Introduction
If weight loss and celebrities are topics which interest you, you might have come across a revolutionary drug: semaglutide. The medication helps people suffering from type 2 diabetes and obesity by regulating blood sugar levels and suppressing appetite. Celebrities like Sharon Osbourne and Elon Musk have credited it for their weight loss success.
Currently, semaglutide is on the market under the brand names Ozempic, Wegovy, and Rybelsus. You administer Ozempic and Wegovy subcutaneously (injecting under the skin) and take Rybelsus orally.
With all these options, one might wonder, ‘Is Rybelsus safe?’ ‘Are semaglutide tablets safe to take?’ This article explores the safety and effectiveness of Rybelsus in managing type 2 diabetes and promoting weight loss.
What is semaglutide?
First things first: What is semaglutide exactly? Knowing what Rybelsus’ active ingredient is and how it works will allow us to better understand its therapeutic applications.
Semaglutide belongs to a class of drugs, glucagon-like peptide-1 receptive agonists, or GLP-1 Ras. Now, in our gut is a hormone, GLP-1. After consuming food, GLP-1 triggers the pancreas to release insulin, a hormone that regulates blood sugar levels.
Semaglutide mimics GLP-1 and does the same. It also has an effect that slows down digestion, making you feel fuller for longer. As a result, people’s appetites are weaker and they lose weight.
You can only purchase semaglutide products with a prescription. Ozempic and Rybelsus have FDA approval for treating type 2 diabetes while Wegovy has approval for weight loss. Despite these key differences, many healthcare providers opt to prescribe Ozempic and Rybelsus off-label for weight loss.
Introducing oral semaglutide Rybelsus
Now that we know how the active ingredient semaglutide works, we can now zoom in on its tablet variant, Rybelsus. The drug helps improve glycemic control in adult patients with type 2 diabetes, in addition to diet and exercise.
Dosage
As we’ve mentioned, Rybelsus is semaglutide’s only brand you have to take orally. According to its medication guide, patients have a starting dose of 3 mg once daily for the first 30 days. This is to give the body a chance to adjust to it. Note that during this period, it won’t be effective for glycemic control yet.
After finishing all 3 mg tablets, they can expect their doctor to prescribe Rybelsus’ 7 mg tablets. This dosage already offers a reduction in glycemic levels.
Should they need to lower their blood sugar levels further, their doctor may increase their dosage to 14 mg once daily.
Proper storage and administration
It’s important that patients take Rybelsus properly each time. Here are the step-by-step instructions on administering it.
- Rybelsus should be taken on an empty stomach when you first wake up. By empty stomach, this means no food, no drink, no oral medications, no vitamins, and no supplements.
- Next, you should drink Rybelsus with no more than a sip of plain water, no more than four ounces. You should swallow the tablet whole. Do not cut, crush, or chew the tablet.
- After taking Rybelsus, you can eat, drink, or take other oral medications, vitamins, or supplements after 30 minutes.
Should you miss a dose, take the next dose the following day. Let your healthcare provider know if with intake of Rybelsus, your blood sugar levels are too high or too low.
To maintain Rybelsus’ efficacy, you should not transfer the tablets to pill organizers and keep them in their original bottles. Shut the blue cap tight each time.
Are semaglutide tablets more effective than injectables?
It’s not surprising that some prefer taking pills or tablets over injectables, as not everyone will be comfortable injecting themselves. For those who don’t mind taking a tablet daily, Rybelsus offers a convenient and effective option.
Both oral and subcutaneous semaglutide are effective at controlling blood sugar levels and promoting weight loss. However, researchers have looked into the possibility that one format is more effective than the other.
A review concluded that once-daily Rybelsus is as, if not more effective, for weight loss and reducing A1C than injectable semaglutide. A1C is a blood sugar test.
Despite the review’s findings, research comparing oral and subcutaneous semaglutide is still relatively new. More studies are necessary to conclude that one form is more effective than the other. There have also been no clinical studies directly comparing the two forms.
Are semaglutide tablets safe and effective?
A quick search on the internet will reveal that safety and effectivity are closely intertwined whenever drugs are concerned. As such, most research on Rybelsus’ safety typically also examines its efficacy as well. The following are some examples.
Lowers blood sugar levels
A 26-week study found that Rybelsus effectively lowered blood sugar levels in adults suffering from type 2 diabetes. The participants experienced a 1.2 to 1.4% reduction in their HbA1c levels. Meanwhile, those on placebo only lost 0.3%.
More effective at higher doses
A study investigated the efficacy and safety of oral semaglutide at 7 mg and 14 mg doses. Participants on oral semaglutide at 7 mg and 14 mg doses reduced their HbA1c levels by 1.06% and 1.10%.
