Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regard to diabetes.
Rybelsus is a type 2 diabetes drug that’s approved by the Food and Drug Administration (FDA), and available by prescription only. It’s one of the more commonly-prescribed diabetes medications in the US.
The branded version of the medication is called Rybelsus, and the generic version is called semaglutide. These terms refer to the same active compound so we’ll use them interchangeably throughout this article.
But is Rybelsus proven to work for diabetes? And if so, how much can it reduce blood sugar levels? Does the medication cause side effects? And how do real patients on Rybelsus rate and describe the effects of the drug?
In this article we’ll answer all of these questions and more, as we review clinical studies on Rybelsus to determine if the drug is effective for the treatment of type 2 diabetes, and if so, how much it can reduce blood sugar levels.
We'll discuss if Rybelsus causes weight loss, document side effects, and feature Rybelsus patient reviews.
We'll also document the cost of Rybelsus, and compare its potential efficacy to other diabetes drugs like Ozempic and metformin.
Does Rybelsus Reduce Blood Sugar?
Rybelsus has been studied in various clinical trials for its effects on blood sugar.
A medical review on Rybelsus for diabetes published in the Drugs in R&D journal analyzed results from 39 clinical trials.
In every single analyzed study, the medication reduced A1C levels, which is a long-term marker for blood sugar levels. Most of the trials showed a moderate reduction in A1C levels between 1-2%.
A 2018 clinical trial tested the effects of Rybelsus on blood sugar spikes after carb-rich meals.
The results were impressive: individuals taking Rybelsus experienced 38.5% lower glucose levels after eating, and improved insulin sensitivity, compared to individuals taking a placebo medication.
Another meta-study analyzed results from 9,980 patients taking Rybelsus for diabetes. The researchers found that the medication was effective, and the average decrease in A1C levels was 0.89%.
The study authors noted that Rybelsus reduced A1C levels by 0.35% more than “active comparators,” which refers to other diabetes medications. This suggests that Rybelsus may be a more effective option than many diabetes drugs on the market today.
We can conclude from the available research that Rybelsus is effective at treating and managing elevated blood sugar levels, which is unsurprising given that the drug is approved by the FDA for this indication.
Does Rybelsus Cause Weight Loss?
While Rybelsus isn't currently approved for the treatment of obesity, some clinical trials on the drug have reported changes in weight.
The active ingredient in Rybelsus (called semaglutide) is the same active ingredient in an FDA-approved weight loss drug called Wegovy.
As we detailed in our Wegovy reviews article, semaglutide is proven to be effective for weight loss when injected, but Rybelsus uses an oral form of the medication.
A clinical trial testing Rybelsus’ effect on weight was recently published in the Diabetes, Obesity & Metabolism journal. All trial participants had type 2 diabetes.
Over a 12 week period, the participants taking Rybelsus lost an average of 5.95 pounds, which equates to a potential annualized weight loss of around 26 pounds.
This is an impressive result, and even more impressive than the reductions in blood sugar in our opinion. The researchers documented that most of the weight loss was body fat, which is the ideal type of weight to lose.
It appears that Rybelsus may be effective for weight loss in patients with type 2 diabetes, but using the drug for weight loss alone would be considered an "off-label" use as the drug is not approved by the FDA for that indication.
It may be better for diabetic, overweight patients to consider weight loss as a potential secondary benefit of Rybelsus rather than a primary use.
Patients who are interested in semaglutide for weight loss should speak with their doctor about Wegovy, because that medication contains the same active ingredient as Rybelsus, but is FDA-approved for weight loss.
Rybelsus vs. Ozempic
Another type 2 diabetes medication with the same active ingredient as Rybelsus is called Ozempic.
Ozempic is an injectable semaglutide formulation, while Rybelsus is an oral semaglutide tablet.
Patients are often curious about which medication is more effective.
A 2021 medical review compared the efficacy of oral and injectable semaglutide. The researchers found that the injectable version decreased A1C by 1.5% to 1.8%, while the oral version only decreased A1C by 1% to 1.4%.
The injectable version was also more effective for weight loss; decreasing body weight more than all active comparator drugs tested, while the oral version was only more effective for weight loss than two of the drugs tested.
This research suggests that Ozempic may be more effective for both type 2 diabetes and weight loss than Rybelsus, but injectable medications often come with more risks, so we recommend that patients speak with their doctor about potential side effects before considering a switch from Rybelsus to Ozempic.
Does Rybelsus Cause Side Effects?
Rybelsus does cause side effects in some patients, and the one that's most concerning in our opinion is the increased potential for a specific type of thyroid tumor.
The FDA label for Rybelsus contains a “black box” warning which is the most severe type of warning issued by the FDA for prescription drugs, and indicates potentially severe or life-threatening side effects.
According to the FDA label, animal studies on Rybelsus noted increased thyroid C-cell tumor rates.
This doesn’t necessarily mean that the same effects will occur in humans, but it’s definitely worth speaking with a doctor about, especially for patients with a family history of thyroid tumors or diseases.
A medical review published in the Frontiers in Endocrinology journal documented the most common side effects of Rybelsus: nausea (experienced by around 20% of patients), vomiting (4% to 11.5% of patients) and diarrhea (4.5% to 11.3%).
