Rybelsus is a brand-name oral tablet that’s prescribed for type 2 diabetes. Rybelsus contains the active ingredient semaglutide and belongs to the glucagon-like peptide-1 (GLP-1) receptor agonist drug class.

Rybelsus is FDA-approved to treat type 2 diabetes in adults. It’s used with a balanced diet and exercise to help manage blood sugar levels.

Drug details

You’ll find key information about Rybelsus below.

  • Drug form: oral tablet
  • Generic available? no
  • Prescription required? yes
  • Controlled substance? no
  • Year of FDA approval: 2017

Rybelsus has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Semaglutide, the active drug in Rybelsus, has been shown to cause thyroid cancer (including medullary thyroid carcinoma [MTC]) in animal studies. It’s not known if Rybelsus increases the risk of thyroid cancer in humans.

Your doctor won’t prescribe Rybelsus if you or someone in your family has had MTC or if you have a rare type of cancer known as multiple endocrine neoplasia syndrome type 2 (MEN 2). For details, see the “Rybelsus precautions” section below.

Rybelsus is available only as a brand-name medication. It’s not currently available in generic form. A generic drug is an exact copy of the active drug in a brand-name medication.

Rybelsus contains one active drug: semaglutide. (As the active drug, semaglutide is the ingredient that makes Rybelsus work.) Semaglutide is also the active drug in a brand-name medication called Ozempic.

Rybelsus can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Rybelsus. These lists don’t include all possible side effects.

For more information on the possible side effects of Rybelsus, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they have approved. If you would like to report to the FDA a side effect you’ve had with Rybelsus, you can do so through MedWatch.

Mild side effects

The most common mild side effects* of Rybelsus can include:

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Rybelsus. To learn about other mild side effects, talk with your doctor or pharmacist, or visit the Rybelsus prescribing information.

Serious side effects

Serious side effects from Rybelsus aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Hypoglycemia (low blood sugar). This is more likely if you take Rybelsus with insulin. Symptoms can include:
    • sweating
    • weakness
    • confusion
  • Pancreatitis (swelling or irritation of the pancreas). Symptoms can include:
    • severe abdominal pain
    • vomiting
    • fever
  • Complications of diabetic retinopathy (a form of eye damage due to diabetes). Symptoms can include:
    • worsened eyesight, such as blurred vision, floaters (specks in your vision that move), and difficulty seeing colors
  • Sudden kidney problems. Symptoms can include:
  • Gallstones or gallbladder inflammation. Gallstones may not always cause noticeable symptoms, but in general, possible symptoms of either condition include:
    • pain in the upper-right side of your abdomen, your right shoulder, or between your shoulder blades
    • fever
    • clay-colored stool
    • jaundice
    • nausea or vomiting

Other serious side effects, explained in more detail below in “Side effect details,” include:

* Rybelsus has a boxed warning for the risk of thyroid cancer. This is the most serious warning from the Food and Drug Administration (FDA). For more information, see “Rybelsus precautions” below.

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on several of the side effects this drug may cause.

Note: You can also refer to this article for details about Rybelsus side effects, in addition to the information below.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Rybelsus. However, it’s not known how often allergic reactions occur with Rybelsus.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • difficulty breathing or speaking

Call your doctor right away if you have a severe allergic reaction to Rybelsus. Call 911 or your local emergency phone number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Weight loss

Weight loss of about 5–10 pounds (2–3 kilograms) may occur when taking Rybelsus for type 2 diabetes. However, this medication is not approved by the Food and Drug Administration (FDA) for weight loss.

Clinical trials showed that people who took Rybelsus lost more weight than people who took the similar drugs liraglutide (Victoza), sitagliptin (Januvia), empagliflozin (Jardiance), or a placebo (treatment with no active drug). But exact numbers for how many people lost weight with each treatment aren’t known.

The weight loss may be a result of better blood sugar management, in addition to changes in diet and exercise. It could also be a result of digestive side effects caused by Rybelsus (see below).

If you have any concerns about weight loss while taking Rybelsus, talk with your doctor. They can review your treatment plan to help make sure you’re at a weight that’s healthy for you.

Digestive side effects

The most common side effects caused by Rybelsus are digestive side effects. These include nausea, abdominal pain, diarrhea, decreased appetite, vomiting, and constipation.

Other less common digestive side effects such as gas, acid reflux, and burping were also reported in clinical trials.

