What are semaglutide dissolving tablets for weight loss? The Found guide

If you’ve been wanting to try a GLP-1 weight loss medication but dread injecting yourself with needles, oral versions of semaglutide—including the new compounded oral semaglutide dissolving tablets available from Found—might be an option. 

What are they, and how do they compare to other forms of semaglutide? We’ll explain. 

What are the oral forms of semaglutide? 

1. Rybelsus®, manufactured by Novo Nordisk, is the first and only FDA-approved oral semaglutide. Though it’s approved as a treatment for type 2 diabetes, it’s also prescribed off-label for weight loss. It’s a pill, typically taken daily with water.

2. Oral semaglutide dissolving tablets, now available at Found, are a compounded form of semaglutide—the same active ingredient in Rybelsus (for type 2 diabetes) and the injectable medications Ozempic® (for type 2 diabetes) and Wegovy® (for weight loss)—with added vitamin B6. Usually taken daily, they dissolve quickly under the tongue or between the cheek and gum, without water.

What’s compounded semaglutide? 

Compounded medications are made in a licensed pharmacy. These medications are designed to meet an individual’s specific health needs. Because there is currently no FDA-approved semaglutide oral dissolving tablet (ODT) on the market, licensed pharmacies can make an ODT version of the semaglutide to meet the unique needs of individual consumers. 

Although compounded medications do not have FDA approval, the U.S. Food and Drug Administration permits them in certain circumstances, and licensed compounding pharmacies must meet strict quality standards. Compounded medications can be more affordable than brand-name drugs, and they may also be designed to meet the individual needs of those who have allergies to available formulations or other concerns about the brand-name version of a drug. 

At Found, compounded semaglutide oral dissolving tablets cost $189 for a 28-day supply. That doesn’t include the cost of clinical visits, labs, or a Found subscription—which provides access to a health coach as well as lifestyle change education and support from a community of fellow Found members within the Found app. (Read more about getting a compounded semaglutide prescription through Found.) 

Found only uses U.S.-based licensed pharmacies to supply its compounded medications. Epiq Scripts of Richardson, Texas, is Found’s vendor for compounded oral semaglutide dissolving tablets. Found is not affiliated with Novo Nordisk A/S, the owner of the registered trademarks Rybelsus, Ozempic and Wegovy.

How does semaglutide work for weight loss? 

Semaglutide is a glucagon-like peptide 1 receptor agonist, or GLP-1 receptor agonist. That means it mimics GLP-1, one of the body’s naturally occurring hormones. In clinical trials, semaglutide has helped people (some with and some without type 2 diabetes) regulate blood sugar, feel fuller, and lose weight. More recent studies found it also can lower the risk of heart attack, stroke, and other adverse events in those with preexisting cardiovascular disease.

Researchers believe semaglutide works in several ways: 

1. By suppressing appetite, those taking it don’t feel hungry as often and feel full after eating smaller meals;
2. By slowing digestion, which can help people feel full for longer; 
3. And by influencing food preferences which helps people choose less calorie-dense foods. 

Does semaglutide work better if taken orally? 

It’s important to note that most published clinical trials about the effects of oral semaglutide thus far have involved pills swallowed whole with water—not ODTs, which dissolve rapidly under the tongue or between the gum and cheek and have different dosages.

In such studies, oral semaglutide pills appear to be as effective as semaglutide injections as a treatment for obesity. In one large placebo-controlled trial, people who took a daily dose of oral semaglutide (25 mg) lost an average of 13.6% of their baseline body weight after 64 weeks. This loss is comparable to the weight lost by people who took the highest dose of injected semaglutide (2.4 mg a week) in similar clinical trials. 

For diabetes care, one  study found that once-daily oral semaglutide pills (not ODTs) may be less effective for lowering glucose levels in people with later onset of type 2 diabetes as compared to those with a more recent diagnosis of diabetes. However, other studies found that oral semaglutide, sometimes in combination with metformin, can be as effective as subcutaneous semaglutide for glycemic control. And recent results from a clinical trial indicated the effect of oral semaglutide may be similar to that of subcutaneous semaglutide injections in lowering blood pressure and reducing the risk of cardiovascular disease or cardiovascular events. 

Though compounded medications are FDA-permitted from licensed pharmacies and reviewed for adverse events after they are sold, compounded drugs, including oral semaglutide dissolving tablets, are not FDA-approved and have not undergone pre-market clinical studies for safety or efficacy. So, we don’t know how oral semaglutide dissolving tablets will compare. 

What is the dosage of oral semaglutide for weight loss? 

