Rybelsus is an oral medication used to help treat blood sugar levels in people who have type 2 diabetes. 

However, many people are not aware of the side effects that this medication may cause. 

This article will describe everything you need to know about the side effects of Rybelsus. 

Three boxes of Rybelsus

What is Rybelsus?

Rybelsus is a relatively new medication that was first approved by the Food and Drug Administration for use in the United States in 2019. 

It is an oral medication taken once daily to help improve blood sugar levels and A1C. 

It is similar to medications like Wegovy and Ozempic, which also have the same active ingredient—semaglutide. 

In trials, patients with an 8.3% A1C were able to lower it by between 1–1.3% when taking Rybelsus.

While Rybelus is not approved for weight loss, it may help some people lose weight

In the OASIS 1 trial, people taking Rybelsus lost more than 17% of their body weight after 68 weeks, on average. 

Additionally, 40% of study participants lost 20% or more of their body weight when compared to a group of people not taking the medication. 

What are the common side effects of Rybelsus?

Many people who take Rybelsus will experience some mild side effects and symptoms, especially when you first start taking the medication and each time you increase your dose.

The most common side effects are:

  • Nausea
  • Vomiting 
  • Diarrhea 
  • Stomach ache 
  • Constipation 
  • Heartburn
  • Gas or bloat
  • Lethargy 
  • Headache

Nausea is the most common of the side effects of Rybelsus.

While most of these symptoms are not serious, and many will fade over time as your body becomes acclimated to the medication, it’s a good idea to keep your doctor informed. 

What are the more serious side effects of Rybelsus?

There are also rare but more serious side effects and complications that you should be aware of:

  • Thyroid tumors, including cancer, especially in people with a family history of medullary thyroid carcinoma (MTC)
  • Pancreatitis 
  • Changes in vision 
  • Worsening kidney problems
  • Low blood sugar 
  • Mental changes or depression
  • Serious allergic reactions

Some people will also experience hypoglycemia (low blood sugar levels), especially if they are on insulin therapy

It’s important to know the symptoms of low blood sugar and know how to treat it.

Low blood sugar can be dangerous if untreated, so watch out for:

  • Dizziness,
  • Light-headedness
  • Confusion 
  • Sudden changes in your mood or perception
  • Shakiness 
  • A rapid heartbeat 

Make sure to test your blood sugar if you’re feeling any of these symptoms. 

Your doctor should discuss all the potential side effects, from common to serious, and can answer the questions you have about the medication and its potential risks and benefits. 

Seek medical attention immediately if you believe you are having any of the serious side effects or an allergic reaction to Rybelsus. 

Seek medical attention immediately if you develop a fever, have changes to your vision, or are feeling weak or in pain after taking the drug. 

How can I reduce the side effects of Rybelsus?

Nausea is the most common side effect of Rybelsus. There are some recommendations you can follow to help alleviate any nausea you experience while taking Rybelsus: 

  • Temporarily changing your diet to focus on bland, low-fat foods, like crackers, toast, or rice
  • Eat foods that contain water, like soups and jello 
  • Avoid lying down soon after eating a meal
  • Get fresh outside air 
  • Eat smaller, more frequent meals instead of large meals
  • Eat more slowly
  • Always drink water with meals and stay hydrated 

Report any side effects you may be experiencing to your doctor and ask them for guidance as to how best to manage those symptoms. 

Your doctor will be able to help make individualized recommendations that take your health history and goals into account. 

You may also need to temporarily decrease your dose of Rybelsus or seek an alternative that may be more appropriate for you. 

How long does it take for the side effects to go away?

The common side effects of Rybelsus tend to ease within the first few weeks of starting the medication. Report any symptoms lasting longer than a few weeks to your doctor. 

Part of the reason that your doctor will start you on a low dose of Rybelsus and increase it over time is to help your body acclimate and to prevent side effects like nausea from getting too severe. 

If you’re finding the side effects of larger doses are too difficult to manage, your doctor may be able to lower your dose of Rybelsus or stop the medication altogether. 

If you stop taking Rybelsus, most side effects stop within a week or two. 

The medication is almost totally eliminated from your body within about a month.

Is Rybelsus safe for long-term use?

Yes. Rybelsus is safe and is meant to be used as a long-term treatment for blood sugar management for people with type 2 diabetes. 

Over the long term, Rybelsus is most effective when used as a supplement to diet and exercise (and sometimes along with insulin therapy). 

Can Rybelsus affect your heart? 

Rybelsus can improve heart health. 

It has been proven to reduce the risk of heart-related death by 51% in people with type 2 diabetes and heart disease. 

Sometimes Rybelsus may be prescribed for people with both type 2 diabetes and heart disease for heart health—even if they’re not having issues with insulin resistance or blood sugar levels. 

Is Rybelsus hard on the kidneys?

Kidney problems are a potentially severe side effect of Rybelsus. 

There are reports of acute kidney injury and worsening of chronic renal failure—sometimes requiring hemodialysis—in patients treated with drugs containing semaglutide. 

This can be tricky because chronic kidney disease (CKD) is a complication of diabetes, so people with diabetes need to be extra careful with their kidney health. 

Some of these kidney complications from taking Rybelsus were reported in patients without pre-existing kidney disease. 

Talk with your doctor if you have questions or concerns about how Rybelsus may affect your kidneys. 

Can you drink coffee while taking Rybelsus?

There is nothing wrong with drinking coffee when you’re on Rybelsus. 

However, it is recommended that Rybelsus be taken on an empty stomach each day. 

You should take the medication with only a few sips of water (no more than four ounces.) 

Wait about 30 minutes before eating or drinking anything else. This will ensure the medication is absorbed properly. Then you can drink coffee afterward!