Skip to content

3 Tips to BEST Use Rybelsus

Share this article

Watch this on YouTube.

Rybelsus, an oral form of semaglutide, is similar to the injectable medications Ozempic and Wegovy. While all these drugs are effective, the way you take Rybelsus can significantly influence its effectiveness. Here’s how to dose it properly to get the best results.

Tips for Taking Rybelsus

  1. Take on an Empty Stomach: It’s crucial to take Rybelsus first thing in the morning on an empty stomach. This helps the medication absorb more efficiently.
  2. Limit Water Intake: Use no more than half a glass of water when taking the pill. This small amount helps the medication dissolve properly without diluting its effects.
  3. Wait Before Eating: After taking Rybelsus, wait at least 30 minutes before eating. This waiting period allows the drug to start working without interference from food.

But why are these steps important? And can we improve on these steps? Let’s break down each instruction to understand better.

Take on an Empty Stomach

Taking Rybelsus on an empty stomach is key. The pill disperses in your stomach and is absorbed into the bloodstream. Studies show that if you take oral semaglutide with food, it’s barely absorbed, which means it won’t be effective. To get the best results, take it first thing in the morning before you eat anything.

Use Less Water

It’s also important to take Rybelsus with a limited amount of water. Research indicates that semaglutide absorption decreases by about 40% when taken with a full glass of water compared to just a quarter cup (50 ml). That’s why the recommendation is to use no more than half a glass of water when taking this medication.

Wait Before Eating

After taking Rybelsus, wait at least 30 minutes before eating. This waiting period helps ensure the medication is absorbed properly. Studies have shown that the longer you wait, the more semaglutide is absorbed. However, the 30-minute guideline strikes a balance between effective absorption and practicality, as waiting for two hours could be challenging for most people.

How to Maximize Your Rybelsus Dose

To get the most out of Rybelsus (oral semaglutide), it’s essential to pay attention to how and when you take it. Here’s a breakdown of the best practices:

Timing and Absorption

Taking Rybelsus with food can severely hinder its absorption. The same goes for taking it with a full glass of water instead of the recommended half glass. For instance, if you take a 14 mg dose with a full glass of water, it might feel more like an 8 mg dose due to reduced absorption. Similarly, a 50 mg dose could end up feeling more like 30 mg.

Additionally, eating only 15 minutes after taking Rybelsus can cut absorption in half. So, a 14 mg dose would feel more like 7 mg, and a 50 mg dose would feel like 25 mg. Combining these two—using a full glass of water and eating too soon—can make the absorption even worse.

Boosting Absorption

On the flip side, waiting longer before eating can significantly increase the drug’s effectiveness. Waiting an hour instead of 30 minutes can boost absorption by up to 25%. For a 14 mg dose, this would feel more like 18 mg, and for a 50 mg dose, it would feel more like 63 mg. Waiting for two hours can increase absorption by up to 70%, making a 14 mg dose feel like 24 mg and a 50 mg dose feel like 85 mg.

While waiting two hours might seem challenging, it could be easier if you’re practicing intermittent fasting. For example, you could take Rybelsus at 9 am with no more than half a glass of water and then wait until noon to eat. This approach can improve the absorption of semaglutide and complement the benefits of intermittent fasting.

These scenarios are theoretical, and the best practice is to follow your doctor’s advice and the prescribed dosing guidelines. However, if you’re looking to maximize the effectiveness of Rybelsus, waiting longer before eating could be beneficial.

Ozempic vs. Rybelsus

Let’s dive into the differences between Ozempic and Rybelsus and why these differences matter, especially in terms of dosing and effectiveness.

Absorption Process

Unlike typical medications or food, oral semaglutide (Rybelsus) is absorbed primarily in the stomach rather than the intestines. This was demonstrated in studies with dogs, where blocking the connection between the stomach and intestines didn’t affect the absorption of semaglutide. This unique absorption route means that anything present in the stomach, like food or other substances, can easily disrupt the process.

Dosing Differences

Both Ozempic and Rybelsus are forms of semaglutide, but they differ in how they’re administered and absorbed. Many clinicians view them as therapeutically similar. However, Rybelsus requires strict adherence to dosing instructions—taking it on an empty stomach, with limited water, and waiting before eating. If these instructions aren’t followed precisely, the effectiveness of Rybelsus can be significantly reduced.

On the other hand, Ozempic (along with other injectable forms like Wegovy) is injected once a week and does not have the same strict requirements regarding food or water intake. This makes it more convenient and ensures nearly complete absorption, regardless of your schedule or eating habits. Therefore, while both forms can be equally effective when used correctly, the injectable versions offer more flexibility.

