Rybelsus is a relatively new medication used to help people manage their blood sugar levels when they live with type 2 diabetes. 

This article will highlight everything you need to know about Rybelsus. 

Image of Rybelsus packages

What is Rybelsus?

Rybelsus is an oral medication that comes in pill (tablet) form. 

It is a prescription medication approved by the Food and Drug Administration (FDA) in 2019 for treating blood sugar levels in people with type 2 diabetes

In conjunction with exercise and healthy dietary habits, Rybelsus is taken daily as a supplement to other medications like metformin or insulin.

It is a glucagon-like peptide 1 (GLP-1) agonist medication. 

The main ingredient is semaglutide, similar to medications like Ozempic and Wegovy. However, it is not taken as an injection like its sister medications. 

GLP-1 medications decrease appetite and slow down digestion. 

Delaying the emptying of food from your stomach into your small intestine helps you to stay fuller for longer. This helps to aid in weight loss and weight maintenance. 

Rybelsus also stimulates the pancreas to release insulin and slows down your liver’s production of glucagon. 

This process decreases insulin resistance and lowers overall blood sugar and A1C levels

What are the benefits of Rybelsus?

The following are proven ways that your health can be improved by taking this medication: 

Lowers blood sugars

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

Lowering blood sugar levels over the long term can help prevent diabetes complications and improve quality of life. 

Aids in weight loss or maintenance 

While it is not FDA-approved as a stand-alone weight loss medication, people taking Rybelsus tend to lose weight

In the OASIS 1 trial, people taking Rybelsus lost more than 17% of their body weight after 68 weeks, on average. Most people will lose ten or more pounds while taking the medication. 

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

People lose the most weight on Rybelsus when it is used along with increased physical activity and healthy changes to diet. 

Protects against cardiovascular death 

Rybelsus reduces the risk of heart-related death by 51% in people with type 2 diabetes and heart disease. However, it may not reduce the risk of cardiovascular events. 

Reducing heart-related deaths is crucial for people with diabetes. Heart disease is the number one cause of death in people with diabetes. 

Why would you be prescribed Rybelsus?

People are typically prescribed Rybelsus if they have type 2 diabetes and are struggling with insulin resistance

Not everyone with type 2 diabetes will be prescribed Rybelsus because many people are able to manage their blood sugar levels with diet, exercise, and other medications. 

However, if you’re struggling to manage your diabetes, it is a great way to combat insulin resistance, improve blood sugar levels, and aid in weight loss. 

Many people who have type 2 diabetes and existing heart disease may also be prescribed Rybelsus to act as a protective agent and improve both diabetes and heart health. 

The safety of Rybelsus has not been established in patients under 18 years of age. 

What are the side effects?

Many people who take Rybelsus will experience some mild side effects and symptoms.

The most common side effects are:

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

Nausea is the most common side effect. 

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 may also experience hypoglycemia (low blood sugar levels), especially if they are on insulin therapy. 

Seek medical attention immediately if you believe you have an allergic reaction or serious side effects to Rybelsus, including developing a fever, changes in vision, or feeling weak or in pain. 

What are the doses?

Doses will vary by the patient and will be based on health history, goals, and lifestyle.

The following are typical Rybelsus doses: 

  • The starting dose is 3 mg until you get used to taking the medication (usually for the first 30 days)
  • Either 7mg or 14 mg, taken once per day

Consult your doctor before increasing your dose. Never take more Rybelsus than you’re prescribed.

How much should I take?

This can only be determined between you and your doctor. However, most doctors will start patients on 3 mg once per day, taken on an empty stomach.

After four weeks, if you’re not having adverse side effects, your doctor may increase your dose to 7mg, taken once daily. 

If you still have blood sugar spikes with no adverse side effects, your doctor may increase your dose to 14 mg. This is the maximum dose of Rybelsus.

Never take two doses on the same day. 

What happens if you take too much Rybelsus?

Taking too much Rybelsus can cause serious adverse side effects.

These side effects include:

  • Debilitating nausea 
  • Vomiting
  • Diarrhea
  • Stomach pain 
  • Constipation 
  • Loss of appetite 
  • Low blood sugar—If you’re also on insulin, this can become fatal if not treated immediately.

Call your doctor right away or seek emergency medical attention if you’ve accidentally taken too much Rybelsus.

Can I miss a dose?

This may happen, and that is totally fine. 

Just try and take your next dose as soon as you’re able, but do not take two doses within 24 hours of each other.

You will not experience insulin resistance or weight gain from one missed dose. 

However, try not to miss doses regularly, as the medication is most effective when taken consistently. 

How to take Rybelsus

Take your dose around the same time every day.

It is best taken on an empty stomach, so many people prefer to take the medication in the morning before eating anything. 

It is best taken with no more than four ounces of water, and you’ll need to wait at least 30 minutes after you’ve taken the pill to eat anything for the best absorption and efficacy. 

After 30 minutes, you can eat and drink as you wish. 

Rybelsus will not cause acute low blood sugar, unlike some diabetes medications, like insulin. 

Who shouldn’t take Rybelsus?

Do not take Rybelsus if you have not been prescribed Rybelsus. 

It is not recommended if you are pregnant, planning on becoming pregnant, or if you are breastfeeding.

It is not recommended for people without diabetes, with prediabetes, or with type 1 diabetes without the guidance of a physician. 

Rybelsus is only FDA-approved for people 18 years and older.

Do not use Rybelsus or any other medication containing semaglutide if you or your family members have ever had medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). 

Do not use Rybelsus if you are allergic to semaglutide. 

How do I stop taking my Rybelsus?

Consult your doctor if you wish to stop taking your Rybelsus. 

Stopping any diabetes medications abruptly can cause adverse side effects, including high blood sugar levels, increased insulin resistance, and weight gain. 

You will want to have a plan in place with your doctor about weaning you off Rybelsus.

Your doctor may also have suggestions for alternative medications to help manage your blood sugar levels. 

Can Rybelsus replace insulin?

No. Rybelsus can be used in conjunction with insulin, but it is not an insulin replacement. 

If you’ve recently been prescribed Rybelsus, do not stop taking your other diabetes medications unless your doctor has specifically told you to. 

If you normally take insulin for food, you will need to continue to do so. 

Rybelsus rarely completely takes away the need to take insulin for your diabetes. Since it improves insulin sensitivity, it may lower your insulin needs over time. 

Can I take Rybelsus with other diabetes medications?

This depends on what other diabetes medications you’re taking. 

Rybelsus can be taken with insulin and metformin, but it should never be combined with other medications containing semaglutide, such as Wegovy and Ozempic. 

Rybelsus should also not be combined with other GLP-1 agonist medications, such as Trulicity, Mounjaro, or Victoza

Always talk with your doctor if you’re unsure of how any medications you take will interact with Rybelsus before starting Rybelsus or any other new diabetes medication. 

How do I store Rybelsus?

Keep all tablets in the original bottle for storing. 

Store at room temperature 68-77 degrees Fahrenheit (20-25 degrees Celsius). 

Keep it in a dry place, away from moisture. 

How do I get a prescription for Rybelsus?

Talk with your doctor if you want a prescription for Rybelsus.

They should be able to write you a prescription if you’re struggling with insulin resistance and have type 2 diabetes.