Higher doses of Rybelsus are usually more likely to cause digestive effects.

If you have digestive symptoms that bother you, become severe, or don’t go away, tell your doctor. They may be able to recommend ways to help ease your side effects or select a different dose or medication for you.

As with all medications, the cost of Rybelsus can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Your insurance plan may require you to get prior authorization before approving coverage for Rybelsus. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the request and let you and your doctor know if your plan will cover Rybelsus.

If you’re not sure if you’ll need to get prior authorization for Rybelsus, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Rybelsus, or if you need help understanding your insurance coverage, help is available.

There is a savings card available for Rybelsus. To learn more, you can visit the drug website or call 833-ASK-A-CDE (833-275-2233).

You can also visit Optum Perks for price estimates of Rybelsus. These estimates are based on the use of Optum Perks coupons. Note: Optum Perks coupons cannot be used with any insurance copays or benefits.

In addition to the information below, you can refer to this article for details about the cost of Rybelsus.

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The Rybelsus dosage your doctor prescribes will depend on several factors. These include:

  • the severity of the condition you’re taking Rybelsus to treat
  • other medical conditions you may have

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug form and strengths

Rybelsus comes as a tablet that you swallow. It’s available in the following strengths in milligrams (mg): 3 mg, 7 mg, and 14 mg.

Dosage for type 2 diabetes

For treatment of type 2 diabetes, you’ll usually take 3 mg of Rybelsus once per day for the first 30 days. After that, your doctor will likely increase your dose to 7 mg once per day. This is usually the dose that’s needed to help improve blood sugar management.

After you’ve been taking 7 mg of Rybelsus for 30 days, your doctor will decide whether they should increase the dose. If you could benefit from better blood sugar management, your doctor may increase your dose to 14 mg once per day.

You can also refer to this article for details about Rybelsus’ dosage.

What if I miss a dose?

If you miss a dose of Rybelsus, wait until the next day to take your regularly scheduled dose. Don’t double up on doses to make up for the dose you missed.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Rybelsus is meant to be used as a long-term treatment. If you and your doctor determine that Rybelsus is safe and effective for you, you’ll likely take it long term.

Rybelsus is prescribed along with a balanced diet and exercise. Good diet and exercise habits may help manage type 2 diabetes. In some instances, the condition may improve so much that your doctor may decrease your dosage of Rybelsus or have you stop taking the drug.

The Food and Drug Administration (FDA) approves prescription drugs such as Rybelsus to treat certain conditions. Rybelsus may also be prescribed off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is prescribed to treat a different condition.

Rybelsus for type 2 diabetes

Rybelsus is an FDA-approved drug for the treatment of type 2 diabetes in adults when taken with a nutritious diet and exercise.

Type 2 diabetes is a condition in which your blood sugar level becomes too high due to problems with insulin. Insulin is a hormone that your pancreas makes to help manage blood sugar. With type 2 diabetes, either your body doesn’t respond well to insulin or doesn’t produce enough insulin.

If type 2 diabetes goes untreated, it can lead to problems with the heart, eyes, and nerves, among other parts of the body. These complications can include high blood pressure, diabetic retinopathy, and neuropathy (nerve damage). For more information about this condition, you can refer to our diabetes hub.

Rybelsus is not prescribed for type 1 diabetes. Also, Rybelsus hasn’t been studied in people who have had pancreatitis (swelling or irritation of the pancreas).

Effectiveness for type 2 diabetes

A clinical trial has shown that Rybelsus helps lower blood sugar more than a placebo (treatment with no active drug). Researchers used blood tests to measure hemoglobin A1c (HbA1c) levels, which is a marker of blood sugar management. Target values of 7% are common for HbA1c, but this varies from person to person.

In the study, people who took Rybelsus had their HbA1c levels decrease more than people who took a placebo. And at the end of the study, more people who took Rybelsus had an HbA1c level of less than 7% compared with those who took a placebo.

Other uses for Rybelsus

In addition to the uses listed above, Rybelsus may be prescribed off-label. Off-label drug use is when a drug that’s approved for one use is prescribed for a different one that’s not approved. And you may wonder if Rybelsus is used for certain other conditions.