The Role of SNAC

Semaglutide is a delicate molecule, easily broken down by stomach acid. This vulnerability is why many GLP-1 agonists, such as Mounjaro, Trulicity, and Ozempic, are injected—they need protection from the acidic environment and digestive enzymes in the stomach and gut.

Oral semaglutide includes a compound called SNAC (sodium N-(8-[2-hydroxybenzoyl]amino) caprylate) to address this issue. SNAC protects semaglutide from stomach acids and helps it absorb through the stomach lining. Studies have shown that SNAC significantly enhances the absorption of oral semaglutide into the bloodstream, making it a crucial component of the medication.

Summary

In conclusion, while both Rybelsus and Ozempic are effective, the choice between them often comes down to personal preference and lifestyle. If you can strictly follow dosing instructions, Rybelsus may work well for you. However, if you prefer a more convenient option without strict requirements, injectable options like Ozempic might be a better fit.

Types of Semaglutide

There are currently three versions of semaglutide available, with a fourth pill version for weight loss expected soon. This means you’ll soon have both injectable and pill options for treating diabetes and managing weight loss.

Comparing different forms of semaglutide (ozempic vs rybelsus vs wegovy)
Comparing different forms of semaglutide

Dosing Methods and Versions

While the drug itself remains the same across all versions, the dosing methods differ. Typically, semaglutide is started at a lower dose and gradually increased until you reach the maximum dosage. For weight loss, the brands approved by the FDA have more steps and a higher maximum dose compared to those approved for diabetes. Although some people use semaglutide off-label for other purposes, sticking to FDA-approved uses is crucial for insurance coverage and cost considerations.

Cost Considerations

Semaglutide is generally expensive, regardless of its use. However, the cost is roughly the same for both the pill and injected forms on a monthly basis. When prescribed for weight loss, as with the brand Wegovy, the cost is usually much higher.

Learn more about

Citations

Aroda VR, Blonde L, Pratley RE. A new era for oral peptides: SNAC and the development of oral semaglutide for the treatment of type 2 diabetes. Rev Endocr Metab Disord. 2022 Oct;23(5):979-994. doi: 10.1007/s11154-022-09735-8. Epub 2022 Jul 15. PMID: 35838946; PMCID: PMC9515042.

Bækdal TA, Breitschaft A, Donsmark M, Maarbjerg SJ, Søndergaard FL, Borregaard J. Effect of Various Dosing Conditions on the Pharmacokinetics of Oral Semaglutide, a Human Glucagon-Like Peptide-1 Analogue in a Tablet Formulation. Diabetes Ther. 2021 Jul;12(7):1915-1927. doi: 10.1007/s13300-021-01078-y. Epub 2021 Jun 2. PMID: 34080123; PMCID: PMC8266944.

Baekdal TA, Donsmark M, Hartoft-Nielsen ML, Søndergaard FL, Connor A. Relationship Between Oral Semaglutide Tablet Erosion and Pharmacokinetics: A Pharmacoscintigraphic Study. Clin Pharmacol Drug Dev. 2021 May;10(5):453-462. doi: 10.1002/cpdd.938. Epub 2021 Mar 22. PMID: 33750044; PMCID: PMC8251533.

Buckley ST, Bækdal TA, Vegge A, et al. Transcellular stomach absorption of a derivatized glucagon-like peptide-1 receptor agonist. Sci Transl Med. 2018;10(467):eaar7047. doi:10.1126/scitranslmed.aar7047

Chao AM, Tronieri JS, Amaro A, Wadden TA. Clinical Insight on Semaglutide for Chronic Weight Management in Adults: Patient Selection and Special Considerations. Drug Des Devel Ther. 2022 Dec 29;16:4449-4461. doi: 10.2147/DDDT.S365416. PMID: 36601368; PMCID: PMC9807016.

FDA. WEGOVY (semaglutide) injection, for subcutaneous use. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/215256s000lbl.pdf Accessed May 22, 2023.

Frías JP, Auerbach P, Bajaj HS, et al. Efficacy and safety of once-weekly semaglutide 2·0 mg versus 1·0 mg in patients with type 2 diabetes (SUSTAIN FORTE): a double-blind, randomised, phase 3B trial. Lancet Diabetes Endocrinol. 2021;9(9):563-574. doi:10.1016/S2213-8587(21)00174-1

Ghusn W, De la Rosa A, Sacoto D, Cifuentes L, Campos A, Feris F, Hurtado MD, Acosta A. Weight Loss Outcomes Associated With Semaglutide Treatment for Patients With Overweight or Obesity. JAMA Netw Open. 2022 Sep 1;5(9):e2231982. doi: 10.1001/jamanetworkopen.2022.31982. PMID: 36121652; PMCID: PMC9486455.

