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Rybelsus
Get guidance on taking Rybelsus safely, and managing potential side effects.
Dr Ashwin Sharma
Medical Doctor
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Using Rybelsus
How Rybelsus® works
Rybelsus is an oral form of semaglutide used to control blood sugar and treat type 2 diabetes. It can also be prescribed off-label for weight loss. For more information see the patient leaflet.
Semaglutide mimics GLP-1, a naturally occurring hormone in your gut. It helps you lose weight by:
Appetite suppression
It targets the hunger centre in your brain, quieting food-related thoughts.
Increasing fullness
It slows digestion, helping you stay satisfied between meals.
Regulating blood sugar
It keeps blood sugar steady, reducing food cravings.
How to take Rybelsus®
For the best results, take one tablet once a day with a sip of water - always on an empty stomach. After taking your tablet, wait at least 30 minutes before eating, drinking, or taking any other medications. This gives your body time to absorb the medication properly.
Taking it with food, or too soon after, can make it less effective.
Rybelsus® dosage guide
The starting dose of oral semaglutide is 3 mg per day for the first 4 weeks. Your dose is increased slowly each month to help you adjust, until you reach your maintenance dose. This is the typical dosing schedule:
Weeks 1-4
3 mg
Weeks 5-8
7 mg
Weeks 9-12+
14 mg
If you miss a dose, skip it and just take your next dose the following day at your usual time. Never take multiple doses at once to make up for a missed one.
How to store Rybelsus®
Keep your medication in the original packaging, protected from light and moisture.
Keep out of sight and reach of children.
Track expiration dates and set reminders to replace your medication if needed.
Contraception, pregnancy and breastfeeding
You should not take Rybelsus while pregnant or breastfeeding.
Stop taking it at least two months before a planned pregnancy to allow it to fully leave your system.
Side effects
Serious side effects
Rare but serious side effects of Rybelsus include: pancreatitis (inflammation of the pancreas), gallbladder problems and serious allergic reaction (anaphylaxis).
Rybelsus is not recommended for people with a personal or family history of certain types of thyroid cancer (like medullary thyroid carcinoma) or MEN2.
General side effects
Side effects like nausea and diarrhoea are very common while taking Rybelsus, while side effects like vomiting, constipation, stomach pain, bloating and indigestion are considered common.
Most people experience side effects when starting treatment or immediately after a dose increase. We increase your dose slowly on a monthly basis to reduce the impact of symptoms, and they typically settle on their own.
Switching to Rybelsus
If you are switching to Rybelsus from another GLP-1 medication, such as Wegovy or Mounjaro, your starting dose will be tailored based on the closest equivalent to what you have been taking and the duration of your treatment.
There isn’t an exact “one-to-one” match between Rybelsus and other GLP-1 medications, but our clinicians will work with you to find the most appropriate starting dose to support comfort, safety, and continued progress.
FAQs about Rybelsus
Rybelsus leads to a more modest weight loss compared to Mounjaro. On average, people with type 2 diabetes lost around 5% of their body weight over 26 weeks. However, everyone responds differently. While many people will see smaller changes, some may experience greater weight loss than expected.
The biggest advantage of Rybelsus is that it is a tablet, rather than an injection. So for those who do not like needles, or who travel a lot, it might be a more convenient option.
Once you have lost weight, Rybelsus is also better for maintaining weight as long as you build diet and exercise changes into your daily routine.
Yes, Rybelsus may be a good option for weight maintenance, especially for patients who want to transition away from injections but still need ongoing support to keep weight off. The weight maintenance will only be achieved if changes to diet and lifestyle are maintained as well.
Yes, higher-strength Rybelsus tablets (25 mg) are expected to be available in the UK from late 2025. This has been shown in clinical trials to achieve greater weight loss; closer to what we see with some injectable treatments.
Not at all. Think of the current Rybelsus dose as a stepping stone. By starting now, you can get used to the daily routine of taking the medication and begin building healthy habits. When the higher strengths arrive, you’ll already be in a good position to switch and aim for bigger results without starting from scratch.
No, Rybelsus is licenced in the UK to treat type 2 diabetes. However, research has shown it can also support weight loss. That’s why our clinicians may prescribe it “off-label” for weight management.
For more information, see the patient leaflet.
Medicines are approved for specific conditions, but under UK law, a clinician may prescribe them for different uses if there’s good evidence that they can help. This is called “off-label” prescribing, and is a common, safe and accepted practice when a clinician feels it’s appropriate for your care.
Every prescription is reviewed by a qualified prescriber. They will only recommend off-label use if it is safe and appropriate for you.
Our clinical team will create a personalised transition plan to help you move to Wegovy with equivalent efficacy and minimal risk of side effects.
If you have any questions about this treatment, you can contact us.