GLP-1 pill: Is a GLP-1 pill a good alternative to injectable GLP-1 meds?

It’s absolutely no surprise that glucagon-like peptide 1 (GLP-1) receptor agonists (RAs) are big news right now. Medications from the glucagon-like peptide 1 receptor agonist drug class, like Ozempic® (semaglutide) and Saxenda® (liraglutide), have made national headlines in recent years because of shortages (most of which are now resolved, according to the US Food and Drug Administration’s drug shortages list) undeniable weight loss success, and cost.

‍Indeed, popular GLP-1s are approved by the U.S. FDA to be prescribed for type 2 diabetes or excess weight and obesity. GLP-1s work by mimicking the GLP-1 incretin hormone your body already makes that lowers blood sugar and controls appetite. This makes them extremely helpful in managing blood glucose levels in those being treated for type 2 diabetes, and the appetite mechanism aids in weight loss.

Even more, some GLP-1s like Trulicity® (dulaglutide) and Wegovy® even help lower the risk of major adverse cardiovascular events (MACE) like heart attack and stroke. The FDA approved Zepbound® in December 2024 as the first medication to treat sleep apnea—a significant breakthrough. The FDA also approved Ozempic in early 2025 to treat kidney disease.  

For weight loss, tirzepatide—sold under the brand names Zepbound and Mounjaro®—a GIP/GLP-1 medication—shows some of the best results among weight loss drugs, with some patients seeing up to a 22.5 percent body weight loss during a clinical trial conducted by manufacturer Eli Lilly. It’s often grouped with the GLP-1 family, but in fact it belongs to a drug class all on its own. Tirzepatide is a GLP-1 and GIP (glucose-dependent insulinotropic polypeptide) receptor agonist—meaning it acts on not one but two incretin hormones that are released when you eat.

But something we don’t discuss very often is whether there’s a pill form for GLP-1s, typically subcutaneous (under-the-skin) injections. And truthfully, some of us may shy away from injecting ourselves daily or weekly with medication. So, let’s chat all about GLP-1 pills. Here’s what we know now.

Does GLP-1 come in pill form?

Yes. But right now, there’s only one FDA-approved GLP-1 pill—Rybelsus® (semaglutide). It was approved in 2019 for the treatment of type 2 diabetes mellitus. Rybelsus is made by the Danish pharmaceutical company Novo Nordisk and shares the same active ingredient as Wegovy and Ozempic—both also made by Novo Nordisk. Although a diabetes drug, Rybelsus is also prescribed off-label for weight loss in those with obesity.

Is Rybelsus as effective as brand name injectable GLP-1 for weight loss?

Truthfully, the answer depends on the GLP-1. In a review of seven randomized controlled trials published in 2021 in Diabetes Therapy, researchers compared the efficacy data of GLP-1 injectables and the oral semaglutide pill.  The once-daily 14 mg semaglutide pill was associated with greater weight loss than the injectable GLP-1s exenatide 2 mg and lixisenatide 20 μg. 

Additionally, the review found that compared to the other GLP-1s, the oral pill performed “non-statistically significant” better than the injectables, meaning, it worked just as well as the injectables or better. The only exception was when compared against the once-weekly 1 mg injectable semaglutide, they performed just the same.

The chances of experiencing the most common Rybelsus side effects of nausea, vomiting, gastrointestinal issues, constipation, and diarrhea with oral semaglutide were comparable to the injectable GLP-1s, so there’s no significant difference.

Will insurance cover Rybelsus?

We’re sure you’ve read some intimidating headlines about how pricey some GLP-1 injectables can be with and without insurance. The good news is that, according to Novo Nordisk, Rybelsus is currently covered by most insurance companies. That means what you pay is entirely dependent on your insurance coverage. And keep in mind diabetes medications are typically covered by insurance when prescribed as indicated.

Moreover, the Rybelsus website has a cost estimator. The out-of-pocket cost of Rybelsus without insurance depends on where you live, the dosage you’re prescribed, and the pharmacy you visit. However, the price for a 30-day supply ranges from $982 to $1197 as of April 2025, depending on the pharmacy per GoodRx. 

Rybelsus also has a savings card available. If you’re eligible, your co-pay for the diabetes drug could be as little as $10 a month for a 30-day, 60-day, or 90-day supply. However, there are many terms and conditions to be aware of, including that you must have commercial or private insurance to qualify.

