Rybelsus and Ozempic are both brand names for a drug called semaglutide, their active ingredient, however both have a different form of delivery. Both have been approved by the Food and Drug Administration (FDA) to control blood sugar levels in adults with type 2 diabetes. 

If your blood sugar is not responding well to other diabetes medications, your health care provider may add these drugs to your treatment regimen. Your health status (such as the presence of other comorbidities) and preference will be considered when prescribing either of these drugs.  

What is Rybelsus and Ozempic? 

Rybelsus and Ozempic are incretin mimetic agents that are used in combination with diet and exercise to help adults with type 2 diabetes control their blood sugar levels. These work by simulating the actions of GLP-1 receptors in the pancreas, increasing insulin release while decreasing the glucagon release response, both of which are glucose-dependent, thereby, lowering blood sugar levels. 

The FDA approved Rybelsus, the first oral GLP-1 receptor agonist drug, in September 2019. Ozempic, on the other hand, was approved by the FDA in December 2017 for the treatment of type 2 diabetes. Later, in January 2020, the FDA approved it once more for the risk reduction of major adverse cardiovascular events (MACE). After Victoza, it is the second GLP-1 agonist medication to be approved to reduce the risk of adverse cardiovascular events. Both are in the midst of clinical trials: Rybelsus for heart protection and Ozempic for kidney health. 

These medications are only prescribed after other diabetic medications have failed to control blood sugar levels, and they work best when combined with a healthy diet and regular exercise. 

Form, Dosage, and Cost 

Both Rybelsus and Ozempic are brand-name medications with no generic equivalents. Brand-name drugs are known for being more expensive than generic drugs. Ozempic costs $1,000 USD on average and Rybelsus costs $8 USD per tablet, with prices varying by pharmacy. However, ordering online through a Canadian pharmacy, patients can save up to 80%. 

If  your body is stressed due to a fever, infection, injury, or surgery, it can become more difficult to control your blood sugar level. If you experience this, contact your doctor as this may require a change in your treatment plan and dosing. 


Rybelsus is a 3mg white to light yellow oval-shaped tablet taken once daily for the first 30 days. The dose may be increased to 7mg, and then to 14mg, depending on your health care provider and your body’s response to the treatment. 

It is recommended that Rybelsus be taken on an empty stomach after waking up in the morning, without splitting, crushing, or chewing, and that it be swallowed whole. It should be taken with a sip of plain water and not with any other beverage. After 30 minutes, you can eat or take other oral medications. 

If you miss a dose, skip it and continue taking the medication as usual. It is not recommended to double the dose to catch up. 

Do not take two doses at the same time; for example, taking two 7mg tablets to get a 14mg dose is not allowed and encouraged.  


Ozempic, on the other hand, is a prefilled, single-patient-use injection pen that is injected subcutaneously into the thigh, abdomen, or upper arm. Each pen has a capacity of 2mg per 1.5mL of medicine. You may require two injection pens per month, depending on your dose. 

The usual starting dose is a 0.25mg injection once a week. Your health care provider may increase the dose to 0.5mg or 1mg after four weeks. Only prepare the injection when you’re ready to administer it. Do not inject in the same spot twice in a row. The needle should not be reused.  

It is recommended that you take Ozempic on the same day each week, exactly as prescribed by your health care provider. If the prescription states that it should be taken as needed, the day of the week can be changed as long as the interval is at least two days. 

If you miss a dose, take it as soon as you remember as long as it is within 5 days of the missed dose. If it has been longer than 5 days, skip the dose. Do not double the dose to catch up; instead, take the next dose as scheduled. 

Keep the pen in the refrigerator, but not in the freezer, for storage. It can be stored at room temperature, but it should be kept away from heat and light. If it is frozen, expired, or more than 8 weeks after the first use, or if the dose counter shows less than 0.25mg, discard it. Unless otherwise directed, the contents should not be flushed or poured down the drain. Inquire with your healthcare provider about proper disposal. 

It’s important to adhere to your health care provider’s dosing, regimen and schedule.  


