Can you just stop taking Rybelsus?

You can stop taking Rybelsus if you and your healthcare provider decide you should stop treatment. You may need to stop Rybelsus because it isn’t working, due to a serious side effect or to change treatments. Speak with your healthcare provider about how to manage your medical condition first.

If you stop taking Rybelsus for type 2 diabetes, your blood sugar levels will most likely increase and you may lose any positive benefit from prior treatment. If you have lost weight, much of the weight will most likely return within 12 months after you stop treatment.

Wegovy is the injectable form of semaglutide approved for weight loss and Ozempic is the injectable form used for type 2 diabetes. Your doctor may prescribe these drugs for different uses than those approved by the FDA.

Rybelsus (semaglutide) is used with diet and exercise for the treatment of adults with type 2 diabetes to help lower the blood sugar (glucose) and A1C levels. It may help patients lose some weight, but is not approved for this use.

Rybelsus is normally used as a long-term treatment if you tolerate it well. You and your healthcare provider will make a shared decision about how long you should stay on treatment, whether you are using it for type 2 diabetes, weight loss or both.

What happens to your body if you stop Rybelsus?

Studies have shown that when you stop taking Rybelsus, your blood sugar (glucose) levels will most likely increase and you may lose any positive benefit from prior treatment for type 2 diabetes. If you have lost weight, most of the weight may return within 12 months after you stop treatment.

Your appetite may increase and you may feel more hungry throughout the day. Health problems, like type 2 diabetes, heart disease or elevated blood pressure may worsen and your risk for a serious cardiovascular event (like a heart attack or stroke) may increase.

If you develop hyperglycemia (elevated blood sugar levels), you may also experience side effects like nausea, vomiting, fruity-smelling breath, excessive thirst, hunger, feeling tired, excessive urination, blurred vision, headaches, weight loss, and trouble thinking or focusing.

Contact medical care right away if:

• you are concerned your blood sugar levels are too high because of side effects.
• your blood sugar level is over 240 mg/dL and you have ketones in your urine.
• you have chest pain, pain radiating down your shoulder or arm, severe headaches, trouble breathing, changes in your heartbeat, or changes in your vision.

Type 2 diabetes is a serious, chronic (long-term) health condition that requires treatment. Your healthcare provider may recommend that you transition to another medicine or reduce your dose to help with possible side effects. You will also need to maintain your exercise and diet plan to help control your condition.

If you stop Rybelsus treatment, talk to your doctor about what side effects you may experience.

Learn more: What happens when you stop taking Ozempic?

Why do people stop Rybelsus treatment?

Reasons you may need to stop Rybelsus treatment right away include:

• serious side effects like pancreatitis (an inflammation of the pancreas)
• a severe, life-threatening allergic reaction
• the need to switch to Ozempic (semaglutide) injection or another type 2 diabetes or weight loss treatment.

How do I switch between Rybelsus and Ozempic?

Your healthcare provider will give you instructions on how to transition from one product to another. Always follow your healthcare provider’s instructions.

In general,

• If you are taking Rybelsus 14 mg daily, you can be switched to Ozempic subcutaneous injection 0.5 mg once weekly. You can start Ozempic injection the day after your last dose of oral Rybelsus.
• If you are treated with once weekly Ozempic 0.5 mg subcutaneous injection, you can switch to the Rybelsus 7 mg or 14 mg once daily oral tablet. You can start Rybelsus up to 7 days after your last injection of Ozempic. Taking two 7 mg Rybelsus tablets to achieve a 14 mg dosage is not recommended.
• There is no equivalent dose of Rybelsus if you are using the Ozempic 1 mg dose.

Do I have to stop Rybelsus if I have a serious side effect?

Yes, there are some serious side effects, like allergic reactions, pancreatitis, or thyroid tumors that may result in your doctor stopping your Rybelsus treatment.

Allergic reactions

Serious, possibly life-threatening allergic reactions were reported after Rybelsus was approved by the FDA. Stop using Rybelsus and seek medical help right away if you think you are having any of these symptoms of a serious allergic reaction:

• swelling of your face, lips, tongue or throat
• problems breathing or swallowing
• severe rash or itching
• fainting or feeling dizzy
• very rapid heartbeat

Do not use this medicine if you previously had a serious allergic reaction or anaphylaxis to semaglutide, Rybelsus, Ozempic or Wegovy.

Pancreatitis

Pancreatitis is an inflammation (swelling) of the pancreas. The pancreas gland is located behind the stomach and secretes digestive enzymes, insulin and glucagon hormones.

Signs or symptoms of pancreatitis include: severe stomach-area (abdominal) pain which may also occur in your back, with or without nausea and vomiting. If you experience these side effects, stop using Rybelsus and call your healthcare provider right away.

It is not known if Rybelsus can be used if you have pancreatitis. In studies, pancreatitis was reported as a serious adverse event in 6 patients receiving Rybelsus compared to 1 patient receiving other treatments.

If your doctor determines you had pancreatitis while taking Rybelsus, you will most likely need to stop treatment.

Thyroid tumors

The labeling for all semaglutide products carries a Boxed Warning, the FDA’s strongest safety warning, for a possible increased risk of thyroid tumors, including cancer, which has been seen in animal studies. It is not known if Rybelsus causes thyroid tumors.

