For many people with type 2 diabetes, Rybelsus is an excellent choice to help improve insulin sensitivity and lower blood sugar levels. 

The appropriate dosage varies based on your health history, health goals, and lifestyle. All dosing decisions should be made after consulting with your doctor. 

Image of a pharmacist reading the label of a medication box

Key Facts

  • Rybelsus is used to improve insulin sensitivity and lower blood sugar levels in people with type 2 diabetes.
  • The initial dose typically starts at 3 milligrams (mg) per day for the first 30 days to minimize side effects.
  • Dosing increases should be guided by a doctor, with the maximum daily dose being 14 mg.
  • Consistent daily intake is crucial for effectiveness.

Table of Contents

What dose do you typically start with?

Doctors usually recommend starting with the lowest dose for people newly on Rybelsus or any diabetes medication containing semaglutide. 

This approach is due to the potential for adverse effects, especially when beginning treatment. 

Common side effects of semaglutide include nausea, vomiting, diarrhea, constipation, hypoglycemia (low blood sugar), and suppressed appetite, which can be severe in the first few weeks.

Read more in: Rybelsus Side Effects: What You Need to Know.

Starting at a lower dose helps minimize the likelihood of these side effects and allows your body to adjust to the medication gradually. According to the manufacturer, most people will start with 3 mg taken once per day (in tablet form) for the first 30 days. 

Your doctor may increase your dose after the first 4 weeks if you see improvements in blood sugar levels and insulin resistance without adverse side effects.

What is a normal Rybelsus dose?

There is no “normal” dose, as everyone is different. However, most people do not stay on the 3 mg dose for more than the first 30 days. 

Typical doses include:

  • New to treatment: 3 mg taken once per day
  • Ongoing treatment: Either a 7 mg tablet or a 14 mg tablet, taken once per day

Talk with your doctor if your blood sugar levels remain high while taking 14 mg per day.

How and when can you increase your dose?

Only increase your dose under the guidance of your doctor, as doing so without medical supervision can cause serious side effects. 

Typically, people will stay on the 3 mg introductory dose for the first 4 weeks. If they do not experience severe side effects, they will generally start taking 7 mg once per day. 

If, after another 30 days, blood sugar levels are still high and there are no severe side effects, your doctor may increase your dose to 14 mg once per day. The maximum dose of Rybelsus is 14 mg taken once per day.

What is the right dose for me?

Deciding the right dose of Rybelsus is a decision to be made between you and your doctor. 

Your dosage may vary based on factors such as your health history, health goals, lifestyle, height, weight, level of insulin resistance, diet, and daily activity level. Doses may also change over time.

Higher doses generally yield better results, such as lower blood sugar levels, weight loss, and improved A1c levels. 

However, higher doses also increase the likelihood of adverse side effects, such as nausea, vomiting, diarrhea, and low blood sugar levels. Keep this in mind as you adjust your doses. 

If a dose ends up being too high for you, you can always lower it to find what works best for you.

What is the right dose for weight loss?

There is no recommended dose for weight loss because Rybelsus is not FDA-approved as a standalone weight-loss medication. However, the medication is dose-dependent, meaning that the more you take, the more effective it will be, and the more weight people tend to lose.

In the OASIS 1 trial, on average, people taking Rybelsus lost more than 17 percent of their body weight after 68 weeks of consistent use. Additionally, 40 percent of study participants lost 20 percent or more of their body weight compared to the group not taking Rybelsus. 

In other research, participants using Rybelsus (in addition to metformin) lost an average of 4.4 kilograms (about 10 pounds) in one year. 

Rybelsus will be more effective if you combine the therapy with healthy eating and exercise. There are other weight loss drugs approved by the FDA that you can take if you have diabetes. 

Read more in: Rybelsus for Weight Loss: Everything You Need to Know.

You can learn more about medications approved by the U.S. Food and Drug Administration (FDA) for weight loss in:

Can I split my dose in half?

No, splitting your dose is not recommended. You should swallow the tablets whole without chewing, splitting, or crushing them. 

Take the medication once per day, preferably on an empty stomach. 

If your prescribed dose is 14 mg per day, you will need a new prescription for the 14 mg tablet. Do not combine two 7 mg tablets to achieve the 14 mg dose. 

What is the maximum daily dose?

The maximum daily dose of Rybelsus is 14 mg, taken once per day. 

Never take more Rybelsus than prescribed. Overdosing on Rybelsus can lead to severe and dangerous side effects, including nausea, vomiting, and low blood sugar, which can be life-threatening, especially if you are also on insulin.

Monitor for signs and symptoms of extremely low blood sugar, including:

  • Dizziness
  • Confusion
  • Increased heart rate
  • Shallow breathing
  • Shakiness
  • Grogginess
  • Fatigue
  • Unconsciousness

In case of suspected overdose, it is critical to seek emergency medical attention immediately or call the Poison Help line at 1-800-222-1222.

Learn more in: Rybelsus Side Effects: What You Need to Know.

What happens if I stop taking Rybelsus?

Do not stop taking any diabetes medications without the guidance of your doctor.

Studies have shown that stopping Rybelsus can lead to regaining lost weight and higher blood sugar levels. On average, people who stop taking medications containing semaglutide (such as Rybelsus) gain back two-thirds of the weight they lost while on the medication.

If you are experiencing severe side effects, find that Rybelsus doesn’t fit into your lifestyle, or your health insurance doesn’t cover the medication, talk to your doctor. There are alternative medications that may be suitable replacements, such as metformin, Victoza (liraglutide), or Trulicity (dulaglutide).

What if I need something stronger than Rybelsus?

You may need a stronger medication if you’ve been taking the maximum dose of Rybelsus for a while and it is not effectively lowering your blood sugar levels or improving insulin resistance. Talk with your doctor to explore your options.

What do I do if I forget to take a dose?

Don’t worry if you forget to take a dose of Rybelsus. Try to take it as soon as possible. 

However, never take two doses of Rybelsus within a 24-hour period. If you’re more than halfway through the day after forgetting your medication, it is OK to skip the missed dose and wait until your next scheduled dose.

Rybelsus is most effective when taken consistently, so aim to take your medication regularly. 

If you’re having difficulty with a daily medication routine, talk with your doctor. There are alternative GLP-1 agonist medications that can be taken once per week instead. 

For example, Ozempic has the same active ingredient as Rybelsus and works in similar ways, though it is an injection instead of an oral tablet.

Learn more in Everything You Need to Know About Rybelsus. Did you find this article helpful? Click Yes or No below to let us know!