Rybelsus

Rybelsus^® (semaglutide) is an oral medication prescribed to adults with type 2 diabetes to help manage blood sugar levels. It’s a glucagon-like peptide-1 (GLP-1) receptor agonist that mimics a natural hormone in the body that boosts insulin secretion, reduces the release of glucagon (a hormone that raises blood sugar), and slows digestion. This combination helps lower blood glucose and may also lead to modest weight loss, although Rybelsus is not approved by the United States Food and Drug Administration (FDA) for weight management. 

Rybelsus is taken once daily. The typical starting dose is 3 milligrams (mg) daily for 30 days, followed by an increase to 7 mg. If additional blood sugar control is needed, the dose may be increased to 14 mg. 

Common side effects include nausea, vomiting, diarrhea, abdominal pain, decreased appetite, and constipation, which are more likely to occur when starting the medication or increasing the dose. Serious side effects, though rare, may include pancreatitis, kidney problems, and gallbladder issues.

Rybelsus (semaglutide) is indicated:

• As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus

Glucagon-like peptide-1 (GLP-1) receptor agonist

Most common adverse reactions (incidence ≥5%) are:

• Nausea

• Abdominal pain

• Diarrhea

• Decreased appetite

• Vomiting

• Constipation

The cost of Rybelsus varies depending on factors such as your insurance plan coverage and which pharmacy you use. 

Without insurance, Rybelsus costs about $998 per month. People without insurance who qualify for the Novo Nordisk Patient Assistance Program may be able to fill their prescriptions for free.

Health insurance plans may cover all or some of the cost of this medication. People who have private or commercial health insurance and who meet criteria for the Rybelsus Savings Card may pay as little as $10 per month for a one-, two-, or three-month prescription.

• Personal or family history of medullary thyroid carcinoma or in patients with multiple endocrine neoplasia syndrome type 2

• Prior serious hypersensitivity reaction to semaglutide or any of the excipients in Rybelsus

• Drug interactions: oral medications—Rybelsus delays gastric emptying

• Pancreatitis

• Diabetic retinopathy complications

• Low blood sugar: Concomitant use with an insulin secretagogue or insulin may increase the risk of low blood sugar, including severe low blood sugar

• Acute kidney injury

• Hypersensitivity reactions

• Acute gallbladder disease

• Pregnancy: May cause fetal harm

• Breastfeeding: Breastfeeding not recommended

• Females and males of reproductive potential: Discontinue Rybelsus in women at least 2 months before a planned pregnancy due to the long washout period for semaglutide

WARNING: RISK OF THYROID C-CELL TUMORS

In rodents, semaglutide causes thyroid C-cell tumors. It is unknown whether Rybelsus causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as the human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined.

Rybelsus is contraindicated in patients with a personal or family history of MTC or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk of MTC and symptoms of thyroid tumors.

*This information is from the label for brand name Rybelsus^®. See the Full Prescribing Information for more complete information. Semaglutide, the active ingredient in Rybelsus, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient semaglutide.