Rybelsus®, the popular GLP-1 receptor agonist medication (or GLP-1 for short) intended to treat type 2 diabetes and prescribed off-label for weight loss, is the brand name of the pill version of the GLP-1 semaglutide. We’re sure you're familiar with its injectable GLP-1 counterparts like Wegovy®, Ozempic®, Victoza®, and Saxenda®.
Rybelsus is manufactured by the Danish pharmaceutical company Novo Nordisk. And whether you’re exploring the med, you’ve been prescribed Rybelsus for weight loss, or will be prescribed it in the near future, you may be concerned about the potential side effects.
It’s true, Rybelsus has side effects you should be aware of before taking the med to ensure your weight loss journey is safe and healthy. Here’s an in-depth look into Rybelsus (semaglutide) side effects and what to expect when taking the med.
Semaglutide is the active ingredient in Rybelsus, a glucagon-like peptide-1 receptor agonist (GLP-1 RA). Rybelsus works to lower blood sugar levels by mimicking the naturally occurring GLP-1 incretin hormone your body already makes. It does this by signaling the pancreas to increase insulin production to reduce blood glucose levels.
On top of that, Rybelsus works to slow your digestion (gastric emptying), helping you to feel fuller longer and suppressing your appetite supporting weight loss. And it decreases the amount of glucose your liver produces, preventing it from making too much.
Rybelsus is the first of its kind GLP-1 pill and is an enticing option for those people who may have a needle-aversion or find an oral tablet easier to remember to take. It was approved by the U.S. Food and Drug Administration in 2019 for the treatment of type 2 diabetes, and clinical studies reported its effectiveness for weight loss as well.
Chat with your health care provider about the common side effects of Rybelsus, and let them know if you experience them or if they become intolerable.
In most clinical trials, patients experienced the common side effects at the beginning of treatment, but they waned after a few weeks—it may take some time for your body to adjust to the new med. Here are the common Rybelsus side effects:
decreased appetite (or loss of appetite)
Other not-so-common possible Rybelsus side effects:
acid reflux or gastroesophageal reflux disease (GERD)
Just remember to stop taking the medication and call your doctor immediately if you start to experience any severe side effects or allergic reactions.
All GLP-1 receptor agonists come with certain precautions about rare but serious side effects. Don’t fret, less than five percent of all the patients studied experience any of them, but we want you to know about any med you’re about to take. Here’s what you may experience.
inflammation of your pancreas (pancreatitis)
changes in vision (blurred vision)
low blood sugar (hypoglycemia)
kidney problems (kidney failure)
serious allergic reactions like hives, rash, trouble swallowing, hoarseness, and shortness of breath
possible thyroid tumors, including thyroid cancer
increase in heart rate or fast heartbeat
Rybelsus includes a black box warning, the most serious warning from the FDA to alert consumers to severe or life-threatening side effects. This is because there is a known risk of thyroid C-cell tumors.
Additionally, the FDA warns that Rybelsus (semaglutide) is never to be used if you have a personal or family history of medullary thyroid carcinoma (MTC), Multiple endocrine neoplasia syndrome type 2 (MEN2), or any history of an allergic reaction to semaglutide.
No, it’s not safe to take while pregnant or breastfeeding. Some animal studies found a correlation between birth defects or even fetal death and semaglutide.
Take extra birth control precautions while on semaglutide if you’re sexually active and can get pregnant. The manufacturer recommends waiting at least two months after your last dose of semaglutide before getting pregnant because of how long it takes to leave your system.
Most people reported Rybelsus side effects decreased after the first few weeks on Rybelsus. The dosing schedule begins with a once-daily 3 mg dose of Rybelsus for 30 days. Then it’s upped to 7 mg for another 30 days, and if additional glycemic control is needed, the dose increases to 14 mg. Be aware that each dosage increase may cause Rybelsus side effects to reoccur briefly, but if you’re tolerating it well, your healthcare provider will increase the dose.
So as your dose increases, they may come on again but the side effects will subside with time as your body gets used to the new dose. If you’re wondering, "do Rybelsus side effects go away?" The answer is generally yes.
As mentioned above, talk to your health care professional if you experience any adverse Rybelsus side effects that aren’t going away over time. They may be able to switch meds and find one that works best for you. Just keep in mind that Rybelsus is a long-acting drug, meaning it stays in your system for a few weeks after stopping it, so it may take that amount of time for the side effects to dissipate.
Right now, Rybelsus is approved for long-term use, so no long-term Rybelsus side effects are associated with oral semaglutide. Safe to say, unless you’re experiencing a major severe effect or if the common side effects become intolerable, Rybelsus is meant to be used long-term without the risk of any lasting effects.
Because Rybelsus slows gastric emptying, it may cause other oral meds to not be absorbed into your body, decreasing their efficacy.
Let your doctor know about any over-the-counter medications or supplements you may take. Also—it’s important to keep them up-to-date on any new prescription drugs you’re on so your healthcare provider can ensure they’re working properly.
Please tell them about any medical conditions and give them a full run-down on your medical history so they can be well-informed to help form the best treatment plan for you.
Rybelsus isn’t meant for those who have type 1 diabetes. And, if you’re currently being prescribed insulin secretagogue (like sulfonylureas) or insulin, the prescribing information recommends lowering the dose to reduce your risk of hypoglycemia (low blood sugar) which can lead to dizziness, lightheadedness, and fainting because of low blood glucose levels.
If you experience any common side effects of Rybelsus, like nausea, you can do a few things to help ease the Rybelsus side effects. Here’s what the manufacturer suggests:
Eat bland, low-fat foods like crackers, toast, and rice.
Eat foods that contain water, like soups and gelatin.
Avoid fried, greasy, or sweet foods.
Avoid lying down after you eat.
Go outdoors for fresh air.
Eat more slowly.
Drink clear or ice-cold drinks.
Although indicated for type 2 diabetes mellitus, Rybelsus could be the right choice for you for chronic weight management. Have a conversation with your doctor about the latest drug information.
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Access to GLP-1s prescriptions is now available as part of Found's weight-loss program. 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 medical history, eating behavior, lab work, and insurance coverage. If a GLP-1 is not appropriate or affordable for you, Found providers can help determine if another effective medication is.
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