Rybelsus (Semaglutide Tablets) Explained
While semaglutide is the active ingredient most commonly found in weight loss injections like Wegovy, it’s also available as a tablet called Rybelsus.
Rybelsus was originally licensed to help manage type 2 diabetes by improving blood sugar control. But because it can also affect appetite and weight, it's sometimes prescribed off-label for weight management.
Here, we take a look at how Rybelsus tablets work, the changes in tablet strengths, and how they compare to weight loss injections.
Three key takeaways
- Rybelsus tablets contain semaglutide and are licensed to treat type 2 diabetes in the UK.
- In certain cases, Rybelsus can be prescribed off-label for weight loss.
- In 2025, Novo Nordisk released a new formulation of Rybelsus that's absorbed more effectively by the body. This means that while doses are lower than the original tablets, they work just as well.
What is Rybelsus?
Rybelsus contains semaglutide, which belongs to a class of medicines called GLP-1 receptor agonists. It works by controlling blood sugar levels, slowing down digestion, and reducing appetite.
Rybelsus is licensed in the UK specifically to treat type 2 diabetes. But due to the way it affects digestion and appetite, people taking oral semaglutide often experience weight loss as well.
This has led some clinicians to prescribe it off-label for weight management when other methods haven’t worked.
Who makes Rybelsus?
Rybelsus is manufactured by Novo Nordisk, a Danish pharmaceutical company that’s been involved in diabetes care for nearly a century. They specialise in diabetes and weight management treatments and have developed several GLP-1 medicines, including Ozempic and Wegovy.
How Rybelsus works
Rybelsus works in several ways to help manage your blood sugar levels and weight:
- It helps control your blood sugar: Rybelsus helps your pancreas release the right amount of insulin when you eat, which keeps your blood sugar more stable throughout the day.
- It slows down your digestion: it slows down how quickly food moves through your stomach, which means you feel fuller for longer after eating.
- It reduces your appetite: Rybelsus affects the appetite signals in your brain, so you naturally feel less hungry and may find it easier to eat smaller portions.
You may also find you're not thinking about food as much (food noise), feel satisfied with less, or don't have the same urge to snack between meals.
Can Rybelsus be used for weight loss?
Yes, Rybelsus can be prescribed off label for weight management in the UK. Off-label prescribing simply means using a medicine for a different condition than it was originally licensed for. This is common, legal, and safe when done under proper medical supervision.
Whether Rybelsus is right for you depends on:
- your BMI
- your overall health
- any medical conditions
- what other medicines you’re taking.
Our clinicians will assess this before deciding if Rybelsus is suitable for you.
If our clinicians recommend Rybelsus for weight loss, they’ll monitor you throughout your treatment journey to ensure it’s working well and you’re not experiencing any concerning side effects.
How quickly can you lose weight with Rybelsus?
Weight loss with Rybelsus is gradual, happening over weeks and months rather than immediately.
Research showed that after 26 weeks, people taking Rybelsus lost an average of 2.3kg on the 7mg dose and 3.7kg on the 14mg dose.
However, everyone is different, and your results may vary. For example, some people may notice changes sooner if they have a higher starting weight.
Remember, like all weight loss treatments, they work best alongside healthy lifestyle changes, like maintaining a balanced diet and staying active.
Understanding Rybelsus tablet formulations
Since Novo Nordisk developed a new formulation that's absorbed more effectively by your body, the strengths of Rybelsus tablets have changed. This means the medicine now works better at lower doses.
The new Rybelsus strengths are:
- 1.5mg
- 4mg
- 9mg
The old Rybelsus strengths were:
- 3mg
- 7mg
- 14mg
Most people start on the lowest dose and gradually increase it over time, a process called titration. This helps your body adjust to the medication and reduces the chance of side effects.
Rybelsus tablet strengths
The new Rybelsus tablets are round rather than oval and come in lower strengths. But don’t let the lower numbers worry you. These tablets are absorbed much more effectively by your body, so they work just as well as the old, higher doses.
