Written by Kyle Ustach | BScEcon
Fact checked by Andrew Lenau, ISSA CPT & Sports Nutritionist
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Semaglutide, commonly known by the popular brand Ozempic, is a revolutionary weight loss drug that has helped thousands of people transform their lives. Semaglutide was initially created to treat type 2 diabetes, but researchers saw remarkable weight loss during clinical trials.
This led to expanding the use of the drug to include weight loss management. Semaglutide is available as a daily oral tablet under the brand name Rybelsus and as a weekly injection in Ozempic and Wegovy.
So, how do you decide between oral semaglutide compared to an injection? We're about to dive into the research to compare semaglutide pills and injections to help you determine your best option.
Table of Contents:
- What is Semaglutide?
- Comparing Semaglutide Forms: Pros, Cons, & Dosing
- Semaglutide Tablets & Injections: Is One Better For Weight Loss & Diabetes?
- How To Get The Most Out Of Semaglutide
- FAQs
What Is Semaglutide?
Semaglutide is a diabetes and anti-obesity medication that belongs to the glucagon-like peptide-1 GLP-1 receptor agonists class. The body releases the hormone GLP-1 in response to eating to help improve blood sugar control by lowering blood glucose.
Semaglutide medications mimic the actions of GLP-1, causing an insulin secretion, reducing the hormone glucagon that increases blood sugar levels and triggering the brain to reduce appetite and increase satiety in higher doses.
We talk more about semaglutide in our article: How Long Does Semaglutide Stay In Your System?
Semaglutide was developed in 2012 by the pharmaceutical company Novo Nordisk, a Danish-based company specializing in diabetes medication. Novo Nordisk produces all three semaglutide medications available: Ozempic, Rybelsus, and Wegovy. The most popular brand name of semaglutide and the first created is Ozempic, a once-weekly subcutaneous injection.
Ozempic is only FDA-approved to treat type 2 diabetes mellitus, but it is commonly prescribed off-label for obesity treatment. The American Diabetes Association encouraged drug manufacturers to have multiple options in medication dosage and form to meet each individual patient's needs correctly. This led to the production of Wegovy and Rybelsus, an oral and subcutaneous semaglutide option for everyone.
Wegovy is nearly identical to Ozempic as a once-weekly subcutaneous injection, although it is available in slightly higher doses to target weight loss specifically. Wegovy is the only semaglutide medication that is FDA-approved solely for chronic weight loss management.
The pill form is Rybelsus, the only oral version of semaglutide on the market. Rybelsus is FDA-approved specifically for type 2 diabetes treatment; however, it is also commonly prescribed off-label for weight loss1. In addition, research has shown semaglutide plays a role in reducing major adverse cardiovascular events and death.
You can learn more about each form of semaglutide in our articles comparing Ozempic vs Rybelsus and Ozempic vs Wegovy.
Comparing Semaglutide Forms: Which Is Better?
There is no clear answer of which is better between semaglutide injection vs pill, as it primarily depends on the individual and personal preference.
Overall, there is a slight advantage in the effectiveness of semaglutide injections compared to pills due to the dosing protocol and absorption rates. In this section, we will compare semaglutide tablets vs injection for weight loss and other areas.
Dosage for Different Semaglutide Forms
The dosage for semaglutide injection medications Ozempic and Wegovy are nearly identical, except that Wegovy offers a higher dosage to target appetite suppression and weight loss directly. Ozempic injections come in 0.25 mg, 0.5 mg, 1.0 mg, and 2.0 mg per week. Wegovy injections come in doses of 0.25 mg, 0.5 mg, 1.0 mg, 1.7 mg, 2.0 mg, and 2.7 mg per week.
Both Ozempic and Wegovy starting dose is 0.25 mg for the first four weeks, followed by 0.5 mg for at least four weeks.
Ozempic users often remain at a maintenance dose of 1.0 mg for several months, whereas Wegovy increases the dosage to 1.7 mg in weeks 13-16 (month 4), followed by the maximum dose of 2.4 mg in weeks 17 and onward. Both medications are injected under the skin of the stomach, upper arm, or thigh. Users should rotate injection sites to limit the damage.
Oral semaglutide has a rigorous dosing protocol, whereas injection semaglutide is less strict. Oral semaglutide needs to be taken at the same time every day, first thing in the morning, with water at least 30-60 minutes before the day's first meal. Rybelsus comes in three doses in tablet form: 3 mg, 7 mg, and 14 mg.
