Rybelsus tablets - doses, weight loss, and safety

Learn about this daily GLP-1 pill for type 2 diabetes and its surprising effect on weight loss.

What is Rybelsus?

Rybelsus is an oral form of semaglutide, a medicine that copies the gut hormone GLP-1.

  • UK licence - controls blood sugar in adults with type 2 diabetes.

  • Weight loss licence - none in the UK (injections like Wegovy are licensed for that).

  • How it helps diabetes - slows stomach emptying, lowers appetite signals and boosts insulin release.

Available doses - 3mg, 7mg and 14mg

Rybelsus comes in three licensed strengths, each with a specific role in treatment:

  • Rybelsus 3mg - Used as a starter dose for the first 30 days. This helps your stomach adjust and has little effect on blood sugar.

  • Rybelsus 7mg. This is the first working dose. It begins lowering HbA1c and may lead to mild weight loss.

  • Rybelsus 14mg. This is the target dose for diabetes treatment. It provides the strongest effect on blood sugar and weight within the licensed range.

Higher doses (25-50 mg) are still in clinical trials and not currently available.

Rybelsus and weight loss

Rybelsus 14mg (licensed strength)

In the PIONEER 4 trial, researchers studied the effects of oral semaglutide (Rybelsus) in people with type 2 diabetes.¹

Participants took 14mg daily for 52 weeks, and on average, they lost around 4 .4kg over the course of the study.

While this dose is currently licensed for diabetes treatment (not weight loss) the trial showed it can still lead to modest weight reduction as a secondary benefit.

Rybelsus 50mg (experimental strength)

The OASIS 1 trial focused on people with obesity but without diabetes, using a much higher dose of oral semaglutide - 50 mg daily for 68 weeks.²

In this study, participants lost an average of 15.1% of their body weight, a result comparable to injectable weight loss medications like Wegovy.

However, it’s important to note that this 50 mg tablet strength is not yet licensed and is still in clinical trials.

How to take Rybelsus for best results

  • Take first thing

    Take Rybelsus as soon as you wake up, before eating, drinking, or taking any other tablets.

  • Use plain water

    Swallow the tablet whole with a small sip of plain water, but no more than 120ml.

  • Wait 30 minutes

    After taking the tablet, wait half an hour before having breakfast or taking other medications.

  • Missed a dose?

    Take your next dose as usual the following morning - don’t double up if you missed a dose.

Rybelsus tablets FAQs

How does Rybelsus work

Rybelsus contains semaglutide, a copy of the gut hormone GLP-1. After you swallow the tablet it boosts insulin when blood sugar is high, slows the speed food leaves your stomach and tells the appetite centres in your brain that you feel full. Those three actions lower blood-glucose levels in type 2 diabetes and can also make you eat less, leading to weight loss.

How often to take Rybelsus

You take one tablet every morning on an empty stomach. Swallow it with a small sip of plain water, then wait 30 minutes before eating, drinking or taking other medicines. Skipping the “empty stomach rule” can cut absorption by half.

How much weight can I lose in a month with Rybelsus?

In studies using the UK-licensed 14 mg dose, most people lose about 1-2kg in the first month once the dose is fully stepped up, assuming they also follow balanced meals and exercise more. Higher experimental doses give faster weight loss but they’re not yet licensed in the UK.

What are the most common side effects of Rybelsus?

The top three are nausea, diarrhoea and acid reflux. Mild tummy cramps, burping or headache can also appear, especially when you increase the dose.³

Do Rybelsus side effects go away?

Often they do. Nausea and loose bowels usually settle within four to six weeks as your body adapts. Eating smaller, lower-fat meals and sipping water through the day can ease the transition.

Is Rybelsus the same as Ozempic?

Rybelsus and Ozempic share the same active drug semaglutide, but Ozempic is a once-weekly injection, whereas Rybelsus is a tablet swallowed daily. Both treat type 2 diabetes.

Rybelsus vs Wegovy - how do they compare?

Rybelsus is a daily tablet (3mg, 7mg or 14mg) licensed for diabetes. Wegovy is a weekly injection (up to 2.4mg) licensed specifically for obesity.

Clinical trials show Wegovy users lose about twice as much weight as people on the 14mg Rybelsus tablet, but Wegovy involves needles which may not be suitable if you have a phobia of needles.

Can you just stop taking Rybelsus?

Yes, you can stop without tapering, but your blood sugar and your appetite may climb back up within days. Always speak to your diabetes team before you stop taking Rybelsus so they can adjust other medicines or give lifestyle guidance.

Can you take Rybelsus at night?

No. The licence and trial data are based on taking it first thing in the morning on an empty stomach. Night time dosing risks food interference and lower absorption.

Who can be prescribed Rybelsus in the UK?

Adults with type 2 diabetes whose HbA1c is still high after diet, exercise and possibly other tablets. It is not licensed for under 18s or women who are pregnant or breastfeeding.

Can you buy Rybelsus in the UK?

You cannot walk into a shop and buy it. You need a prescription from an NHS or private clinician to help manage type 2 diabetes.

How much does Rybelsus cost in the UK?

For diabetes on the NHS you pay the standard prescription fee in England (£9.90) or receive it free in Scotland, Wales and Northern Ireland.

Medically reviewed by Dr Jackir Hussain

This page was last medically reviewed by Dr Jackir Hussain on 14 July 2025.

At Pill Scout, we prioritise accurate, evidence-based health information you can trust.

Our medical team regularly reviews and updates our content to ensure it stays aligned with the latest clinical research and guidance.

Dr Jackir Hussain, MBChB, MRCGP
GMC: 7074207

Dr Jackir Hussain is a UK-based GP with over 14 years of clinical experience since earning his medical degree from the University of Manchester. He has worked across diverse healthcare environments, including NHS GP surgeries, urgent care services, homeless shelters, and telemedicine platforms.

His areas of interest include general practice, weight loss, and the use of digital health to improve patient access to care.

Sources

¹ PIONEER 4 trial. Oral semaglutide vs. liraglutide and placebo in type 2 diabetes. Last accessed July 2025.

² OASIS 1 trial. Oral semaglutide 50mg for obesity without diabetes. Last accessed July 2025.

³ EMC database. Summary of product characteristics and side effects for Rybelsus 14mg tablets. Last updated April 2025.

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