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Generic Name: semaglutide (SEM a GLOO tide)
Brand Name: Rybelsus

Medically reviewed by Judith Stewart, BPharm. Last updated on Dec 5, 2019.

What is Rybelsus?

Rybelsus (semaglutide) is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus.

Rybelsus is usually given after other diabetes medicines have been tried without success.

Rybelsus is not for treating type 1 diabetes.


You should not use Rybelsus if you have multiple endocrine neoplasia type 2 (tumors in your glands), a personal or family history of medullary thyroid cancer, insulin-dependent diabetes, or diabetic ketoacidosis.

Call your doctor at once if you have signs of a thyroid tumor, such as swelling or a lump in your neck, trouble swallowing, a hoarse voice, or shortness of breath.

Before taking this medicine

You should not use Rybelsus if you are allergic to semaglutide, or if you have:

  • multiple endocrine neoplasia type 2 (tumors in your glands);

  • a personal or family history of medullary thyroid carcinoma (a type of thyroid cancer); or

  • diabetic ketoacidosis (call your doctor for treatment).

To make sure Rybelsus is safe for you, tell your doctor if you have ever had:

  • a stomach or intestinal disorder;

  • pancreatitis;

  • kidney disease; or

  • eye problems caused by diabetes (retinopathy).

In animal studies, semaglutide caused thyroid tumors or thyroid cancer. It is not known whether these effects would occur in people using regular doses. Ask your doctor about your risk.

Semaglutide may harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. Semaglutide can have long-lasting effects on your body. Avoid getting pregnant for at least 2 months after you stop using this medicine.

You should not breastfeed while using Rybelsus.

Rybelsus is not approved for use by anyone younger than 18 years old.

How should I use Rybelsus?

Take Rybelsus exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Rybelsus (oral) is taken by mouth. Take this medicine on an empty stomach when you first wake up, at least 30 minutes before you eat or drink anything. Take this medicine with no more than 4 ounces of water. Swallow the tablet whole and do not crush, chew, or break it.

Rybelsus works best if you eat 30 to 60 minutes after taking it.

You may have low blood sugar (hypoglycemia) and feel very hungry, dizzy, irritable, confused, anxious, or shaky. To quickly treat hypoglycemia, eat or drink a fast-acting source of sugar (fruit juice, hard candy, crackers, raisins, or non-diet soda).

Your doctor may prescribe a glucagon injection kit in case you have severe hypoglycemia. Be sure your family or close friends know how to give you this injection in an emergency.

Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your dose or medication schedule.

Call your doctor if you have ongoing vomiting or diarrhea, or if you are sweating more than usual. You can easily become dehydrated while taking Rybelsus. This can lead to kidney failure.

Rybelsus is only part of a complete treatment program that may also include diet, exercise, weight control, regular blood sugar testing, and special medical care. Follow your doctor's instructions very closely.

Store the tablets in their original package at room temperature, away from moisture and heat.

Dosing information

Usual Adult Dose for Diabetes Type 2:

Oral Tablets:
Initial dose: 3 mg orally once a day for 30 days; then 7 mg orally once a day
-Titration: If additional glycemic control is needed after at least 30 days at 7 mg/day, may increase to 14 mg orally once a day
Maintenance dose: 7 to 14 mg/day
Maximum dose: 14 mg/day (taking two 7 mg tablets to achieve a 14 mg dose is not recommended).
Use: Along with diet and exercise to improve blood glucose control in adults with type 2 diabetes mellitus.

What happens if I miss a dose?

Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using Rybelsus?

Never share an injection pen with another person, even if the needle has been changed. Sharing this device can allow infections or disease to pass from one person to another.

Rybelsus side effects

Get emergency medical help if you have signs of an allergic reaction to Rybelsus: hives, itching; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • vision changes;

  • signs of a thyroid tumor - swelling or a lump in your neck, trouble swallowing, a hoarse voice, feeling short of breath;

  • symptoms of pancreatitis - severe pain in your upper stomach spreading to your back, nausea with or without vomiting, fast heart rate;

  • low blood sugar - headache, hunger, weakness, sweating, confusion, irritability, dizziness, fast heart rate, or feeling jittery; or

  • kidney problems - little or no urination; painful or difficult urination; swelling in your feet or ankles; feeling tired or short of breath.

Common Rybelsus side effects may include:

  • nausea (especially when you first start using this medicine);

  • vomiting, stomach pain, loss of appetite;

  • diarrhea; or

  • constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Rybelsus?

Rybelsus can slow your digestion, and it may take longer for your body to absorb any medicines you take by mouth.

Tell your doctor about all your other medicines, especially:

  • insulin; or

  • oral diabetes medicine.

This list is not complete. Other drugs may interact with semaglutide, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

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Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Rybelsus only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.