Oral Semaglutide vs. Injectable Semaglutide
There’s a lot of talk about weight loss injections like semaglutide. But there’s also a type of semaglutide you can take by mouth. This brand-name oral semaglutide is called Rybelsus®.
Oral semaglutide contains the same active ingredient as Ozempic® and Wegovy®. But how does oral semaglutide work compared to the injectable version? Is one form of semaglutide more effective than the other? Or does one type cause more side effects?
Keep reading as we answer all these questions and compare oral semaglutide versus injectable semaglutide.
What Is Semaglutide and What Does It Do?
Semaglutide is the active ingredient in three medications: Ozempic®, Wegovy®, and Rybelsus®. These drugs belong to a class of medicines called glucagon-like peptide-1 receptor agonists, or GLP-1 receptor agonists.
Semaglutide works by mimicking the GLP-1 hormone, which is naturally produced in the intestines.
This medicine has several effects on the body, including:
Managing blood sugar (glucose) by helping the pancreas release insulin when blood glucose is high
Regulating appetite by acting on brain centres that control hunger and fullness
Slowing gastric emptying, helping you feel full sooner and for longer
Supporting weight loss and maintenance when used with a reduced‑calorie diet and increased physical activity
As a result, semaglutide can help you eat less, leading to a reduced calorie intake. This makes it easier to lose weight (and maintain weight loss). If you’re finding that hunger is still an issue, you might find it helpful to explore why some people are still hungry on semaglutide.
Research shows semaglutide can promote significant weight loss for people with a high body mass index (BMI). In a clinical trial called STEP1, those taking Wegovy® lost an average of 14.9 percent of their body weight over 68 weeks. However, these participants also paired Wegovy® with healthy lifestyle changes to support their weight loss.
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Semaglutide Tablets vs. Injections
The Medicines and Healthcare products Regulatory Agency (MHRA) has authorised three prescription products containing semaglutide in the United Kingdom, all from Novo Nordisk. Although the active ingredient is the same, each has a different brand and indication.
Here’s the difference between the three medications.
Brand name | Type | Authorised in UK for | Availability for weight loss |
Rybelsus® | Daily oral semaglutide pill | Type 2 diabetes | Some clinicians may prescribe off‑licence On‑licence options should be prioritised |
Ozempic® | Weekly semaglutide injection | Type 2 diabetes | Not licensed for weight management Off‑licence use is discouraged to protect supplies for people with diabetes |
Wegovy® | Weekly semaglutide injection | Weight management | Licensed for weight loss in UK |
Is Oral Semaglutide Effective for Weight Loss?
Does oral semaglutide work? Although the medicine can help you lose weight, oral semaglutide may not be as effective as injectable semaglutide for weight loss.
While both versions typically help people lose weight, injectable semaglutide may lead to more significant weight loss. But both oral and injectable semaglutide help effectively lower blood sugar levels.
Ask your GP (general practitioner) about the semaglutide oral dose for weight loss that may work best for your needs. Even though it’s usually only prescribed for diabetes, you might experience weight loss as a side effect.
Research on Oral vs. Injectable Semaglutide
Research sponsored by Novo Nordisk in patients with type 2 diabetes found that:
Ozempic® (injectable) led to average losses of roughly 4 to 5 kilos (kg) in some studies
Rybelsus® (oral) led to average losses of roughly 3 to 4 kilos
It’s important to note, though, that these trials involved lower doses of semaglutide (Ozempic®) than those sometimes used to treat obesity. Also, the studies combined weight loss medication with lifestyle changes (like a balanced, healthy diet and increased exercise).
In clinical trials of Wegovy®, which included a higher dose of injectable semaglutide (2.4 mg), people lost an average of almost 15 percent of their body weight.
“In my experience, patients taking injectable semaglutide typically lose more weight than those on oral semaglutide,” says Craig Primack, MD, a U.S.-based physician specialising in obesity medicine. “The injectable form achieves higher blood levels and, therefore, better appetite control.” This helps you eat fewer calories, which makes it much easier to lose weight.
So, yes, you might lose weight on oral semaglutide. But injectable semaglutide may be more effective for weight loss.
If you’re comparing your options, you can also look at how semaglutide stacks up against other treatments, including the strongest weight loss prescription pill.
Is Rybelsus® the Only Oral Semaglutide Product?
At the moment, yes. Rybelsus® is currently the only oral formulation of semaglutide.
But Novo Nordisk is looking into creating another oral semaglutide product — a higher-dose form. This would be the first official oral semaglutide weight loss medication.
In double-blind studies sponsored by Novo Nordisk, participants lost an average of 17.4 percent of their starting body weight after 68 weeks of using this new oral formulation. Those who took a placebo medication lost only 1.8 percent of their starting weight.
However, the drug manufacturing process is complex, and it’s not clear if or when this new product will be available in the UK.
Oral Semaglutide Side Effects vs. Injectable Semaglutide
Both oral semaglutide and injectable semaglutide have side effects. The most common side effects are gastrointestinal.
