ NEXT

• Rybelsus side effects: Do you experience nausea after taking Rybelsus (semaglutide)? Learn about potential semaglutide side effects and how to manage them.

• Ozempic vs. Rybelsus: Ozempic and Rybelsus both contain semaglutide, but one is an injection and the other is a pill. Here’s how Ozempic and Rybelsus compare.

• Oral semaglutide for weight loss: Oral semaglutide may soon become an option for weight loss. Learn about the latest clinical trial results and the expected timeline for FDA approval.

Thyroid medications

One of the ways Rybelsus works is by slowing down how quickly food leaves your stomach. This effect can potentially interfere with how your body absorbs certain oral medications. One example is levothyroxine (Synthroid). When it’s taken with Rybelsus, you may be exposed to greater amounts of levothyroxine.

Rybelsus and levothyroxine are both recommended to be taken first thing in the morning on an empty stomach. So you may need to adjust your dosage schedule to manage this interaction. For example, you may be told to take levothyroxine at night, at least 3 hours after your last meal of the day, instead. Your prescriber may also want to monitor your thyroid levels more frequently.

Bisphosphonates

Another potential Rybelsus interaction is with oral bisphosphonates, such as alendronate (Fosamax). These medications should also be taken first thing in the morning on an empty stomach for best absorption. And taking them at bedtime isn’t recommended. That’s because oral bisphosphonates can damage the esophagus, especially if you lie down after taking them.

In this case, your prescriber may recommend switching to an injectable bisphosphonate, such as ibandronate or zoledronic acid (Reclast). These forms wouldn’t interact with Rybelsus.

4. Some foods are best to limit when taking Rybelsus

There aren’t specific foods that you absolutely need to avoid with Rybelsus. But some may worsen side effects or interfere with how well the medication works. Here are a few foods and drinks to consider limiting while taking Rybelsus:

• High-fat or greasy foods: These can make side effects such as nausea, upset stomach, and diarrhea worse.

• Sugary or processed foods: These can raise your blood glucose (sugar) and may make it harder to manage your diabetes. Focus on whole foods, such as vegetables, lean proteins, and whole grains.

• Alcohol: Drinking alcohol may worsen side effects such as nausea, dizziness, and low blood sugar (hypoglycemia). It can also potentially offset weight loss from the medication.

5. Don’t crush or cut Rybelsus tablets

Rybelsus normally isn’t absorbed very well. That’s why it’s co-formulated in a specific way with an absorption enhancer called salcaprozate sodium. It’s not known if splitting, crushing, or chewing Rybelsus tablets interferes with this formulation. So it’s recommended to swallow Rybelsus tablets whole.

If you have difficulty swallowing Rybelsus tablets, talk to your prescriber about an alternative. As mentioned earlier, Ozempic may be a pill-free option to consider.

6. There are ways to manage nausea from Rybelsus

One of the most common Rybelsus side effects is nausea, especially when you start treatment and after dose increases. This side effect (and other Rybelsus side effects) usually improve over time. But in the meantime, here are a few tips for managing nausea from Rybelsus.

• Follow the titration schedule. It’s best to start with a low Rybelsus dose, which is then slowly increased on 30-day intervals as directed by your prescriber. This titration schedule helps your body get used to Rybelsus over time to lessen side effects.

• Avoid or minimize foods that worsen nausea. Greasy, fatty, and sugary foods; alcohol; and ultra-processed foods can make nausea worse. It’s a good idea to avoid or minimize these foods while taking Rybelsus.

• Eat smaller meals. Rybelsus can make you feel full faster. Eating smaller meals throughout the day can help you feel less nauseous after you eat.

7. Store Rybelsus tablets in their original container, not a pill organizer

For Rybelsus to work properly, it’s important to preserve its integrity. That means storing it properly to protect it from heat, light, and moisture, which can affect how well it works.

The manufacturer recommends storing Rybelsus in its original bottle — not a pill organizer or regular prescription bottle. That’s because the Rybelsus bottle’s blue cap is made a certain way to protect the tablets by absorbing moisture. Keep the bottle closed until it’s time for your dose. And put the cap back on right after you take out a tablet.

Keep your Rybelsus bottle in a cool, dry place. For example, you can keep your medication in your dresser drawer, on a shelf, or in a closet. Just make sure it’s out of reach of children and pets. Although tempting, avoid places like the bathroom that tend to get humid.

Keeping your Rybelsus bottle in the same spot as other medications can help you to remember to take it. Putting a reminder on your phone in the morning or using one of the many medication reminder apps can also be helpful.

Tips for saving on Rybelsus

There are ways to save on Rybelsus, which is only available as a brand-name medication. If you’re eligible, you could pay as little as $10 for a 30- to 90-day supply of Rybelsus with a manufacturer copay card. You could also get Rybelsus for as little as $0 through a patient assistance program, depending on your eligibility.

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Written by:

Sandy P. Bonfin, PharmD, BCPS

Sandy Bonfin, PharmD, BCPS, is a clinical pharmacist at a Florida hospital. Bonfin has worked in pediatric medicine, emergency medicine, internal medicine, and intensive care.

Edited 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:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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