1.5mg starting dose
The 1.5mg dose is the starting strength for the new formulation. Like the original 3mg, it's designed to help your body adjust to the medicine gradually.
You'll typically stay on this dose for about a month before your prescriber increases it to 4mg, assuming you're tolerating it well.
4mg ongoing dose
The 4mg dose is usually where you'll start to notice the main effects of Rybelsus, including reduced appetite and better blood sugar control.
Many people find this strength is enough to meet their treatment goals. Your prescriber will review your progress and decide whether you need to move up to the 9mg dose.
9mg maintenance dose
The 9mg dose is the highest strength of the new formulation and is used for longer-term treatment when needed.
While it's not identical to injectable semaglutide products like Wegovy or Ozempic, it provides an effective dose for ongoing weight management or diabetes control in tablet form.
How to take Rybelsus
- Take it first thing in the morning. Swallow your tablet whole with up to half a cup of water on an empty stomach, ideally when you first wake up. Don't break, crush, or chew it.
- Wait before eating. After taking Rybelsus, wait at least 30 minutes before eating or taking any other medicines. This helps your body absorb it properly.
- If you miss a dose, skip the missed dose and take your tablet the next day as usual. Don't take two tablets to make up for the missed dose.
- Don't stop suddenly. Always speak to your prescriber before stopping Rybelsus, as your blood sugar levels could increase suddenly if you have diabetes.
Switching Rybelsus dosage strengths
If you're switching from the original Rybelsus to the new formulation, your prescriber will make sure you get the equivalent dose:
| Old Rybelsus Dose | New Rybelsus Dose |
| 3mg | 1.5mg |
| 7mg | 4mg |
| 14mg | 9mg |
The new tablets work just as effectively because they're absorbed better by your body. Your prescriber will guide you through the switch, and you shouldn't notice any difference in how the medicine works.
Are the original strength tablets getting discontinued?
Yes, the original Rybelsus tablets (3mg, 7mg, and 14mg) are being phased out and replaced with the new formulation.
If you're currently taking the original tablets, your prescriber will discuss switching you to the equivalent new strength when the time is right.
You won't be left without medication, and the transition will be managed carefully to make sure your treatment continues smoothly.
Weight loss tablets vs injections
Rybelsus tablets and Wegovy injections both contain semaglutide, work in the same way, and have similar side effects. However, there are some practical differences that you should be aware of.
How they are taken
Rybelsus is a daily tablet that you take first thing in the morning on an empty stomach. You then need to wait at least 30 minutes before eating or taking other medication.
Weight loss injections like Wegovy are taken once a week. You inject either in your stomach, thigh, or upper arm, and you can use them with or without food.
Some people prefer the convenience of a weekly injection, while others prefer taking a daily tablet to avoid injecting. This can be down to preference or to an aversion to needles. Either way, neither option is “better or worse”. It's about what works for your lifestyle and circumstances.
Weight loss outcomes
Studies have found that people using Wegovy lost around 15-17% of their body weight after 68 weeks, while those taking Rybelsus lost around 6% of their body weight after a year.
However, it’s important to remember that these are averages, and some people lose more, others less. Your results will depend on:
- your starting weight
- any lifestyle changes you make
- how well you tolerate the medication
- how your body responds to treatment
Rybelsus vs Wegovy
Take a look at the comparison table below to find out more about the differences between Rybelsus and Wegovy.
| Rybelsus | Wegovy | |
| Active ingredient | Semaglutide | Semaglutide |
| Type | Daily tablet | Weekly injection |
| License in the UK | Type 2 diabetes | Weight management |
| Doses | 1.5mg, 4mg, 9mg | 0.25mg, 0.5mg, 1mg, 1.7mg, 2.4mg |
| Average weight loss | Around 6% after 52 weeks | Around 15-17% after 68 weeks |
| How it’s taken | Swallowed once daily with water on an empty stomach | Injected once weekly, with or without food |
| NHS availability | For type 2 diabetes | For weight management in certain circumstances |
| Use for weight loss | Off-label | Licensed for this purpose |
Why are injections prescribed more often
Injections like Wegovy are prescribed more often simply because they’re licensed for weight management in the UK, while Rybelsus is only licensed for diabetes.
