Key takeaways:
Rybelsus (semaglutide) is a once-daily, oral glucagon-like peptide-1 (GLP-1) receptor agonist. It’s approved to treat Type 2 diabetes in adults.
Rybelsus comes in two formulations: R1 and R2. The R2 formulation has slightly different ingredients to improve absorption, so it has less semaglutide per dose.
The starting Rybelsus dosage is 3 mg (R1) or 1.5 mg (R2) once daily for 30 days. After that, the dose is increased to 7 mg (R1) or 4 mg (R2) daily. Based on your response, the dose may be increased to a maximum of 14 mg (R1) or 9 mg (R2) daily.
There are ways to save on Rybelsus, which is available only as a brand-name medication. The manufacturer copay savings program can help make your prescription more affordable, for example.
Save on related medications
If you’ve been prescribed Rybelsus (semaglutide) for Type 2 diabetes, you might be wondering what dose to expect — and how it might change over time. The short answer is that you’ll typically start on the low end, then work your way up. This helps you find the most effective dose to support your treatment goals.
Rybelsus is taken once a day, and it has specific instructions you’ll need to follow for best results. Below, we’ll walk through the typical Rybelsus dosage schedule, how to take it, and the steps to take if you miss a dose.
Rybelsus formulations
Rybelsus comes as an oral tablet. You’ll be prescribed one of two formulations: R1 or R2. The R1 product is the original Rybelsus formulation. R2 was made with slightly different ingredients to improve absorption, so it has a smaller amount of semaglutide per dose.
Here’s how they compare:
Rybelsus R1 formulation | Rybelsus R2 formulation | |
|---|---|---|
Ingredients | • Semaglutide • Magnesium stearate • Microcrystalline cellulose • Povidone • Salcaprozate sodium (SNAC) | • Semaglutide • Magnesium stearate • SNAC |
Available doses | • 3 mg • 7 mg • 14 mg | • 1.5 mg • 4 mg • 9 mg |
After your first month of treatment, it’s possible to switch between Rybelsus formulations. You can switch from the 7 mg R1 dose to the 4 mg R2 dose (and vice versa). This is also the case for the 14 mg R1 dose and 9 mg R2 dose.
What’s the typical Rybelsus dosage?
Rybelsus is approved to treat Type 2 diabetes in adults. If you’re new to Rybelsus, you’ll typically start with a low dose that’s increased every 30 days until you reach the best dose for you. This starting dose isn’t intended to significantly affect your blood glucose (sugar). It’s designed to help your body get used to the medication and lessen side effects.
Here’s what a typical Rybelsus dosage schedule looks like, depending on the formulation:
Dosage schedule | Rybelsus R1 dosage | Rybelsus R2 dosage |
|---|---|---|
Days 1 to 30 | 3 mg once daily | 1.5 mg once daily |
Days 31 to 60 | 7 mg once daily | 4 mg once daily |
Days 61 and beyond (if needed) | 14 mg once daily (max dose) | 9 mg once daily (max dose) |
Keep in mind that your prescriber may have you follow a different dosage schedule, depending on how you respond to the medication. Be sure to follow their instructions.
Good to know: Ozempic is another medication that contains semaglutide. It’s also used to treat Type 2 diabetes. But unlike Rybelsus, Ozempic is administered as a once-weekly injection. Wegovy is another injectable semaglutide medication, but it’s approved for weight loss.
How do you take Rybelsus?
Rybelsus has specific instructions to follow when taking it. That’s because only a small amount of the medication is absorbed with each dose. Food, other medications, and even fluids can interfere with absorption. Here are some general steps to follow for best results:
Take Rybelsus on an empty stomach first thing in the morning.
Use no more than 4 oz of water to take your dose.
Wait at least 30 minutes before eating, drinking, or taking any other medication after your Rybelsus dose.
Don’t crush, split, or chew Rybelsus tablets. They need to be swallowed whole.
Exposure to light and moisture can also affect Rybelsus tablets. Be sure to keep your pills in their original container. Don’t store them in a pill organizer or any other container.
Are there any dosage adjustments for medical conditions?
No. The manufacturer doesn’t recommend any dosage adjustments for medical conditions, such as liver or kidney disease.
