Rybelsus for Weight Loss: Effectiveness, Evidence, Side Effects…

Rybelsus or semaglutide (generic name) is a once daily oral medication for treatment of type 2 diabetes. It is used along with diet and exercise to control blood sugar levels and A1c in patients with type 2 diabetes. While Rybelsus is not approved for weight loss, if you are taking it for diabetes it may help you lose some weight.

Rybelsus for weight loss and blood sugar control

Rybelsus belongs to a class of medications called glucagon-like peptide-1 (GLP-1) agonists. In diabetics, it helps control blood sugar levels by signaling your body to produce more insulin when blood sugar levels are high. Rybelsus has been shown to decrease A1C by over 1%. For weight loss, Rybelsus works by regulating appetite and slowing stomach emptying, causing you to feel full sooner, which may lead to eating less calories and losing weight.

It works similarly to other medications in the same class: Ozempic (once a week injection), Wegovy (once a week injection) and Saxenda (once daily injection).

Rybelsus weight loss results from clinical trial

Rybelsus was studied in multiple clinical trials that enrolled thousands of patients for diabetes and blood sugar control. These trials also collected data about patient’s weight loss results.

In PIONEER 4 trial, patients on Rybelsus 14 mg dose had an average weight loss of 9.7 lbs after 26 weeks.

In PIONEER 3 trial, patients on Rybelsus 14 mg dose had an average weight loss of 6.8 lbs after 26 weeks. Patients on Rybelsus 7 mg dose had an average weight loss of 4.8 lbs after 26 weeks.

In PIONEER 2 trial, patients on Rybelsus 14 mg dose had an average weight loss of 8.4 lbs after 26 weeks.

Rybelsus Dose

Rybelsus is started at a dose of 3 mg once daily for 30 days and then increased to 7 mg once daily. After 30 days on the 7 mg dose, it may be increased to 14 mg once daily if better blood glucose control is required. It is started at a low dose (3 mg daily) and increased slowly to reduce the risk of side effects and help increase tolerance.

Rybelsus should be take 30 minutes or more before the first food, beverage or other medications of the day.

Rybelsus missed dose

If you forget to take a Rybelsus dose, continue taking as per your usual schedule. Do not double up dose.

Rybelsus side effects

The most common side effects of Rybelsus are nausea, vomiting, diarrhea and abdominal pain. To reduce the risk of side effects, it is started at a lower dose and increased slowly. These side effects are most common when you first start taking Rybelsus. If side effects are intolerable, you may have to stop taking Rybelsus and speak to your doctor.

If you experience severe stomach pain (abdomen) that will not go away, with or without vomiting, you should call your healthcare provider right away. Rybelsus may cause inflammation of the pancreas (pancreatitis). Seek medical attention right away if you have any signs of an allergic reaction such as rash, hives, swelling of the lips/tongue/throat or difficulty breathing. Tell your healthcare provider if you have changes in vision during treatment with Rybelsus. If you experience upper abdominal pain, fever, yellowing of your skin or eyes (jaundice), clay-colored stools, or yellowing of your skin or eyes (jaundice), you should speak with your healthcare provider right away as Rybelsus may rarely cause gall bladder problems.

Rybelsus should not be used If you or someone in your family has medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). In animal studies, Rybelsus caused thyroid C-cell tumours but it is unknown whether it causes the same in humans. If you are on Rybelsus, you should monitor for symptoms of thyroid tumours such as a mass in the neck, trouble swallowing, shortness of breath and persistent hoarseness.

Rybelsus in Pregnancy and Breastfeeding

Data collection to monitor pregnancy and infant outcomes following exposure to Rybelsus/semaglutide is ongoing. Rybelsus is not recommended for patients that are pregnant or planning to become pregnant. Patients who could become pregnant should use effective contraception during therapy. It is not known if Rybelsus is present in breast milk. You should talk to your doctor to consider the risks vs benefits.

Reference: FDA monograph