Rybelsus for weight loss (off-label use)

Rybelsus is not FDA-approved for weight loss. However, it may be prescribed off-label to help with weight loss or weight management. Weight loss can be a side effect of Rybelsus treatment for type 2 diabetes (see “Rybelsus side effects” above for details). If you have questions about Rybelsus and weight management, talk with your doctor.

Rybelsus for type 1 diabetes (under study)

Type 1 diabetes is another form of diabetes, and it’s less common than type 2 diabetes. Type 1 diabetes causes high blood sugar levels because the body doesn’t make enough of a hormone called insulin, which helps manage blood sugar.

The Food and Drug Administration (FDA) hasn’t approved Rybelsus for the treatment of type 1 diabetes. However, the drug is being studied for use with insulin and other medications for type 1 diabetes and may be prescribed off-label by doctors. Research shows that adding drugs such as Rybelsus to insulin treatment in people with type 1 diabetes may help lower hemoglobin A1c (HbA1c) levels and body weight.

If you have questions about Rybelsus or treatments for type 1 diabetes, talk with your doctor.

Rybelsus and children

Rybelsus isn’t approved for use in children. More studies are needed to show whether the medication is safe and effective for this age group.

Rybelsus is approved to treat type 2 diabetes when used with a balanced diet and exercise. But if Rybelsus, along with diet and exercise changes, is not enough to help manage your blood sugar levels, your doctor may prescribe other medications, such as metformin (Glumetza).

If you have questions about your diet and exercise plan or other medications while taking Rybelsus, talk with your doctor.

Rybelsus can interact with several other medications. It can also interact with certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.

For more information about Rybelsus and interactions, see this in-depth article.

Rybelsus and other medications

Below is a list of medications that can interact with Rybelsus. This list doesn’t contain all drugs that may interact with Rybelsus.

Before taking Rybelsus, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Rybelsus and sulfonylurea drugs

You may be more likely to develop hypoglycemia (low blood sugar) if you take Rybelsus and medication in a drug class called sulfonylureas. (A drug class is a group of medications that work in a similar way.) Sulfonylurea drugs help treat type 2 diabetes.

Examples of medications in the sulfonylurea drug class include:

If you’re taking any of these drugs, tell your doctor before you start taking Rybelsus. They’ll create a plan to monitor you for signs and symptoms of low blood sugar, which can include sweating, dizziness, and confusion. Your doctor may also decrease your dose of the sulfonylurea drug during your Rybelsus treatment.

Rybelsus and insulin

You may be more likely to develop hypoglycemia if you take Rybelsus and any type of insulin.

Examples of insulin include:

If you’re taking insulin, tell your doctor before you start taking Rybelsus. They can create a plan to monitor your blood sugar. Also, your doctor may decrease your dose of insulin during your Rybelsus treatment.

Rybelsus and all other oral medications

You should take Rybelsus at least 30 minutes before taking any other oral medications. (“Oral” refers to a drug that you swallow as a tablet, capsule, or liquid.) Otherwise, Rybelsus won’t work as well to treat your condition.

Rybelsus slows down how quickly your stomach empties, and this can change the way your body absorbs other medications. Because of this, your doctor may test you more often than usual to make sure your medication is working well.

Before you start taking Rybelsus, tell your doctor about any medications you take. They can help advise you on when to take them and Rybelsus.

Rybelsus and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Rybelsus. However, you should still check with your doctor or pharmacist before using any of these products while taking Rybelsus.

Rybelsus and foods

You should take Rybelsus at least 30 minutes before you eat or drink anything, except for water. And you shouldn’t drink more than 4 ounces of water within those 30 minutes. Taking Rybelsus with food or liquids other than water can decrease the amount of the drug that your body absorbs. So Rybelsus may not work as well to treat your condition.

If you have any questions about the timing of your Rybelsus doses and meals, talk with your doctor.

Rybelsus and alcohol

There’s no known interaction between Rybelsus and alcohol.

Keep in mind that you should take Rybelsus at least 30 minutes before eating or drinking anything other than 4 ounces of water. If you don’t wait 30 minutes, the medication may be less effective. So it’s best to avoid drinking alcohol at least 30 minutes before taking Rybelsus.

If you have questions about alcohol use during your Rybelsus treatment, talk with your doctor.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Rybelsus, talk with your doctor. They can tell you about other medications that may work well for you.