But you should tell your healthcare team if you’re experiencing vomiting or diarrhea that’s severe or persistent while taking Rybelsus. This is especially important if you have preexisting kidney problems, since these symptoms can worsen your condition.
Pills vs. injection: Rybelsus and Ozempic both contain semaglutide. But one is a daily pill, and the other is a once-weekly injection. Here’s how Rybelsus and Ozempic compare.
Can you take Rybelsus at night? Pharmacists cover the best time to take Rybelsus, plus other tips for taking it.
How to save: Glucagon-like peptide-1 (GLP-1) medications like Rybelsus don’t need to break the bank. Explore ways to save on your prescription with this GLP-1 savings guide.
What happens if you miss a dose of Rybelsus?
If you miss your morning Rybelsus dose, skip it and take your regular dose the next day. Don’t take the medication later in the day. And don’t take 2 doses at the same time to make up for a missed dose.
If you have questions about taking Rybelsus, speak with your prescriber or pharmacist. And if you’re finding it difficult to take your doses on time, try a medication reminder app to help you stay on schedule.
What should you do if you take too much Rybelsus?
If you take too much Rybelsus, you may be more likely to experience side effects such as nausea and vomiting, abdominal pain, and diarrhea.
When taken on its own at the correct dosage, Rybelsus has a low risk of hypoglycemia (low blood sugar). But if you take too much of the medication, this risk can go up — especially if you’re taking Rybelsus with other diabetes medications.
Hypoglycemia may cause you to feel sweaty, shaky, and weak. If you experience hypoglycemia symptoms, check your blood sugar and follow the instructions provided by your healthcare team. These instructions usually include consuming glucose tablets, fruit juice, or hard candies to bring your blood glucose levels back up.
If you think you may have taken too much Rybelsus, contact your healthcare provider right away, or call Poison Control at 1-800-222-1222 for guidance. If any of your side effects are concerning, go to the ER.
How to save on Rybelsus
There are ways to save on Rybelsus, which is available only as a brand-name medication. If you have commercial insurance, there is a manufacturer copay savings program available. Through the program, you could pay as little as $10 when you fill your Rybelsus prescriptions.
If you don’t have insurance, you may be eligible for a patient assistance program. If you qualify, you could pay as little as $0 for your Rybelsus prescription.
Frequently asked questions
Rybelsus may not noticeably lower your blood sugar levels during the first 30 days, since the starting dose is mainly meant to help your body adjust to treatment. After 30 days, your dose is typically increased, which is when you may begin to see more significant improvements.
No, not typically. Rybelsus is meant to be taken every day to build up a consistent amount of medication in your system. Taking it less frequently can make Rybelsus less effective.
Generally, yes. You aren’t required to slowly decrease your dose when you stop taking Rybelsus. But don’t stop taking it without talking to your prescriber first. They may need to make adjustments to your treatment regimen to ensure your blood sugar levels stay in your target range.
Rybelsus may not noticeably lower your blood sugar levels during the first 30 days, since the starting dose is mainly meant to help your body adjust to treatment. After 30 days, your dose is typically increased, which is when you may begin to see more significant improvements.
No, not typically. Rybelsus is meant to be taken every day to build up a consistent amount of medication in your system. Taking it less frequently can make Rybelsus less effective.
Generally, yes. You aren’t required to slowly decrease your dose when you stop taking Rybelsus. But don’t stop taking it without talking to your prescriber first. They may need to make adjustments to your treatment regimen to ensure your blood sugar levels stay in your target range.
The bottom line
Rybelsus (semaglutide) is a once-daily, oral tablet used to treat Type 2 diabetes in adults. It comes in two formulations: R1 and R2. The typical Rybelsus R1 dosage is 7 mg to 14 mg daily. For the R2 formulation, it’s 4 mg to 9 mg daily. But with both, you’ll likely start with a lower dose (3 mg or 1.5 mg) for the first 30 days to help your body adjust.
Take Rybelsus first thing in the morning, with no more than 4 oz of water. Then wait at least 30 minutes before you eat, drink, or take other medications. If you miss your morning dose, skip it and take your usual dose the next day.
If you have any questions about Rybelsus or your dosage, talk to your prescriber or pharmacist.
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References
MedlinePlus. (2023). Semaglutide.
Novo Nordisk. (2024). Rybelsus- oral semaglutide tablet [package insert]. DailyMed.