Since oral forms of semaglutide aren’t labeled or FDA-approved as obesity treatments, researchers are still studying what dose is most effective for weight loss.

Approved at doses of up to 14 mg daily as a treatment for type 2 diabetes, Rybelsus is available in 3 mg and 7 mg tablets. However, in clinical trials, doses of 50 mg per day were most effective for weight loss.

Adele Feng, PharmD, director of clinical operations at Found, notes that oral dissolving tablets typically require less of an active ingredient than pills that are swallowed. That’s because the oral dissolving medicine passes directly into the bloodstream through the delicate tissues under the tongue or in the gums and cheek, rather than moving through and breaking down in the digestive system.

Epiq Scripts, the vendor of compounded oral semaglutide dissolving tablets available from Found, recommends starting most patients at 1 mg dose per day for the first month and progressing to 2 mg a day thereafter or, for patients who are making a switch from injectable semaglutide, starting most at a 4 mg dose per day for the first month and progressing to 6 mg a day.

At Found, while decisions about whether a patient is qualified for medication and what dosage to prescribe ultimately rest with the provider, Found clinicians work closely with each patient to determine the best formulation and most effective dose for their needs.

What are the side effects of semaglutide? 

All GLP-1 medications have known potential side effects. The most common are nausea, vomiting, diarrhea, and constipation. More serious but less common side effects include pancreatitis, gallbladder disease, gastroparesis (stomach paralysis), and worsening of diabetic eye disease, as well as pulmonary aspiration while under general anesthesia or deep sedation. Those with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasias should not use them.  

Side effects and risks differ by brand and formulation. And compounded medications, which lack pre-market clinical study and FDA approval, may include different non-active ingredients and pose additional risks or cause additional side effects.

Find details about side effects and risks for specific medications by name on our dedicated medication page.

Comparing semaglutide injectables vs oral pills vs. dissolving tablets 

Here are some key differences among injectable semaglutide, oral semaglutide, and compounded oral semaglutide dissolvable tablets: 

Frequency: 

• Injectable semaglutide is typically taken once a week, on the same day of the week. 
• Brand-name oral semaglutide pills and compounded oral semaglutide dissolving tablets are typically taken once a day, at about the same time of day.

With or without food/water: 

• Injectable semaglutide can be taken with or without food. Sip water throughout the day. 
• Oral semaglutide pills are taken on an empty stomach, swallowed whole with only a small amount of water, and at least 30 minutes before eating, drinking, or taking other medications or supplements.
• Oral semaglutide dissolving tablets are taken without food or water. They dissolve in less than a minute. Epiq Scripts recommends avoiding eating or drinking anything with calories or carbonation for 30 minutes after taking them. If you take other drugs by mouth, tell your health care provider, as you may need to stagger the timing of your medications.

Method of administration:

• Injectable semaglutide is injected just under the skin on the thigh, upper arm, or abdomen. Learning how to self-administer injection medication can be tricky, and pre-filled semaglutide injector pens can be easier to use than syringes and vials.
• Oral semaglutide pills are easy to take—swallowed whole with water—but, importantly, they must be taken on an empty stomach when you first wake up and at least 30 minutes before eating, drinking, or taking other medications or supplements.
• Oral semaglutide dissolvable tablets are easy to take: Patients place the tablet under their tongue or inside their cheek and let it dissolve. It’s OK to crush it under the tongue to aid absorption, but it’s important not to chew or swallow it whole.

Dose escalation:

• All forms of semaglutide typically are started at a low dose and gradually increased to achieve a therapeutic dose. This approach helps lower the risk of side effects and adverse events.

Lifestyle interventions:

• Based on clinical studies of injectable and brand-name oral semaglutide, semaglutide should be combined with lifestyle interventions, including a calorie-restricted diet and increased exercise, to optimize weight loss and weight management. Epiq Scripts recommends similar lifestyle changes when taking dissolving oral semaglutide tablets. 

Could oral semaglutide be right for you?

While that’s a question best explored with your health care provider, oral semaglutide may be an alternative for those seeking the benefits of semaglutide without injections. Whether you choose the FDA-approved Rybelsus or compounded oral dissolving tablets, your Found provider can help you find the right combination of medication and lifestyle changes to achieve your weight management goals.
‍

About Found

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

While GLP-1s are effective for weight loss, they are not clinically appropriate for everyone. Eligibility for a GLP-1 is based on a provider’s evaluation of your medical history, MetabolicPrint, and lab work. If a GLP-1 is not appropriate for you, a provider will work with you to determine an effective medication for your health profile. This content does not provide medical advice and does not substitute for a consultation with a doctor or health care provider.