With all of the recent talk about diabetes medications and their role in prompting weight loss, it is not surprising that many patients are confused. They may find themselves wondering if they’re pretty much all the same. And if they’re not the same, they may wonder why they should use one option over the other to manage their health concerns.

Two medications for diabetes that are often compared are Wegovy and Rybelsus. Both are bio-similar drugs that contain the same active ingredient, semaglutide, but they serve slightly different purposes.

Below, we’ll explore their many similarities and differences so you’ll have the information you need in the event that your provider suggests it to you.

Why Are They Used To Treat Diabetes Type 2?

Before explaining some of their differences, here is how they are similar. Wegovy and Rybelsus are glucagon-like peptide-1 receptor agonists. Even though this sounds like a tongue twister, it basically means they belong to a class of medications used to treat type 2 diabetes and obesity. Other medications also fall under this category, such as Bydureon, Lixisenatide, and Albiglutide.

Medications like Rybelsus and Wegovy are crucial to individuals with type 2 diabetes because they often experience decreased GLP-1 activity. For clarity, this means that they don’t properly stimulate insulin secretion and inhibit glucagon secretion. Fortunately, semaglutide stimulates the pancreas to begin producing more insulin than it naturally would, and this insulin, in turn, helps control and modulate blood sugar levels.

Wegovy: A Weight Loss Drug

Wegovy is an FDA-approved medication for patients at high medical risk due to their weight. Therefore, individuals with a BMI between 27 and 29 with one weight-related health problem, such as type 2 diabetes or cardiovascular disease, are ideal candidates for Wegovy. Patients with a BMI that’s 30 or more can be approved without any other medical conditions.

This medication is prescribed to assist individuals with weight loss, which could help curb their risk of further health complications. Wegovy gained approval in 2021 and was the first medication since 2014 to be approved as a weight loss drug. Then, in December 2022, the FDA approved it for teens ages 12 and older. A 68-week clinical trial revealed that Wegovy helped 50% of the teen participants reverse obesity, which is a significant risk factor for diabetes.

The Dosages

Wegovy is an injection that is delivered at 2.4 mg per week. However, it takes time to build up to this maximum dosage. This gradual build-up gives the body time to adjust and prevents weight loss from happening too rapidly. It also controls against dramatic fluctuations in blood sugar, particularly blood sugar going too low.

In the first month, the weekly dose is 0.25 mg. This is then bumped up to 0.5 mg in month 2. In month 3, the dose is 1.0 mg per injection. During month 4, the dose is increased to 1.7 mg. In months five and beyond, the patient stays at the full dose of 2.4 mg weekly.

Rybelsus: Helps Control High Blood Sugar

Rybelsus was first approved by the FDA in 2019, and it was the first oral semaglutide to receive this approval. In 2023, its approval was updated so that it can now be used as a frontline treatment. Before this change, patients needed to have shown a lack of response to Metformin or one of the other existing type 2 diabetes medications.

When combined with a good diet and exercise, Rybelsus can be very effective at helping individuals achieve weight loss.

The Dosages

Rybelsus also requires a gradual build-up for the same reason that people need to take time with Wegovy. Patients begin with 3 mg per day for 30 days. After this, the patient is bumped up to 7 mg daily, which is maintained for 30 days. If there is an improvement in a patient’s blood glucose level, this 7 mg dosage is maintained. If blood sugar levels remain an issue, then the dosage can be increased to the maximum level of 14 mg per day.

Is One Option Better Than The Other?

There is no straightforward answer to this question, as Rybelsus and Wegovy are prescribed for different purposes. However, many patients could potentially benefit from either option. Another thing that sets the two options apart is the method of delivery. Rybelsus is a daily pill, while Wegovy is a weekly injection. For individuals who dislike needles, have a phobia of needles, or react badly to injections, this may automatically make Rybelsus a better choice.

Which Is Better for Weight Loss: Rybelsus or Wegovy?

It is important to remember that the dose for Wegovy is higher than for many of the other injectables, with it being dosed at 2.4 mg per week after a period of intermediate build-ups. This high dose definitely promotes weight loss compared with other injectables like Ozempic.

No clinical trials have compared Rybelsus and Wegovy weight loss head to head, at least not yet. However, the evidence indicates that Wegovy’s weight loss is more dramatic.

Patients on Wegovy have been shown to lose up to 16% of their body weight during a clinical trial of this drug lasting only months. On the other hand, patients on Rybelsus for six months lost approximately 8 pounds. However, it should be noted that these trials had different set-ups and different patient populations, so some of these comparisons are apples to oranges.

How Much Do Rybelsus and Wegovy Cost

These new diabetes and weight loss drugs do not come cheap. This is especially true for Wegovy, which is not covered by all insurance plans at the moment. A general estimate is that Wegovy costs upwards of $1300 per month. Rybelsus costs between $900-1000 per month at most major pharmacies, although comparison shopping may occasionally reveal deals. However, some manufacturers offer assistance programs to make the medication more affordable.

What Are the Side Effects of Rybelsus and Wegovy?

These two drugs, along with all semaglutide medications, may cause certain side effects, such as headaches and dizziness. Even though these side effects may be unpleasant, most patients find them manageable and continue to take their medication.

The most common side effects are gastrointestinal, such as bloating, nausea, diarrhea, and/or constipation. However, it should be noted that Rybelsus is more likely to cause GI issues since it’s taken orally. Those taking Wegovy specifically may notice discomfort and/or pain, as well as redness or swelling, at the injection site.

Uncommon, But Severe Side Effects

Patients should contact their medical provider for advice if side effects become more severe or troublesome. Patients should also immediately reach out to their providers if they experience one of the more severe and rarer side effects of these drugs, such as: vision changes, sudden sweating, pancreatic inflammation, and kidney problems. In addition, low blood sugar could occur if either is taken with other diabetes medication.

There is also a boxed label warning for these medications elevating a person’s risk of developing thyroid and/or pancreatic cancer. These downsides should always be carefully weighed against the drug’s benefits when making decisions with your provider.

Who Shouldn’t Take Rybelsus or Wegovy?

A small group of people should not take Rybelsus or Wegovy under any circumstances.

The first group is people with medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2. Both medications should be avoided if you have a family history of these extremely rare conditions. This is because preliminary animal trials on rats and mice showed that semaglutide increased the risk of developing thyroid cancer to some degree. It is unclear if this heightened cancer risk will be replicated in human patients, although trials are currently exploring this topic.

In addition to these patients, those with an allergy to semaglutide should not take Rybelsus or Wegovy.

Doctors also advise that Wegovy should not be taken during pregnancy or in the immediate two months leading up to pregnancy. Breastfeeding individuals should talk to their providers before starting Wegovy.

Wegovy vs. Rybelsus: Tools In The Diabetes Arsenal

Diabetes is a chronic condition affecting millions of people around the world. However, medications like Wegovy and Rybelsus are available to help nip blood sugar issues in the bud and restore people’s quality of life.

While neither is a cure, they’re both popular and effective tools in the diabetes arsenal. Unfortunately, their high cost often hinders individuals from getting the treatment they need. If your doctor suggests either medication to you and you’re trying to figure out how to cut costs, Buy Canadian Insulin can help.

ManufacturerNovo NordiskNovo Nordisk
FDA ApprovedJune 2021September 2019
Approved UseWeight lossControls high blood sugar
Method of DeliveryOnce weekly injectionDaily pill
Dose Range0.25 mg to 2.4 mg3 mg to 14 mg
Average cost (USD)$1300/month$900 – $1000/month