Alternatives for type 2 diabetes

Examples of other drugs that may be used to treat type 2 diabetes include:

You may wonder how Rybelsus compares with other medications that are prescribed for similar uses. Here we look at how Rybelsus and Ozempic are alike and different.

Note: In addition to the information below, you can refer to this article about Rybelsus vs. Ozempic.

Ingredients

Both Rybelsus and Ozempic contain the active ingredient semaglutide.

Uses

The Food and Drug Administration (FDA) has approved Rybelsus and Ozempic to treat type 2 diabetes. The drugs help manage blood sugar in adults when used with a balanced diet and exercise.

Ozempic is also FDA-approved to decrease the risk of major cardiovascular problems in people with type 2 diabetes and cardiovascular disease. Rybelsus isn’t approved by the FDA for this use.

Drug forms and administration

Rybelsus comes as a tablet that you swallow.

Ozempic comes as a single-use pen that you use to administer a subcutaneous injection. You’ll have the injections in your abdomen, thigh, or upper arm.

Dosage differences between Rybelsus and Ozempic

You’ll usually take 3 mg of Rybelsus once per day for the first 30 days. After that, your doctor will likely increase your dose to 7 mg, once per day. This is usually the dose that’s needed to help improve blood sugar management.

After you’ve been taking 7 mg of Rybelsus for 30 days, your doctor will decide whether they should increase the dose. If you could benefit from better blood sugar management, your doctor may increase your dose to 14 mg once per day.

You’ll usually start with a 0.25-mg injection of Ozempic once a week. After 4 weeks, your doctor may increase the dose to a 0.5-mg injection once a week. If you could benefit from better blood sugar management, your doctor may continue to increase your dosage.

Switching between Rybelsus and Ozempic

Your doctor may switch you to Rybelsus from Ozempic if you prefer taking medication by mouth instead of having injections. Or they may switch you to Ozempic from Rybelsus if you prefer taking a drug once a week instead of once per day.

If you have cardiovascular disease, your doctor may recommend Ozempic over Rybelsus. Ozempic is FDA-approved to decrease the risk of major cardiovascular problems in people with type 2 diabetes and cardiovascular disease. Rybelsus isn’t approved for this use.

If you’re taking 14 mg of Rybelsus once per day, your doctor may switch you to a 0.5-mg injection of Ozempic once a week. You can start having your Ozempic injections the day after your last dose of Rybelsus.

If you’re taking a 0.5-mg injection of Ozempic once a week, your doctor may switch you to either a 7-mg or 14-mg dose of Rybelsus once per day. You can start taking Rybelsus up to 7 days after your last injection of Ozempic.

If you’re taking 1-mg injections of Ozempic once a week, keep in mind that there’s no equal dose of Rybelsus.

Side effects and risks

Rybelsus and Ozempic both contain the active drug semaglutide. Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain examples of up to 10 of the most common mild side effects that can occur with each drug, or with both Rybelsus and Ozempic (when taken individually).

Serious side effects

This list contains examples of serious side effects that can occur with Rybelsus and Ozempic (when taken individually):

* Rybelsus and Ozempic each have a boxed warning about a possible risk of thyroid cancer. This is the most serious warning from the FDA. For more information, see “Rybelsus precautions” below.

Effectiveness

Rybelsus and Ozempic haven’t been directly compared in clinical studies. However, studies have found both Rybelsus and Ozempic to be effective for treating type 2 diabetes when used with a balanced diet and exercise.

Costs

Rybelsus and Ozempic are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

Rybelsus and Ozempic generally cost about the same. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Visit Optum Perks to find coupons and savings for Rybelsus and Ozempic.

Like Ozempic (above), the drug metformin has uses similar to those of Rybelsus. Here’s a comparison of how Rybelsus and metformin are alike and different.

Note: In addition to the information below, you can refer to this article about Rybelsus vs. metformin.

Ingredients

Rybelsus contains the active ingredient semaglutide. Metformin contains the active ingredient metformin. It’s a generic drug, and it’s also the active ingredient in the brand-name drug Glumetza.

Uses

The Food and Drug Administration (FDA) has approved Rybelsus and metformin to treat type 2 diabetes in adults. Metformin is also approved for use in children ages 10 years and older. The drugs help manage blood sugar in adults when taken with a nutritious diet and exercise.

Drug forms and administration

Rybelsus comes as an oral tablet. You’ll usually take it once per day.