What dosages are available for Rybelsus?

There are three dosages available of the oral semaglutide Rybelsus: 3 mg, 7 mg, and 14 mg. Novo Nordisk advises starting the oral semaglutide medication at 3 mg once daily for 30 days and then increasing it to 7 mg once daily. Patients requiring additional glycemic control can increase the dose to 14 mg once daily after taking the 7 mg dose for at least 30 days.

It’s important to note that, unlike GLP-1 injections, oral semaglutide needs to be taken “at least 30 minutes before the first food, beverage, or other oral medications of the day and that it be taken with no more than 4 ounces of plain water only,” according to the Rybelsus prescribing information by Novo Nordisk. The prescribing information also warns that if you take it with food or water, it lessens the efficacy of the oral tablet, and waiting longer than 30 minutes may actually increase the absorption of Rybelsus into your body.

Does Rybelsus have other side effects?

As we mentioned above, the oral GLP-1 med has the same most common side effects as its injectable sister meds, but you should be aware of other serious side effects before taking the medication. 

Although extremely rare, here’s a list of negative reactions to look out for:

• Risk of thyroid C-cell tumors 
• Pancreatitis (inflammation of the pancreas)
• Diabetic retinopathy Complications (damage to the eye’s retina)
• Hypoglycemia (low blood sugar)
• Acute kidney Injury 
• Hypersensitivity 
• Acute gallbladder disease 

Rybelsus also comes with a black box warning that you shouldn’t take the medication if you have a personal or family history of medullary thyroid carcinoma (MTC) or you have multiple endocrine neoplasia syndrome type 2 (MEN 2). 

The prescribing information also details that you shouldn’t take Rybelsus if you’re pregnant or planning to become pregnant or breastfeeding. Additionally, Rybelsus is not meant for those patients with type 1 diabetes. 

It’s important to talk to your health care provider about your history and let them know about any other medications or supplements you’re currently taking.

Are other GLP-1 pills in the works?

The short answer: yes. Eli Lilly is developing an oral GLP-1 drug, orforglipron. In its ACHIEVE 40-week Phase 3 trial, the highest dose of orforglipron, 36 grams, reduced A1c by an average 1.5%, and caused an average of 7.9% weight loss. Side effects were similar to other GLP-1s. Many expect orforglipron to be available in 2026. 

Novo Nordisk is also developing a new oral GLP-1. In the 68-week OASIS Trial, participants who had obesity or excess weight with one coexisting condition and who took the once-daily 50mg semaglutide tablet lost an average of 17.4% of their body weight. 

In terms of overall timing for new meds, they go through three phases of trials to be approved by the FDA. The final phase 3 trial can take anywhere from one to four years but varies greatly from drug to drug. The FDA wants to ensure any new drug is safe and effective, so treatments are thoroughly tested, and long-term effects are studied before FDA approval. 

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GLP-1*

GLP-1 prescriptions, filled through your local pharmacy, are now available as part of Found's weight-loss toolkit. While GLP-1s are effective for weight loss, they are not clinically appropriate for everyone. Eligibility for a GLP-1 is based on a thorough evaluation of your medical history, eating behavior, lab work, and insurance coverage. If a GLP-1 is not appropriate for you, our providers will work with you to determine an effective medication for your health profile.

About Found

Found is among the largest medically-supported telehealth weight care platforms in the country, having served more than 250,000 members to date. To start your journey with Found, take our quiz.

Found is not affiliated with or endorsed by Novo Nordisk A/S., the owner of the registered trademarks Wegovy®, Ozempic®, Victoza®, Rybelsus®, and Saxenda®. Found is not affiliated with or endorsed by Eli Lilly and Company, the owner of the registered trademarks Mounjaro® and Zepbound®. The content provided is for informational purposes only and should not be used as a basis for diagnosing or treating any health condition, or for determining actual costs incurred.  Always follow your health care provider’s instructions to ensure safe and effective management of your health conditions. Certain medications are only FDA-approved to treat conditions other than weight but may be prescribed to help aid in weight loss. Prescriptions are up to a medical provider’s discretion. For key risk information by drug, visit the Found medication page.

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