Semaglutide is a medication approved by the Food and Drug Administration (FDA) for weight loss and diabetes treatment. In scientific terms, it’s a glucagon-like peptide-1 (GLP-1) receptor agonist, meaning it acts like a digestive hormone and regulates blood sugar levels and appetite.
The appetite suppression characteristic makes semaglutide an effective weight-loss aid for many people. It works for individuals with diabetes, as well as non-diabetic people.
Semaglutide comes in two forms: injectable and oral. Semaglutide injections are available under the brand names Wegovy and Ozempic. The tablet form is Rybelsus. Both options can bring results, but it’s important to understand the differences so you can choose the option that works best for you over the long term.
Here’s what to consider when making this choice.
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Effectiveness of Semaglutide Tablets vs. Injections
Semaglutide works the same way for weight loss in pill and injection forms. Both mimic GLP-1 hormones to help suppress appetite. One study of patients with diabetes found that those receiving injections lost 8.1 lbs, compared to 7.2 lbs for tablet takers. Another study in the Journal of American Medicine (JAMA) found oral and injectable semaglutide produced similar results, with participants experiencing a 15.1% reduction in body weight.
Adherence to the dosage schedule is important for results. Also, oral semaglutide gets absorbed in the stomach.
Time Needed for Results
The results of injectable semaglutide are evident quickly, with a reduced appetite evident after one to four weeks and weight loss occurring between five and 20 weeks. After the first five or six months, you can begin to incorporate diet and exercise to prepare to maintain your weight after you stop injections.
Short-term effectiveness also depends on taking the pills in the right conditions (on an empty stomach, 30 minutes before eating anything for the day, and with four ounces of water).
Frequency of Administration
Ozempic, the injectable form of semaglutide, requires weekly shots. You inject yourself on the same day each week during the treatment. A doctor may adjust doses as needed.
Rybelsus is a daily pill that you need to take under the same conditions each morning.
Frequency can affect overall outcomes. If you miss days or fail to take tablets under the right circumstances, you could limit their effectiveness. This can make it more difficult to adhere to your dosage regimen.
Ease of Administration: Oral Semaglutide vs. Injection
Ozempic and Wegovy come in single or multi-injection devices. A vast majority of patients in a study published in the journal Diabetes, Obesity, and Metabolism reported no pain, very mild pain, or mild pain after each injection.
However, oral semaglutide doesn’t require an injection, though you do need to swallow doses daily instead of taking a weekly shot.
Personal preference plays a role in determining which type is easier to take. You might prefer the shallow weekly injection and the mild discomfort it might bring over the daily tablets taken in precise conditions. Or, you could opt to avoid the challenge of needles and use the completely non-invasive oral route.
Safety
The FDA has approved Ozempic for weight loss and labeled it safe to use for this purpose. However, it warns of the potential of developing thyroid tumors, pancreatic cancer, and kidney damage.
There are also concerns about overdoses, such as accidentally injecting multiple doses. You can’t flush semaglutide out of your system; this means you need to wait for it to process through your kidneys. The extra dose will take approximately five weeks to dissipate.
Further, drinking alcohol while taking the medication can result in extremely low blood sugar, which can impact patients with diabetes. There are also concerns about interactions with other medications, including over-the-counter cold and flu meds.
Some in the medical community are concerned that the popularity of Ozempic and its peers is based on a few clinical studies and social media buzz. They contend that more research is needed to explore the safety and effectiveness of the different delivery options.
Side Effects
In addition to concern about long-term cancer, organ risks, and overdoses, you should also consider the more common acute side effects of the two semaglutide delivery options.
According to oral semaglutide brand Rybelsus, the most common side effects are:
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Stomach pain
Nervousness, rashes, dizziness, and mood changes have also occurred. Because of the delivery method, nausea and other digestive tract ailments are more common with oral semaglutide.
Injectable semaglutide has a similar set of side effects, including:
- Digestive tract issues and nausea
- Fatigue
- Gallstones
- Headaches
- Hair loss
Regardless of your delivery choice, it’s important to monitor your health while taking semaglutide. That way, you can detect side effects early and take steps to limit their impact.
Directions for Use
The manufacturers provide directions for taking oral and injectable semaglutide. However, you should consult a doctor before starting your regimen and defer to their directions.
The directions for oral use are quite specific: Take the tablet in the morning, 30 minutes before eating or taking any other medication or vitamins. You should take the pill with no more than four ounces of water.
Injections should be on the same day each week. The directions are as follows: Add a new needle to the pen-like injection device. You can then check the flow of the medication. If the device allows you to select a dose, make sure you choose the one prescribed by your doctor.
You make the injection under your skin, not in your muscle or vein. The stomach, shoulders, or thighs are the best injection sites. After injecting, you then need to dispose of the needle in a safe container, which should be supplied with the injection devices.
Cost
Cost is usually a factor when you have to choose between multiple medications. In the case of semaglutide, this is technically not the case. Monthlong supplies of Ozempic and Rybelsus cost the same, at $935.
Keep in mind that increased demand or supply shortages can raise the price tag. This can affect the cost of one or both of these medications.
Insurance coverage is possible. However, most insurers will only cover semaglutide for diabetes treatment, not for weight loss, which often falls under “elective” or “medically unnecessary” treatments. These classifications can vary from insurer to insurer and can also depend on a doctor’s diagnosis or medical coding.
Scarcity
Scarcity of each drug is something else to consider when deciding between oral and injectable semaglutide. Novo Nordisk, the company that makes Wegovy and Ozempic, has already experienced shortages due to high demand. Other factors like supply chain issues and lack of certain ingredients needed to make the medications can also create scarcity.
This is a significant issue because this drug is also necessary for some patients with diabetes and weight loss regimens can last for more than a year. Shortages could cause a premature end to your weight loss treatment.
During the most recent shortage, oral semaglutide remained available after supplies of injectable drugs ran out. However, with many doctors switching their patients to tablets, the oral semaglutide supply could also be strained.
You should weigh the benefits and drawbacks of oral and injectable semaglutide and decide with the help of your physician which option is best for your weight-loss plans and goals.