This means that healthcare professionals have clearer guidance on prescribing Wegovy for weight loss.
However, that doesn’t mean Rybelsus can’t be prescribed off-label for weight loss if your prescriber thinks it’s the right option for you.
Rybelsus side effects
Like all medications, Rybelsus can cause side effects, though not everyone will get them. Many side effects are related to your digestive system and tend to happen when you first start treatment or increase your dose, but they often improve as your body adjusts.
While side effects can be uncomfortable, they’re usually temporary and manageable, and knowing what to expect can help you feel more prepared.
Potential benefits
Beyond helping with blood sugar and weight, some people notice other positive changes while taking Rybelsus, like:
- thinking about food less (reduced food noise)
- have fewer cravings
- find it easier to make healthier choices
- reduced cardiovascular risk
Blood sugar control
If you have type 2 diabetes, improving blood sugar control is likely why you’ve been prescribed Rybelsus. It works by supporting your body's natural insulin response, which helps keep your blood sugar more stable throughout the day with fewer highs and lows.
Your prescriber will monitor your HbA1c levels (which measure long-term blood sugar control) to see how well it's working. Even if you're taking Rybelsus for weight management rather than diabetes, it can still help keep your blood sugar stable, which some people notice through steadier energy levels.
Common side effects
The most common Rybelsus side effects are the same as the most common Wegovy side effects:
- nausea
- diarrhoea
- vomiting
- constipation
- reduced appetite
- stomach pain
- acid reflux
How to manage Rybelsus side effects
Managing nausea and vomiting
There are several ways to help manage your nausea:
- eat smaller, more frequent meals. Choose bland foods, like toast, crackers, and rice, which are often easier to tolerate than richer foods
- avoid triggers like greasy, spicy, or very rich foods, especially in the first few weeks
- have ginger tea or ginger biscuits to help settle your stomach
- stay upright after eating
- stay hydrated
If your nausea is severe or you're vomiting regularly, speak to your prescriber as they may need to adjust your dose or give you additional support.
Diarrhoea and constipation
Changes in bowel habits are common with Rybelsus. Here's how to manage them.
For diarrhoea:
- stay hydrated, and consider oral rehydration sachets
- cut back on caffeine and very fatty foods as these can make it worse
Contact your prescriber if your diarrhoea is severe, lasts more than a few days, or you notice signs of dehydration (dark urine, dizziness, or extreme thirst).
For constipation:
- increase your fibre intake by adding more fruits, vegetables, and whole grains to your diet
- stay hydrated
- gentle exercise can help get things moving
- consider laxatives
Speak to your clinician if your constipation is very uncomfortable or hasn't improved with lifestyle changes.
Reduced appetite
Having a reduced appetite is one of the ways Rybelsus works, so it's expected to some degree. You might feel full more quickly, be less interested in food, or forget to eat. While this helps with weight management, it's important to make sure you're still eating enough:
- eat regular, smaller meals, and try to eat consistently even if you're not feeling particularly hungry
- choose nutrient-dense foods
Speak to your prescriber if you're struggling to eat anything at all, losing weight very rapidly, or feeling weak and unwell. They can check whether your dose needs adjusting.
Stomach pain and reflux
Some people experience stomach discomfort or acid reflux while taking Rybelsus, often related to slower stomach emptying. Here's what you can do to help:
- avoid lying down after eating
- eat smaller portions
- avoid trigger foods like caffeine, alcohol, spicy foods, and very acidic foods
Contact your doctor urgently if you experience:
- sharp, severe abdominal pain
- pain that spreads to your back
- persistent pain that's getting worse
This could be a sign of something more serious like pancreatitis.