Metformin comes in three forms. One is an oral tablet. You’ll typically take it once or twice a day. With higher doses, your doctor may have you take metformin three times a day.

The second form of metformin is an extended-release oral tablet, which releases the drug into your body slowly over time. The third form is a liquid solution that you swallow.

Side effects and risks

Rybelsus and metformin are both used to treat type 2 diabetes. Therefore, these medications can cause some similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain examples of up to 10 of the most common mild side effects that can occur with each drug, or with both Rybelsus and metformin (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Rybelsus, with metformin, or with both drugs (when taken individually).

* Rybelsus has a boxed warning about a possible risk of thyroid cancer. This is the most serious warning from the FDA. For more information, see “Rybelsus precautions” below.
† Metformin has a boxed warning about lactic acidosis. For more information, see the drug’s prescribing information for the oral tablet, oral solution, and extended-release oral tablet.

Effectiveness

The only condition both Rybelsus and metformin are used to treat is type 2 diabetes, in combination with a balanced diet and exercise.

These drugs haven’t been directly compared in clinical studies, but studies have found both Rybelsus and metformin to be effective for treating type 2 diabetes when taken with a balanced diet and exercise.

Costs

Rybelsus is a brand-name drug. Metformin is a generic drug. Brand-name medications usually cost more than generics.

Rybelsus costs significantly more than metformin. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Visit Optum Perks to find coupons and savings for Rybelsus and metformin.

You should take Rybelsus oral tablets according to your doctor’s or healthcare professional’s instructions.

When to take

You’ll usually take Rybelsus once per day. You should take the drug at least 30 minutes before you eat or drink anything, except for water. And you shouldn’t drink more than 4 ounces of water within those 30 minutes.

Also, you should take Rybelsus at least 30 minutes before taking any other medication that you swallow.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Taking Rybelsus with food

It’s important to take Rybelsus at least 30 minutes before having any food or drink (aside from up to 4 ounces of water).

Taking Rybelsus with food or liquids other than water can decrease the drug’s ability to help manage your blood sugar.

After taking your Rybelsus dose, you can eat and drink like usual.

Can Rybelsus be crushed, split, or chewed?

No, you shouldn’t split, crush, or chew Rybelsus tablets. Swallow them whole with less than 4 ounces of water.

With type 2 diabetes, your blood sugar level is higher than usual. This is because of insulin (a hormone that manages blood sugar). The insulin level in your body is too low or your body can’t properly use insulin.

Rybelsus is a glucagon-like peptide-1 (GLP-1) receptor agonist. It works to decrease blood sugar levels by raising the level of insulin and lowering the level of a hormone called glucagon. Rybelsus also increases the amount of time that food stays in your stomach before moving through the rest of your digestive system. This may help decrease blood sugar levels as well.

How long does it take to work?

It typically takes about 1 month for Rybelsus to work.

You’ll usually start taking 3 mg of Rybelsus a day, which helps your body get used to the medication. Keep in mind that this isn’t the recommended dose used to treat type 2 diabetes.

After 1 month, your doctor will typically change your dose to 7 mg a day. This will start adjusting your blood sugar levels to reach the goal you and your doctor set. It’s possible that you may need a higher dose of Rybelsus. (For more information, see the “Rybelsus dosage” section above.)

It’s usually not recommended that you take Rybelsus during pregnancy unless your doctor thinks that the benefits of treatment are greater than the potential side effects.

There hasn’t been enough research in humans to show whether Rybelsus is safe to take while pregnant. Animal studies show that Rybelsus may harm a fetus, but it’s not known whether these results apply to humans.

If you’re planning a pregnancy and decide to take Rybelsus, you should wait until at least 2 months after your last dose to become pregnant. It takes that long for the drug to fully clear out of your body.

If you’re pregnant or are planning to become pregnant, tell your doctor before you start taking Rybelsus. They can review your treatment options with you.

If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re taking Rybelsus.

It’s usually not recommended that you take Rybelsus during pregnancy unless your doctor thinks that the benefits of treatment are greater than the potential side effects.

You should not breastfeed while taking Rybelsus. Animal studies show that Rybelsus passes into breast milk. For this reason, you shouldn’t take the drug while breastfeeding.

If you’re breastfeeding or are planning to breastfeed, tell your doctor before taking Rybelsus. They may recommend a different drug for you.

Here are answers to some frequently asked questions about Rybelsus.