Symptoms of thyroid tumors can include a mass in the neck, trouble swallowing, shortness of breath or persistent hoarseness in your voice.

Do not use these products if:

• you or your family has a history of medullary thyroid carcinoma (MTC), or
• if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

Related Questions

• What are 4 key Ozempic side effects to watch out for?
• Mounjaro vs Ozempic: How do they compare?
• How do Ozempic, Mounjaro, Wegovy, Zepbound compare for weight loss?

What common side effects happen with Rybelsus?

Safety with oral Rybelsus is similar to the subcutaneous injectable forms of semaglutide (Ozempic, Wegovy). Common side effects reported in at least 5% of patients are primarily related to the stomach and include nausea, stomach pain, diarrhea, decreased appetite, vomiting and constipation.

Because stomach side effects are related to higher doses, your doctor will slowly increase your dose over the first 60 days.

Low blood sugar levels (hypoglycemia) are not common when Rybelsus is used alone. The risk of hypoglycemia (in Rybelsus studies, defined as plasma glucose less than 54 mg/dL) is higher when Rybelsus is used with insulin or sulfonylureas (for example: glipizide, glyburide or glimepiride).

What if I have to stop Rybelsus because I can’t afford it?

Some people may need to stop Rybelsus treatment because it is no longer covered by their insurance or it is too expensive. If you are having trouble filling a Rybelsus prescription due to a supply issue or cost concerns, your healthcare provider can recommend alternatives or money-saving options.

Novo Nordisk, the manufacturer, may be able to offer copay assistance or patient financial assistance, if you qualify. Follow this link below to learn about cost-saving programs.

• Related: Rybelsus Price Guide, Coupons, and Manufacturer Patient Assistance

What are some alternatives to Rybelsus?

Rybelsus (semaglutide) tablets are approved by the FDA for adults with type 2 diabetes to control blood sugar levels. Rybelsus has also been shown in studies to help weight loss, but it is not approved for this use. It is given as an oral once-a-day tablet used in addition to diet and exercise. It can be used as your first treatment, if your doctor prescribes it this way.

Your healthcare provider will recommend the best alternative based on your needs and there are many options. Some alternatives to Rybelsus (oral semaglutide) for the treatment of type 2 diabetes include:

• Ozempic (semaglutide injection)
• Mounjaro (tirzepatide injection)
• Metformin tablets
• Victoza (liraglutide injection)
• Trulicity (dulaglutide injection)
• Jardiance (empagliflozin tablets)
• Invokana (canagliflozin tablets)

Ozempic and Wegovy

Rybelsus is from the class of medicines called GLP-1 receptor agonists (glucagon-like peptide-1 receptor agonists). GLP-1 receptor agonists mimic the body’s natural hormone called GLP-1. Approved by the FDA in Sept. 2019, it is available as a 7 mg and 14 mg oral tablet and was the first oral glucagon-like peptide-1 (GLP-1) receptor agonist.

The injectable form of semaglutide for type 2 diabetes is known as Ozempic, and the injectable form of semaglutide for long-term weight management is known as Wegovy. Rybelsus oral tablets contain semaglutide, the same active ingredient that’s found in Wegovy and Ozempic injections.

Wegovy is approved for weight loss management, while Ozempic is approved for treatment of type 2 diabetes. They are both given as once weekly subcutaneous injections. All products are used in addition to a reduced-calorie diet and increased physical activity.

Wegovy and Ozempic have also been approved to help reduce the risk of serious cardiovascular events like a heart attack, stroke or death in adults with heart disease. Rybelsus does not carry this indication. All GLP-1 like products are used in addition to a reduced-calorie diet and increased physical activity.

Rybelsus, Ozempic and Wegovy are all manufactured by Novo Nordisk.

Mounjaro and Zepbound

Mounjaro and Zepbound both contain the active ingredient tirzepatide, a GIP and GLP-1 receptor agonist.

Tirzepatide works similarly to semaglutide, but it activates an additional receptor site known as the GIP (glucose-dependent insulinotropic polypeptide). GIP and GLP-1 are natural incretin hormones that help regulate blood sugar levels.

Both Mounjaro and Zepbound are used in addition to a reduced-calorie diet and increased physical activity and are manufactured by Eli Lilly and Co.

Note: Ozempic and Mounjaro are both approved to treat type 2 diabetes, and Wegovy and Zepbound are both approved for long-term weight loss.

This is not a complete list of possible alternatives to Rybelsus.

How does Rybelsus work for type 2 diabetes?

Rybelsus works in type 2 diabetes in three different ways:

• It reduces your blood sugar levels by increasing insulin output
• It decreases the amount of sugar made and released from your liver
• It slows down how fast food moves out of your stomach (slows gastric emptying), which can make you feel fuller for a longer period of time.

In the 26 week long clinical studies, use of Rybelsus alone once daily resulted in a statistically significant reduction in HbA1c (reduction of 1.2% to 1.4%). HbA1c is a blood test that assesses longer-term control of blood sugar. In addition, people had an average weight loss of about 5 to 8 lbs. (2.3 to 3.6 kg).

Learn more: What is the mechanism of action for Rybelsus?

This is not all the information you need to know about Rybelsus (semaglutide) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.