Similarly, another study looked at once-daily oral semaglutide’s safety and efficacy over 68 weeks at higher doses. 25 mg and 50 mg proved to be more effective in lowering blood sugar levels and reducing weight. However, researchers recorded more side effects with taking 25 mg and 50 mg versus only taking 25 mg of semaglutide. The adverse effects were mainly gastrointestinal disorders, most of which were mild to moderate.
Adverse reactions
Whether you use Rybelsus, Ozempic, or Wegovy for type 2 diabetes or weight loss, you still potentially face side effects. Fortunately, the more common side effects are manageable and the serious side effects are rare.
You should continue to take caution regardless of which semaglutide format part of your treatment plan. Make sure to let your doctor know if you experience any side effects.
Common side effects
The most common side effects of Rybelsus include nausea, abdominal pain, constipation, decreased appetite, diarrhea, and vomiting. These account for at least 5% of cases. Note that nausea is the most common side effect but this is normally reduced as you keep on taking semaglutide.
Serious side effects
Risk of thyroid c-cell tumors
Patients may experience elevated levels of serum calcitonin, a tumor marker of medullary thyroid carcinoma or MTC.
In a study involving lab rats, researchers discovered that these developed thyroid tumors or MTC after being given semaglutide. Despite these results, it is still unknown whether semaglutide may also potentially cause the same in humans.
Pancreatitis
Clinical trials have reported a risk of developing pancreatitis, a condition characterized by the sudden inflammation of the pancreas. The symptoms include persistent severe abdominal pain.
Diabetic retinopathy
A two-year trial showed a higher incidence of diabetic retinopathy (blindness) in patients taking semaglutide than those on placebo.
Hypoglycemia
When used with other anti-diabetic medicines, semaglutide can potentially trigger hypoglycemia, a condition where blood sugar is lower than normal. Hypoglycemia can cause shaking, sweating, dizziness, difficulty concentrating, quickening of the heart rate, as well as feelings of extreme hunger.
Acute kidney injury
Patients taking semaglutide were found to suffer from acute kidney injury and worsened chronic renal failure. Researchers speculated that the weight loss caused by semaglutide may have contributed to the patient’s decline in kidney function.
Hypersensitivity
Some patients taking semaglutide have experienced hypersensitivity reactions such as anaphylaxis or angioedema. Anaphylaxis is life-threatening whole-body allergic reaction while angioedema is sudden swelling of tissues below the skin due to allergic reaction.
Acute cholecystitis or acute gallbladder disease (inflammation of the gallbladder)
There was a higher incidence of acute cholecystitis among those taking GLP-1 receptors such as semaglutide. Acute cholecystitis usually develops when a gallstone obstructs the cystic duct. Complications from this condition include gallbladder tissue death or gangrenous cholecystitis (death of tissue and perforation of the gallbladder wall).
It is not recommended for patients with a history of the above, are pregnant, or planning to get pregnant. Moreover, it is not recommended for lactating or breastfeeding women to take semaglutide tablets in any form, given the risks.
Based on animal studies, there are potential risks to the fetus should the mother take semaglutide. Should a woman intend to get pregnant, she should stop taking semaglutide at least two months in advance.
Conclusion
Semaglutide is a revolutionary drug that helps people suffering from type 2 diabetes and obesity. It effectively lowers blood sugar levels and promotes weight loss.
The drug comes in two formats: injectables and tablet form. Its brands Ozempic and Wegovy come in pre-filled injectable pens while its third brand, Rybelsus, comes in tablet form. Ozempic and Wegovy are injected once weekly while Rybelsus is taken once daily.
Although Rybelsus’ FDA-approved use is for the treatment of type 2 diabetes, it is often prescribed off-label for weight loss.
Rybelsus comes in tablet form, which is more convenient for some people. Still, proper dosage, administration, and storage are vital for its efficacy. Your doctor will typically start you off on a low dose, working your way up to a maintenance dose. They should be taken the same way each day to achieve results.
Several clinical studies prove the safety and efficacy of semaglutide tablets. However, patients should fully disclose their medical history to their doctor and watch out for any potential side effects.
Rybelsus comes with the risk of developing mild to serious adverse effects. Its most common side effects include nausea, constipation, diarrhea, abdominal pain, decreased appetite, and vomiting. While there are serious side effects, these are rare. Make sure to inform your healthcare provider should you experience any side effects.
Taking semaglutide alone is not enough. It should be taken along with lifestyle changes such as proper diet and ample exercise.
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