Is Rybelsus a type of insulin?

No, Rybelsus isn’t a type of insulin. Insulin is a hormone that manages blood sugar. Rybelsus is a type of drug called a glucagon-like peptide-1 (GLP-1) receptor agonist. GLP-1s such as Rybelsus help manage blood sugar by increasing insulin levels and decreasing levels of a hormone called glucagon.

In some cases, your doctor may have you take Rybelsus with insulin for even better blood sugar management.

If you have questions about Rybelsus or insulin, talk with your doctor.

Why do I need to take Rybelsus 30 minutes before I eat or drink?

Taking Rybelsus at least 30 minutes before you eat or drink helps your body absorb the drug properly. Keep in mind that you can drink a little water (no more than 4 ounces) when you take the medication. But consuming other drinks or food, or taking other medications, within 30 minutes can decrease the effectiveness of Rybelsus.

If you have any questions about the timing of your Rybelsus doses and meals, talk with your doctor.

What’s wrong with storing Rybelsus tablets in my pill box?

If you store Rybelsus tablets in a pill box or pill organizer, the drug may be exposed to moisture. This can make Rybelsus less effective in managing your blood sugar. So it’s best to keep the medication in its original packaging until you’re ready to take it.

Can I take Rybelsus for type 1 diabetes?

The Food and Drug Administration (FDA) hasn’t approved Rybelsus for the treatment of type 1 diabetes. However, the drug is being studied for use with other medications to treat type 1 diabetes. For more information, see the “Rybelsus uses” section.

If you have questions about Rybelsus or treatments for type 1 diabetes, talk with your doctor.

This drug comes with several precautions.

FDA warning: Thyroid cancer

This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Semaglutide, the active drug in Rybelsus, has been shown to cause thyroid C-cell tumors in animal studies. (Tumors are masses of cancerous tissue, and in this instance, they occur in the thyroid gland. The tumors actually start in a type of cell called a C cell.) However, it’s not known if Rybelsus causes these tumors in humans. The tumors include medullary thyroid carcinoma (MTC).

Your doctor won’t prescribe Rybelsus if you or someone in your family has had MTC. Your doctor also won’t prescribe the drug if you have a rare type of cancer known as multiple endocrine neoplasia syndrome type 2 (MEN 2).

Your doctor will talk with you about the risk of MTC and other thyroid tumors, as well as possible symptoms. These symptoms can include trouble swallowing, hoarseness that lasts, a mass in your neck, or shortness of breath.

If you have questions or concerns about this boxed warning, talk with your doctor or pharmacist.

Other precautions

Before taking Rybelsus, talk with your doctor about your health history. Rybelsus may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Diabetic retinopathy. Taking Rybelsus may increase your risk for diabetic retinopathy (a form of eye damage due to diabetes). If you have a history of diabetic retinopathy, your doctor will monitor you closely while you use Rybelsus.
  • Chronic kidney failure. Taking Rybelsus may cause chronic kidney failure to worsen. Your doctor will monitor you closely during your Rybelsus treatment.
  • Pancreatitis. Rybelsus hasn’t been studied in people who have had a pancreas problem known as pancreatitis. So if you have this condition, your doctor will likely recommend a different diabetes medication.
  • Allergic reaction. If you’re allergic to Rybelsus or any of its ingredients, your doctor won’t prescribe Rybelsus. They may recommend a different treatment that’s a better choice for you.
  • Pregnancy. It’s usually not recommended that you take Rybelsus during pregnancy. For more information, please see the “Rybelsus and pregnancy” section above.
  • Breastfeeding. You should not breastfeed while taking Rybelsus. For more information, please see the “Rybelsus and breastfeeding” section above.

Note: For more information about the potential negative effects of Rybelsus, see the “Rybelsus side effects” section above.

Do not take more Rybelsus than your doctor recommends.

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or visit the website. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

When you get Rybelsus from the pharmacy, the pharmacist will add an expiration date to the label on the packaging. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid taking expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about how to correctly dispose of it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

You should store Rybelsus tablets at room temperature (68°F to 77°F/20°C to 25°C) in the original container. If needed, you can keep the drug between 59°F and 86°F (15°C and 30°C) for a short time. Avoid storing this medication in areas where it could get damp or wet, such as in bathrooms.

Disposal

If you no longer need to take Rybelsus and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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