Both Rybelsus and Ozempic are used to help control blood sugar in adults with type 2 diabetes, and best used in combination with diet and exercise. Both drugs are only approved for use in adults, thereby, those under 18 years old should look into other alternatives. 

Ozempic is also used to reduce the risk of serious heart problems in people who have type 2 diabetes and heart disease. It reduces the risk of having a heart attack, having a stroke, and dying from heart disease. Rybelsus has not been approved for use in these circumstances. 


Rybelsus and Ozempic are not used as the first-line drug for the control of type 2 diabetes and are not used to treat type 1 diabetes. For patients with pancreatitis or other pancreatic problems, your doctor may prescribe a different diabetes medication. 

If you or a member of your family has a history of thyroid cancer, specifically medullary thyroid carcinoma, or a rare form of cancer known as multiple endocrine neoplasia syndrome type 2 (MEN 2), you should not use these medications.  

Both medications should not be taken while pregnant or breastfeeding. It is recommended that you stop taking these medications at least two months before you intend to become pregnant. When this situation arises, talk to your doctor about other treatment options. 

It is not recommended to consume alcohol while on Rybelsus or Ozempic. Drinking in moderation is permitted, with a daily limit of one drink for women and two drinks for men (1 drink: 5oz wine, 12oz beer, 1.5oz distilled spirits) in addition to your regular meal plan. Drinking on an empty stomach is not advised due to the increased risk of hypoglycemia. 

Do not take different brands of semaglutide at the same time. 

How does it interact with other drugs? 

Drug interactions can alter the way your medication works and put you at risk for serious side effects. Make sure your doctor is aware of all medications you are taking, including herbal supplements and over-the-counter medications. Do not start, stop, or change the dosage of any medication without first consulting your doctor. 

Beta-blockers may help to prevent the fast/pounding heartbeat that is common in hypoglycemia. As a result, if you take beta-blockers along with Rybelsus or Ozempic, symptoms of one of its side effects may be masked. 

Ozempic may interact with exogenous insulin as well as other medications taken at the same time.   

Side effects 

Rybelsus and Ozempic are not used to lose weight, but you may lose some while taking them. Common side effects include nausea and vomiting, diarrhea, abdominal pain, constipation, upset stomach, bloating, and flatulence. 

Rybelsus may also cause a decrease in appetite, whereas Ozempic may cause an allergic reaction at the injection site, such as redness or discomfort. These side effects are only temporary and can last anywhere from a few days to a few weeks. Consult your health care provider if these symptoms persist or worsen. 

Some serious side effects include allergic reactions, hypoglycemia, pancreatitis, diabetic retinopathy complications, sudden kidney problems, and thyroid cell tumors. Thyroid cancer symptoms include difficulty swallowing, persistent hoarseness, shortness of breath, and a lump in the neck. If you notice any of these symptoms, see your doctor right away. 

Below are highlighted points of key similarities and differences between Rybelsus and Ozempic: 

  • Rybelsus and Ozempic contain the same active drug, semaglutide. 
  • Rybelsus is available as an oral tablet that you will take once a day; while Ozempic is administered as a subcutaneous injection, once a week – frequency is dependent on your blood sugar control needs. 
  • These medications are only approved for use in adults over the age of 18. 
  • If your blood sugar levels are not well controlled with other diabetes medications, your doctor may consider adding Rybelsus or Ozempic to your treatment plan. Either drug would be used in conjunction with a healthy diet and regular exercise. 
  • Both are not first-line drugs for the control of blood sugar levels. 
  • Ozempic has been approved to reduce the risk of having a heart attack or stroke in people who have type 2 diabetes and heart disease. Rybelsus is not approved for this usage. 
  • Depending on your comorbidities, your healthcare provider might choose to prescribe Ozempic over Rybelsus. 
  • Nausea and vomiting are common side effects, as are diarrhea, abdominal pain, constipation, upset stomach, bloating, and flatulence. 

Speak with your doctor or pharmacist if you want to learn more about Rybelsus or Ozempic. They can assist you in answering any questions you may have about the similarities and differences between these  drugs.