Clearly, the more common side effects are milder than the potential side effect noted in the FDA black box warning.
Real People Try Rybelsus
A YouTube creator called "Mainely" has a review of Rybelsus after five weeks of use:
A TikTok creator named Cori claims to have lost weight while taking Rybelsus, and has a video with before-and-after images:
@cori_sahm Dr put me on after battling pcos for the past 10 yrs started at 190 down 8pds#rybelsusweightloss #rybelsus #pcosawareness #pcos #pcossucks #weightlossjourneystart #weightlosscheck #gettingstrongereveryday ♬ Sunroof - Nicky Youre & dazy
How Much Does Rybelsus Cost?
The retail price of Rybelsus is relatively high in the US, as is the case with many prescription medications.
At the time of updating this article, Rybelsus costs around $950 according to GoodRx. However, this is just the retail price, which can often be subsidized by health insurance.
The Rybelsus manufacturer's website has a Savings & Support resource page with a coupon offer. The manufacturer claims that some eligible patients may qualify for prices as low as $10 for a several-month supply.
We strongly recommend that patients considering this medication contact their health insurance company to check what their final cost will be, and to use the manufacturer resource linked above.
Speaking with your doctor may also be worthwhile to discuss other ways to bring the retail price down.
We typically recommend that patients speak with their doctor about the generic version of drugs, which should be equally effective but are often significantly cheaper than brand-name drugs.
Unfortunately in the case of Rybelsus, generic semaglutide doesn’t yet appear to be on the market in the US.
Patent law allows drug manufacturers to have exclusive rights to sell a drug for a number of years, so they can recoup costs of research and development.
We recommend that patients ask their doctor to update them when and if generic semaglutide becomes available, because for patients on a budget it may be a better option than Rybelsus.
Patients Review Rybelsus
Drugs.com is a website that allows prescription medication patients to rate and review the drugs they're taking.
We cannot verify the accuracy or authenticity of any reviews on this site.
The average review rating for Rybelsus on Drugs.com, at the time of updating this article, is 5.6 out of 10.
The top positive review is from a user named “Jarin” who claims that the medication significantly reduced their A1C:
“This med Rybelsus is awesome. It has helped me bring my A1C down to 5.1 from a high of 9.7. I first started with the 3mg and am now on the 14mg. Been on this med since March”
The top negative review is from a user named “Dori” who claims that the medication caused uncomfortable side effects. This user also reports significant weight loss:
“I've been on the 7mg for 17 days and the nausea, indigestion, stomach pain and now diarrhea have been almost unbearable and are getting worseI've also lost 18 lbs because I can barely eat anything.”
Rybelsus vs. Metformin
Metformin is another commonly-prescribed diabetes medication, so patients are often curious about which drug is more likely to be effective.
Unfortunately, we cannot locate any medical studies directly comparing the efficacy of the two drugs.
Both medications are proven to be effective for treating and managing type 2 diabetes, and both have been shown to cause weight loss in overweight patients with type 2 diabetes (but neither medication is currently FDA-approved for weight loss alone).
A medical study examining the effects of combined Rybelsus and metformin administration, published in the Clinical Pharmacokinetics journal, found that combining the two drugs was safe.
This suggests that patients with difficult-to-treat diabetes may benefit from speaking to their doctor about taking both Rybelsus and metformin in combination.
Doctor Reviews Rybelsus
A doctor and YouTube creator named “SugarMD” has a Rybelsus review with over 40,000 views that answers common patient questions:
How Does Rybelsus Work?
Rybelsus is part of a class of prescription medications called glucagon-like peptide-1 receptor agonists (GLP-1RA).
These drugs are effective for diabetes because they help normalize glucose levels.
According to medical studies, GLP-1RA medications may block the release of a hormone called glucagon which is commonly elevated in type 2 diabetics. Glucagon causes the body to increase blood sugar levels, so by limiting circulating levels of this compound, blood sugar levels tend to decrease.
In regard to weight loss, Rybelsus may be effective because it reduces hunger and increases the sense of fullness. The medication delays gastric emptying which causes patients to feel full longer.
Our Blood Sugar Support Picks
Cinnamon extract is a dietary supplement that can help support healthy blood sugar levels.
A medical review published in the Annals of Family Medicine journal found that cinnamon consumption reduced fasting blood sugar levels, reduced total cholesterol levels and reduced triglyceride levels.
A clinical trial from 2006 found that cinnamon extract caused a 10.3% blood sugar reduction in type 2 diabetics, while placebo pills only caused a 3.4% reduction.
Illuminate Labs Ceylon Cinnamon Extract is our Ceylon cinnamon supplement that only costs $15 on a subscription basis.
Bulletproof Magnesium is our top magnesium supplement pick, because it's affordable (under $15 at a subscription rate at the time of updating this article) and has no inactive ingredients that we consider to be unhealthy.
We're not suggesting either of these supplements should be used to treat any medical condition, or that they're as effective as any FDA-approved medication; rather, we're just sharing information that individuals averse to prescription medication can speak with their doctor about.