Kushner RF, Calanna S, Davies M, Dicker D, Garvey WT, Goldman B, Lingvay I, Thomsen M, Wadden TA, Wharton S, Wilding JPH, Rubino D. Semaglutide 2.4 mg for the Treatment of Obesity: Key Elements of the STEP Trials 1 to 5. Obesity (Silver Spring). 2020 Jun;28(6):1050-1061. doi: 10.1002/oby.22794. PMID: 32441473; PMCID: PMC7318657.

Kim HS, Jung CH. Oral Semaglutide, the First Ingestible Glucagon-Like Peptide-1 Receptor Agonist: Could It Be a Magic Bullet for Type 2 Diabetes? Int J Mol Sci. 2021 Sep 14;22(18):9936. doi: 10.3390/ijms22189936. PMID: 34576096; PMCID: PMC8470357.

Novo Nordisk. Oral semaglutide 25 mg and 50 mg demonstrate superior reductions in HbA1c and body weight versus 14 mg in people with type 2 diabetes in the PIONEER PLUS phase 3 trial. https://www.novonordisk.com/news-and-media/news-and-ir-materials/news-details.html?id=165597 Accessed May 22, 2023.

Novo Nordisk. Oral semaglutide 50 mg achieved 15.1% weight loss (17.4% if all people adhered to treatment) in adults with obesity or overweight in the OASIS 1 trial. https://www.novonordisk.com/news-and-media/news-and-ir-materials/news-details.html?id=166110 Accessed May 24, 2023

Paquot N. Le médicament du mois. Le sémaglutide oral, premier agoniste des récepteurs du GLP-1 administré par voie orale (Rybelsus®) [Oral semaglutide, first oral GLP-1 receptor agonist (Rybelsus®)]. Rev Med Liege. 2021;76(12):896-903.

PubChem. Danuglipron. https://pubchem.ncbi.nlm.nih.gov/compound/Danuglipron Accessed May 24, 2023.

PubChem. Semaglutide. https://pubchem.ncbi.nlm.nih.gov/compound/Semaglutide Accessed May 24, 2023.

Research Study to Compare Three Doses of Semaglutide Tablets Taken Once Daily in People With Type 2 Diabetes (PIONEER PLUS). ClinicalTrials.gov Identifier: NCT04707469. https://beta.clinicaltrials.gov/study/NCT04707469 Accessed May 22, 2023.

Research Study to Investigate How Well Semaglutide Tablets Taken Once Daily Work in People Who Are Overweight or Living With Obesity (OASIS 1). ClinicalTrials.gov Identifier: NCT05035095. https://beta.clinicaltrials.gov/study/NCT05035095 Accessed May 22, 2023.

Reuters. Novo Nordisk exec: oral weight-loss drug will have similar efficacy as Wegovy. https://www.reuters.com/business/healthcare-pharmaceuticals/novo-nordisk-exec-oral-weight-loss-drug-will-have-similar-efficacy-wegovy-2023-05-04/ Accessed May 23, 2023.

Saxena AR, Frias JP, Brown LS, et al. Efficacy and Safety of Oral Small Molecule Glucagon-Like Peptide 1 Receptor Agonist Danuglipron for Glycemic Control Among Patients With Type 2 Diabetes: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(5):e2314493. Published 2023 May 1. doi:10.1001/jamanetworkopen.2023.14493

Saxena AR, Gorman DN, Esquejo RM, et al. Danuglipron (PF-06882961) in type 2 diabetes: a randomized, placebo-controlled, multiple ascending-dose phase 1 trial. Nat Med. 2021;27(6):1079-1087. doi:10.1038/s41591-021-01391-w

Singh G, Krauthamer M, Bjalme-Evans M. Wegovy (semaglutide): a new weight loss drug for chronic weight management. J Investig Med. 2022 Jan;70(1):5-13. doi: 10.1136/jim-2021-001952. Epub 2021 Oct 27. PMID: 34706925; PMCID: PMC8717485.


See also

  • 3 Tips to BEST Use Rybelsus
    It’s more important than you might think to take Rybelsus with minimal water on an empty stomach and waiting at least 30 minutes before eating.
  • Comparing Weight Loss Drugs in 2024
    Ozempic and Mounjaro are highly effective at treating obesity, however there are many other approved and off-label options that also work.
  • Bupropion vs Contrave vs Naltrexone
    Contrave is a synergistic combination of buproprion and naltrexone, which can be replicated to some degree using the generics individually.
  • New Obesity Drugs in 2024
    New obesity drugs target more than just GLP-1 and do much more than suppress appetite for a more nuanced approach to weight loss.
  • Mounjaro: Who Loses the Most Weight?
    White or Asian younger women who use metformin and have lower sugar and lipid levels tend to experience more weight loss with Mounjaro.

Share this article

Leave a Reply

Your email address will not be published. Required fields are marked *