What foods should I eat or avoid when taking Rybelsus?

There are no specific foods to avoid, but if you are being treated for type 2 diabetes you should avoid regular consumption of foods high in fat, sugar and calories. Rybelsus works best if you combine it with a healthy diet and exercise plan as recommended by your healthcare provider.

Although you don't have to avoid specific foods with Rybelsus, but you must take this medicine on an empty stomach when you first wake up with a sip of plain water (4 ounces or less). Take it 30 minutes before first food, drink (except sip of water), or other oral medications.

Avoid foods that are fried, fatty, spicy or high in sugar if you find that Rybelsus upsets your stomach or causes nausea. Try eating smaller meals, eat more slowly and be sure to drink plenty of water throughout the day. For most people, stomach upset or diarrhea is temporary and usually resolves in a few weeks after treatment starts.

What food can I eat while taking Rybelsus?

Treatment for type 2 diabetes involves following a healthy diet plan, often combined with medications and a regular exercise routine. Follow the specific diet plan given to you by your healthcare provider.

Your doctor may suggest that you see a registered dietitian to help learn about healthful food choices, meal planning, and address any food habits that may interfere with treatment.

8 tips for what to eat while taking Rybelsus

1. Include fresh fruits, vegetables, whole grains, legumes, and low- or non-fat dairy products. Avoid sugar-sweetened beverages (including fruit juice, sodas, teas and coffee drinks). Drink fresh water as a replacement
2. Low fat, low carbohydrate, Mediterranean, or vegetarian diets may be acceptable. Very low carbohydrate diets or keto-diets may be harmful and you should talk to your doctor before following this type of diet
3. Avoid trans fats and saturated fats (whole milk, butter, cream, cheese, ice cream, red meats). Replace with monounsaturated and polyunsaturated fats (fish, olive oil, nuts). Trans fats are now prohibited from processed foods in the U.S
4. Limit the amount of red meat you consume, which can be high in fat content. In general, get your protein from lean meats (lean chicken, lean turkey, fish, eggs, beans, soy, and nuts)
5. Increase fiber in your diet by eating whole grains; avoid highly processed (refined) white bread, pastas and rice that can lead to blood sugar spikes. Try brown rice, wheat or other whole grain bread and pastas, which also have added fiber
6. Eat on a regular schedule, manage your portion size and limit snacking in-between meals. Monitor your carbohydrate intake and blood sugar levels as directed by your doctor
7. Avoid excessive salt (sodium) in your diet, which can be frequently found in crackers, chips and canned foods like soup and certain vegetables. Ask your doctor if you should follow a low-sodium diet
8. If you choose to drink alcohol, only do so with a meal, and drink in moderation (no more than one serving per day for women or two servings per day for men). Check your blood sugar levels frequently after drinking. Ask your doctor if you can safely drink while taking Rybelsus.

Review the American Diabetes Association (ADA) website which may be useful for recipe and meal planning.

2024 Expert guidelines

New expert guidelines published in Obesity in June 2024 offer some evidence-based direction for what to eat if you are using an incretin mimetic (Wegovy or Zepbound) to lose weight. Other GLP-1 agents approved for use in type 2 diabetes, such as Ozempic, Rybelsus or Mounjaro, have also been prescribed off-label for weight loss.

A day’s worth of eating should include:

• Protein: More than 60 to 75 grams/day of protein, like beans, peas, lentils, seafood, lean meat, poultry, low-fat daily products, nuts, seeds and eggs.
• Carbohydrates: Healthy carbohydrates constituting 45% to 65% of overall energy intake (about 135–245 g/d per 1,500 calories), with added sugars limited to less than 10% of intake. Whole grains, nuts and seeds, fruits, vegetables and dairy (milk, yogurt and dairy alternatives like soy milk) are recommended.
• Fats: Fats that equal 20% and 35% of your day's energy intake (saturated fats equal to less than 10%). Nuts, seeds, avocado, vegetable oil (limit palm and coconut oil), fatty fish and seafood (salmon, albacore tuna, sardines) are recommended. Avoid fried and high-fat foods due to stomach side effects associated with weight-loss drugs like GLP-1's.
• Fiber: About 21 to 25 grams of fiber per day for women and 30 to 38 grams for men. Fruits, vegetables, beans, peas, lentils, nuts and seeds and whole grains are recommended sources. A fiber supplement can be used if a person is not able to meet fiber goals through diet
• Fluids: Two to three liters of fluids, including water, low-calorie beverages (coffee, tea) and low-fat dairy (low fat milk, soy milk). Limit or avoid caffeine and sugar-sweetened beverages.

