Ｒｙｂｅｌｓｕｓ　Ｔａｂｌｅｔｓ　(Ｓｅｍａｇｌｕｔｉｄｅ)

- No Prescription
- Manufactured by Novo Nordisk Ltd.
- Product of Japan
- Ships Worldwide from Japan


What is Rybelsus®?
Rybelsus is a prescription drug that’s approved by the U.S. Food and Drug Administration to treat Type 2 diabetes. Clinicians prescribe it off-label for weight loss because clinical evidence shows it also helps people with excess weight and obesity lose weight.

Rybelsus is a brand-name version of an oral semaglutide manufactured by Novo Nordisk. It is a synthetic version of the body’s natural GLP-1 hormone. There’s no generic version that is approved by the FDA.


Benefits of Rybelsus®:
Expected weight loss depends on the dosage of Rybelsus. Research shows that over 26 weeks, people on the 7 mg dosage lost around 5 pounds, and those on the 14 mg dosage lost around 8 pounds. (Safe weight loss is one to two pounds per week.)


How does Rybelsus® work?
Rybelsus is a synthetic GLP-1 receptor agonist (RA). A drug that works as an agonist activates the same cell receptors as the body’s natural hormones. So, Rybelsus works in the body like its natural GLP-1.

Eating triggers the gut to release GLP-1. This hormone helps lower blood glucose (blood sugar) by stimulating insulin secretion and reducing the amount of glucose produced by the liver.

Rybelsus slows digestion, which helps curb hunger and signal fullness to the brain. As a result, some people with obesity have lost weight while taking it.

Patients typically take Rybelus, a tablet, once daily on an empty stomach in the morning with a sip of water. Wait 30 minutes before eating or drinking after taking Rybelsus. Store Rybelsus in its bottle with the cap on at room temperature away from moisture — don’t store it in the bathroom.

Dosing:
For most patients, Rybelsus dosing begins with 3 mg taken once daily by mouth for 30 days. After 30 days, the dosage is typically increased to 7 mg taken once daily for another 30 days. If clinically appropriate after at least 30 days on a 7 mg dose, your provider may increase the dosage again to a 14 mg daily pill, the highest prescribed dosage.


Side effects:
Many people experience no side effects. Some of the most common or potential side effects include:

- Nausea
- Constipation
- Vomiting
- Diarrhea
- Abdominal Pain
- Headache
- Indigestion
- Dizziness
- Back pain
- Increased Lipase or Amylase
- Altered taste
- Nasopharyngitis (common cold)
- Passing Gas
- Bloating
- Belching
- Gastroenteritis
- Decreased appetite
- Fatigue
- Gastroesophageal reflux disease
- Low blood sugar (hypoglycemia) in those with Type 2 diabetes
- Upset stomach

These symptoms often subside as your body adjusts to the medications. Please notify your provider if side effects persist. For a complete list of side effects, review the medication packaging inserts.


Black Box Warning:
Although rare, semaglutide caused thyroid C-cell tumors in animal studies. Rybelsus’ “black box” warns of the risk of these tumors. If you have trouble swallowing, develop hoarseness, or feel swelling or a lump in your neck, contact your health care provider immediately.


Precautions:
Rapid or significant weight loss can lead to too much muscle loss. To protect your muscles while taking Rybelsus it’s important to start a strength training program and exercise regularly.

Use effective contraception while taking this medication. If you are pregnant, breastfeeding, or planning to become pregnant, do not take Rybelsus.

The FDA also warns not to take Rybelsus if you have a personal or family history of multiple endocrine neoplasia syndrome Type 2, medullary thyroid cancer, insulin-dependent diabetes, or diabetic ketoacidosis. So, if that’s you, Rybelsus isn’t the right fit.


Interactions:
Some drugs can also interact with Rybelsus, including:

- Insulin
- Sulfonylureas (these can cause blood sugar levels to drop dangerously low when combined with Rybelsus)
- Some birth control pills
- Other GLP-1 or GLP-1/GIP receptor agonist medications such as liraglutide, dulaglutide, or tirzepatide

You should not drink alcohol while taking this drug because alcohol can lower blood sugar. Combining alcohol with Rybelsus may cause blood sugars to fall too fast, leading to fainting and dizziness.