When to speak to a doctor
While most side effects are manageable, there are some situations where you need medical attention. Contact your doctor or seek urgent care if you experience:
- severe or persistent vomiting that won't stop
- signs of dehydration (very dark urine, dizziness, extreme thirst, or not urinating)
- severe abdominal pain, especially if it spreads to your back
- symptoms of pancreatitis (severe upper stomach pain, nausea, vomiting, or fever)
- allergic reactions (rash, swelling of your face or throat, or difficulty breathing)
- very rapid heartbeat or palpitations
- changes in vision
- symptoms of low blood sugar (if you're taking other diabetes medications)
Don't wait if you're worried. It's always better to check with a healthcare professional if something doesn't feel right.
Is Rybelsus prescribed in the UK for weight loss?
Yes, Rybelsus can be prescribed off-label for weight loss in the UK. However injectable semaglutide (Wegovy) is prescribed more often due to it already being licensed for this purpose.
As it’s a prescription-only medicine, Rybelsus is only available through GPs, licensed pharmacies, and hospital specialists.
Frequently asked questions about Rybelsus
How much does Rybelsus cost in the UK?
Rybelsus costs between £120 and £190 depending on your chosen provider.
How can you tell it’s working?
You'll notice Rybelsus is working through changes like reduced appetite, feeling fuller after meals, or thinking about food less often. If you're monitoring your weight, you should see gradual changes over weeks and months, but don't forget about non-scale victories too, with things like how your clothes fit. For people with diabetes, blood sugar readings should become more stable.
When can you eat after taking Rybelsus?
Wait at least 30 minutes after taking Rybelsus before eating or drinking. This helps your body absorb the medication properly. Don't take any other medications during this time either. Many people find it easiest to take Rybelsus first thing in the morning.
Why does Rybelsus cause tiredness?
Some people feel tired while taking Rybelsus. This might be because you're eating less than usual, so make sure you're getting enough calories and nutrients. If you have diabetes, check your blood sugar levels as tiredness could be related to changes in those.
What if you miss a Rybelsus dose?
Skip the missed dose and take your next one the following day as normal. Don't take two tablets to make up for it. Missing one dose won't have a major impact but try to stay consistent. If you're regularly forgetting, set a reminder or keep your tablets somewhere visible.
What is off-label prescribing?
Off-label prescribing is when a healthcare professional prescribes a medicine for something other than its original licensed purpose. It's common, legal, and safe when done properly.
Rybelsus is licensed for type 2 diabetes, but it may be prescribed off label for weight management because it reduces appetite and slows digestion. Your prescriber should explain they're prescribing off label and why it's right for you.
Sources
- Rybelsus (Semaglutide) Information. (2025). Diabetes UK. [Accessed 22nd December 2025].
- Rybelsus Official Website. Rybelsus. [Accessed 22nd December 2025].
- About Novo Nordisk. Novo Nordisk. [Accessed 22nd December 2025].
- Our Medicines. Novo Nordisk. [Accessed 22nd December 2025].
- How Rybelsus Works. Rybelsus. [Accessed 22nd December 2025].
- Rybelsus for Weight Loss. (2025). Drugs.com. [Accessed 22nd December 2025].
- Rybelsus: Transition to New Formulation and Risk of Medication Error. (2025). MHRA Drug Safety Update. [Accessed 22nd December 2025].
- MHRA Drug Safety Update: Rybelsus Formulation Change. (2025). Centre for Pharmacy Postgraduate Education. [Accessed 22nd December 2025].
- How to Start Rybelsus. Rybelsus. [Accessed 22nd December 2025].
- Rybelsus vs Wegovy Comparison. Drugs.com. [Accessed 22nd December 2025].
- Semaglutide Clinical Trial. (2021). New England Journal of Medicine. [Accessed 22nd December 2025].
- Rybelsus Clinical Research. (2023). PMC/NCBI. [Accessed 22nd December 2025].
- Rybelsus Cardiovascular Outcomes Trial. Novo Medlink. [Accessed 22nd December 2025].
- Weight Loss Injections Explained. (2025). British Heart Foundation. [Accessed 22nd December 2025].
- Weight Loss Medications FAQ. General Pharmaceutical Council. [Accessed 22nd December 2025].