Women taking a weight-loss drug should eat between 1,200 to 1,500 calories per day and men should eat 1,500 to 1,800 calories each day.

The guidelines also recommend multivitamin, calcium and vitamin D supplementation to make sure a person is getting the daily required levels of these micronutrients.

Related questions

• Rybelsus vs Ozempic for weight loss: Which to choose?
• How much weight can you lose with Rybelsus?
• How long does it take for Rybelsus to start working?

Why do I have to take Rybelsus on an empty stomach?

The absorption of Rybelsus into your body may be reduced if you do not wait at least 30 minutes after eating or drinking (other than a sip of water) to take your Rybelsus. It also causes a delay of gastric emptying and can impact the absorption of other oral medications.

Swallow the Rybelsus tablets whole (do not crush or chew them) with a sip of water (no more than 4 ounces of plain water). If you miss a dose, it should be skipped. Take your next dose at the regular time.

Take Rybelsus exactly as your healthcare provider tells you to take it to treat type 2 diabetes. If you take other medicines first thing in the morning, speak to your doctor about a schedule change.

Store this medicine only in the original Rybelsus bottle and keep it closed tightly. Do not store in any other container. Keep away from children and pets.

Does Rybelsus cause an upset stomach?

Rybelsus can commonly cause stomach side effects like nausea, diarrhea and stomach pain, especially when you first start treatment and are increasing up to your maintenance dose.

• Decreased appetite, vomiting and constipation can also occur. In most people, these side effects usually decrease over time once they get used to the treatment.
• In studies, 32% to 41% of patients receiving Rybelsus experienced stomach side effects, compared to 21% taking a placebo (an inactive treatment).
• Overall, 4% to 8% of patients taking Rybelsus stopped treatment due to stomach side effects.

Your doctor will probably slowly increase your Rybelsus dose to help lessen these side effects. Reaching a higher dose of Rybelsus quickly may make stomach side effects more severe.

If you experience nausea, diarrhea, abdominal pain or other stomach side effects while taking Rybelsus, try:

• eating smaller meals and avoiding fatty or fried foods, unhealthy "fast-foods" and foods high in sugar
• limiting spicy or acidic foods, if they bother you
• eating more slowly
• avoiding or limiting alcohol consumption (no more than one serving per day for women or two servings per day for men). Speak to your doctor before you consume alcohol if taking Rybelsus.
• limiting excess sugar intake
• avoiding or limiting carbonated beverages

Can I drink alcohol with Rybelsus?

While there are no specific foods you must avoid when taking Rybelsus, you should ask your doctor before you drink alcoholic beverages. Alcohol consumption in patients with type 2 diabetes can alter blood sugar levels, causing them to go high or low.

You should avoid drinking alcohol if your diabetes is not well controlled or if you have high triglycerides, neuropathy (nerve damage), or pancreatitis.

Blood sugar can also be affected by stress, illness, surgery, exercise, other medicines or skipping meals. Tell your healthcare provider if you are taking other medicines to treat diabetes, including insulin or sulfonylureas.

Is Rybelsus also approved for weight loss?

Rybelsus (semaglutide) is a once-a-day tablet that is used along with diet and exercise for adults with type 2 diabetes mellitus to control blood sugar levels. Rybelsus has also been shown in studies to help with weight loss, but it is not approved for this use. Rybelsus is not used for treating type 1 diabetes.

Rybelsus is from the class of medicines called GLP-1 receptor agonists (glucagon-like peptide-1 receptor agonists). Rybelsus works to lower blood sugar (glucose) levels by increasing how much insulin is released and decreasing glucagon secretion. It also may slow gastric emptying after eating.

Rybelsus tablets contain semaglutide, the same active ingredient in Wegovy injection and Ozempic injection. Wegovy is approved for weight loss management, and Ozempic is approved for type 2 diabetes.

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.