Rybelsus (semaglutide) is an oral GLP-1 (Glucagon-like peptide-1 receptor agonist) medication that reduces blood sugar in patients with type 2 diabetes and can help promote weight loss when used alongside intensive lifestyle adjustments including food and exercises under the supervision of trained professional to coach and to support.
This is good for adults seeking an injection-free GLP-1 medication, an alternative to injectable like Ozempic®. This helps in patient compliance, especially for those with a fear of needles or those that simply find injections unpleasant or inconvenient.
How Does Rybelsus Work?
The active ingredient in Rybelsus is Semaglutide. Semaglutide works by targeting a specific hormone called GLP-1(glucagon-like-peptide-1), an incretin hormone. GLP-1 is a naturally occurring hormone in the body which handles blood sugar management and appetite. Semaglutide is a GLP-1 analogue, which means it increases the levels of GLP-1 in the body.
There are several complex mechanisms at play that allow Rybelsus to improve glucose metabolism and cause weight loss by mimicking the natural incretin hormones that your body produces when you eat a meal.
Incretins are gut hormones that are secreted from enteroendocrine cells into the blood within minutes after eating. One of their many physiological roles is to regulate the amount of insulin that is secreted from the pancreas after eating. They also help promote a feeling of fullness by delaying gastric emptying and activating the satiety centres of the brain.
Two incretin hormones are known as GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1).
Studies have found that people with overweight or obese may have a reduction in incretin hormone levels, especially if they have had frequent weight fluctuations due to yo-yo dieting.
GLP-1 receptor agonist medications like Rybelsus®, which shares 94% of the same structure as human GLP-1, make up for some of that loss in incretin hormones, making it easier to reach your goals and lower your metabolic set point. This is a plus for people trying to lose weight.
Presentation and Dosages of Rybelsus Available
Rybelsus is semaglutide in tablet form. Manufactured by Novo Nordisk. It is a once-daily pill. Rybelsus tablets are available in 3 doses: 3mg, 7mg and 14mg. Your dose is increased gradually to promote sustainable and healthy weight loss.
How Do You Take Rybelsus for Weight Loss?
You will start on a low dose of 3mg which will be taken once daily till you are stable on the dose for about one month then you can progress to the 7mg dose.
You may stay on the 7mg dose, but if your doctor thinks otherwise, you may be stepped up to 14mg after at least one month of being stable on the 7mg dose.
Never alter your dose unless the doctor or your healthcare provider has instructed you to do so. Note that you cannot exceed a dose of 14mg per day. If for any reason you take more than you should, consult your doctor as soon as possible.
You can take the Rybelsus® tablet at any time of the day, but you should take it at least 30 minutes before your first meal or drink of the day. This means that it must be taken on an empty stomach, usually first thing in the morning. This helps for better absorption thereby increasing the effectiveness of the medication.
If you miss a dose, please skip it and take your normal dose the next day. Do not stop taking Rybelsus® unless you have been instructed to do so by your doctor or healthcare provider.
If after 12 weeks on the maximum dose you have not lost at least 5% of your initial body weight, treatment should be discontinued and you should consult your doctor for an alternative.
How Effective is Rybelsus in Weight Loss?
Although Rybelsus® is not a weight loss drug many people lose weight when on the drug either as an “off-label” prescription or as a prescription drug used in type 2 diabetes.
It has been observed that people on 7mg of Rybelsus lost on average, 2.3kg (5 pounds) and people on 14mg Rybelsus lost on average, 3.7kg (8.1 pounds). Research has shown that the above effects are noticed after 26 weeks of taking Rybelsus.
One of the ways Rybelsus works is by helping to make you feel full after a meal.
People with higher initial body weight and those experiencing more digestive symptoms may be more likely to lose weight once treatment starts with Rybelsus.
Some Common Possible Side Effects
- Nausea (feeling sick)
- Vomiting
- Indigestion and general stomach discomfort
- Acid reflux and heartburn
- Bloating and gas (flatulence)
- Constipation
- Inflammation of the stomach (gastritis)
Refer to the patient information leaflet for a more comprehensive list of both common side effects and more serious side effects.
Who Can Take Rybelsus for Weight Loss?
You can take Rybelsus® for weight loss if you have a body mass index (BMI) of 30 and above. If you have a BMI of 27 and above with weight-related conditions such as high blood pressure, high cholesterol or type 2 diabetes, you can also take Rybelsus®.
People That Must Not Take Rybelsus
The following group of persons must not take Rybelsus®:
- Pregnant or trying for a baby and breastfeeding mother.
- Persons under the age of 18.
- People who are allergic to the active Rybelsus®, semaglutide.
- Persons with type 1 diabetes
- Persons that have diabetic ketoacidosis (a complication of diabetes where your blood sugar is very high).
There are certain long-term conditions that you can have or if you are on certain medications, you will need to consult your doctor before taking Rybelsus so they can ensure it is safe for you to take as Rybelsus has affected these conditions or interacts with these medications. They are as follows:
- Persons that have eye problems caused by diabetes (diabetic retinopathy).
- Persons that have kidney or heart problems.
- Persons that have a history of pancreatitis.
- Persons on insulin (may cause hypoglycemia)
- Persons taking levothyroxine for thyroid disease.
- Persons that are taking medicines to reduce blood clotting (e.g., warfarin)
It is advised that you check with your doctor or healthcare provider before taking Rybelsus.
Benefits of Taking Rybelsus
Let us consider the benefits of taking Rybelsus to lose weight:
- The main benefit of taking Rybelsus is that the drug is effective. It was discovered in multiple clinical studies that patients on Rybelsus for Type 2 diabetes lose as much as 4.5kg, (about 10% of their body weight), after around 52 weeks of treatment. There were also significant reductions in waist size and other measurements.
- It is easy to take compared to other weight loss drugs that require you to inject yourself daily or weekly. Rybelsus, however, is an oral medication that can be conveniently taken just once a day, especially for those that do not like a needle piercing them.
- It is recommended by professionals. Currently, Rybelsus is only off-label for weight loss, in February 2022, the National Institute for Health and Care Excellence (NICE) in the UK recommended Semaglutide for obesity treatment.
Interactions with Food and Other Drugs
There are 245 drugs known to interact with Rybelsus(semaglutide), 6 disease interactions and 2 alcohol/food interactions. Of the total drug interactions, 2 are major, 222 are moderate and 21 are minor.
Most of these have already been treated above.
Conclusion
Rybelsus®, an oral semaglutide tablet, mainly used for type 2 diabetes but has been recommended for use in weight loss as an off-label prescription, is a very convenient addition to diet and lifestyle changes in weight loss.
It is advised that before you consider using it for weight loss, you should discuss it with your doctor or healthcare provider to guide all through the course of treatment. Convenience and efficacy are sacrosanct in determining the choice of medication for weight loss.
Therefore, choose the medication that has these two qualities for better compliance and desired outcome!