They can include:
Vomiting
Diarrhea
Constipation
Abdominal pain
Serious but rare risks include:
Acute pancreatitis
Gallbladder disease
Kidney disease
Liver issues
Hypoglycaemia (low blood sugar)
Worsening diabetic retinopathy in susceptible individuals
There isn’t much difference between oral and injectable semaglutide side effects — one doesn’t seem to cause a higher incidence of side effects than the other.
A 2024 Novo Nordisk-funded study found that there wasn’t a significant difference in the number of people reporting side effects for each form of semaglutide.
Another common side effect of injectable semaglutide is discomfort at the injection site. Sometimes, the injection can be a bit painful, irritated, or itchy. You obviously won’t experience this with oral semaglutide — plus, taking a pill is a lot less nerve-wracking than injecting yourself, especially if you have a fear of needles!
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How Do You Take Oral Semaglutide?
You take oral semaglutide once daily by mouth.
According to the prescribing information for Rybelsus®, you should also:
Take your medicine when you first wake up, while you still have an empty stomach
Swallow each tablet whole — don’t chew it
Take it with only a small sip of water
Wait 30 minutes before having additional liquids, food, or other oral medications
Go with your prescribing healthcare provider’s instructions and reach out to them if you’re ever unsure how to take your medication.
How Do You Take Injectable Semaglutide?
Injectable semaglutide is taken once weekly. It’s a subcutaneous injection, meaning you inject it into the layer of fatty tissue just under the skin — not into a vein or muscle.
You can inject subcutaneous semaglutide into a few areas:
Abdomen
Thigh
Upper arm
The prescribing information for both Ozempic and Wegovy® has additional injection instructions:
Do your injection on the same day each week. (But you can do your injection any time that day.)
It’s possible to change your injection day as long as your last injection was at least two days ago. Just check with your healthcare provider first.
Don’t use the exact same injection site for each dose. Regularly rotate your injection site to avoid irritation or bruising.
Your injection can be done with or without food.
When you’re prescribed semaglutide for weight loss or diabetes, a healthcare provider will explain the exact process before you have to do it yourself.
It’s perfectly normal to have concerns about pain during or after an injection. If that’s you, some research suggests that subcutaneous injections in the abdomen (a few inches to either side of the belly button) are less painful than those given in the thigh. A cold compress can ease pain at the injection site.
Oral Semaglutide UK: Can You Get Oral Semaglutide on the NHS?
Yes, but only for type 2 diabetes — not for weight loss. There’s currently no oral UK-licensed form of oral semaglutide for weight loss in non-diabetics.
Since Rybelsus® is only licensed in the UK for type 2 diabetes, it can only be prescribed on the NHS when clinically appropriate under NICE (National Institute for Health and Care Excellence) guidance and local formulary policies.
Your care team will decide if it suits you based on HbA1c (haemoglobin A1c) control, previous treatments (such as metformin), cardiovascular risk, and tolerability.
For weight management, oral semaglutide is not licensed in the UK, so it isn’t routinely available through the NHS for that purpose. For obesity treatment, the NHS currently commissions injectable options (like Wegovy® and Mounjaro®).
Because of long waiting times and strict eligibility criteria, it’s easier to access weight loss medicines through private clinics or online telemedicine providers like Hers UK.
Other Weight Loss Medicines
Beyond injectable and oral semaglutide, there are a number of other weight loss treatments worth considering.
These include:
Mounjaro® (tirzepatide), a weekly injection that mimics GLP-1 and GIP (glucose-dependent insulinotropic peptide), two hormones that reduce appetite and slow gastric emptying
Saxenda® (liraglutide), a daily GLP-1 injection
Orlistat (Xenical®, Alli®), a non-prescription oral medication that reduces fat absorption
Don’t combine different weight loss medications, as this can worsen side effects. Doubling up on GLP-1 receptor agonists, for example, puts you at an increased risk of low blood sugar.
No matter which weight loss medicine you’re prescribed, it’ll work best when paired with lifestyle changes — like a reduced calorie diet, frequent physical activity, and stress management.
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Oral vs. Injectable Semaglutide: Which Form of Semaglutide Is Best?
There’s no standardised answer. Your GP or another medical professional will prescribe oral or injectable semaglutide depending on the condition you’re trying to treat (diabetes versus weight management).
Here’s what to keep in mind:
Rybelsus® is currently the only brand-name version of oral semaglutide. Ozempic® and Wegovy® are the brands for the injectable form of semaglutide.
Rybelsus® is licensed for treating type 2 diabetes. At present, no oral semaglutide formulation is licensed as a weight loss treatment in the UK. However, it might be prescribed off-license in rare cases.
Wegovy® is licensed for weight management. The MHRA has only authorised one type of semaglutide for weight loss: Wegovy®.
If you’d rather swallow pills than take an injection, semaglutide tablets might be the way to go. Other oral weight loss medications, like orlistat, may also be suitable.
Whether you’re considering GLP-1s or other weight loss medications, the first step is connecting with a healthcare provider.
Ready to get started? You can take our free virtual weight loss assessment. A UK-licensed healthcare provider will go over your answers and let you know if you’re a good candidate for weight loss medications.
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your GP about the risks and benefits of any treatment.