People typically start with the 3mg tablet for the first month before moving to 7 mg. Drug manufacturer Novo Nordisk states that users can switch from 0.5 mg of semaglutide injections to 7 or 14 mg of Rybelsus for insulin treatment or weight management without issue.
|
Aspect |
Semaglutide Tablets |
Semaglutide Injections |
|
Dosage Forms |
3mg |
0.25mg |
|
Starting Dose |
Typically 3mg |
0.25mg for first 4 weeks |
|
Initial Duration |
1st month at 3mg |
1st 4 weeks at 0.25 mg |
|
Dose Escalation |
Progress to 7mg after 1st month |
Increase to 0.5 mg for 4+ weeks |
|
Maintenance Dose |
7 mg |
1.0 mg |
|
Additional Increases |
N/A |
1.7 mg (weeks 13-16) |
|
Injection Sites |
N/A |
Under the skin of: |
|
Administration Time |
Morning |
Weekly dosage |
Pros Of Semaglutide Pills
There are a few perks to taking the once daily oral semaglutide over injections. Let's get into it!
- Convenience: Some people struggle with needles, especially self-administered shots, so an oral semaglutide tablet is easier to use. Rybelsus and other oral medications can be more convenient because you simply swallow a tablet versus injecting yourself.
- Effective: Recent research found that oral semaglutide is equally, if not more, effective when compared to its injectable counterpart in managing type 2 diabetes (T2) while maintaining similar tolerability2.
Cons Of Oral Semaglutide
We just learned that a huge plus of oral semaglutide is that you can take a pill instead of an injection. Now, let's review the cons.
- Gastrointestinal Side Effects: One con of oral semaglutide is potentially worse gastrointestinal side effects. It's important to note that all forms of semaglutide can cause gastrointestinal side effects because the medication directly affects the digestive system and stomach. However, oral semaglutide can be slightly more harsh than injections since it passes through the stomach. Patients taking oral semaglutide may experience stomach pain, vomiting, and nausea.
- Dosing: Another con of taking oral semaglutide compared to injectable semaglutide is the dosing frequency and strict protocol. You have to take oral semaglutide every day at roughly the same time, which has to be first thing in the morning, 30 to 60 minutes before eating. You are also only supposed to take one sip of water to swallow the tablet. This is inconvenient and requires a strict schedule, which can be a problem for people who travel often or have a different schedule for work.
Pros of Semaglutide Injections
Here are the best features of semaglutide injections.
- Proven Safety & Effectiveness: One pro of semaglutide injections is that they are proven safe and effective by clinical trials in 2016, and Ozempic has been available since 2017. There is a long, proven history of semaglutide injections effectively lowering blood sugar and weight loss. Rybelsus, the oral semaglutide, was not released until late 2019, so there is less history of success.
- Convenient Dosing Protocol: Another major advantage of semaglutide injections compared to oral semaglutide is the convenience of the dosing protocol. Semaglutide injections are only once a week and can be taken at any time of the day, with or without food. The only thing that matters is the injection is the same day each week. Lastly, semaglutide injections can potentially have less gastrointestinal side effects than oral versions.
Cons Of Injectable Semaglutide
Here are the drawbacks of injectable semaglutide.
- Taking Injections: The most obvious con of semaglutide injections is the injection itself. Several people struggle with fear and anxiety of needles, so the idea of taking weekly injections that you administer yourself is unappealing.
- Injection Site Pain: Aside from fear of needles, there is the possibility of injection site pain with a semaglutide injection. It's important to rotate injection sites to avoid the possibility of injection site pain.
Price
The cost of medicine will depend heavily on what country you are in and what kind of insurance plan you have. As of late 2023, the Ozempic list price is $935.77 for a 28-day supply of all dosages, Rybelsus is $851.60 for a 30-day supply, and Wegovy is $1,349.02 in the United States.
However, if you live in the United Kingdom, Ozempic is only $93 and even lower in France at $83. Similarly, Wegovy is only $328 in Germany, roughly one-fourth the price in America.
Novo Nordisk offers copay savings cards that can save you up to $225 per month supply for Wegovy. Copay savings cards also drop the price significantly down to roughly $25 for Ozempic and $10 for Rybelsus and Wegovy.
To learn more about the prices of semaglutide medications, check out our article How Much Is Semaglutide Without Insurance?
Semaglutide Shot vs Pill: Side By Side Comparison
Here's a snapshot view of both versions, so you can see similarities and differences.
|
Aspect |
Injectable Semaglutide |
Oral Semaglutide |
|
Administration Method |
Injection |
Oral (Pill) |
|
Efficacy in T2D Management |
Highly Effective |
Highly Effective |
|
Dosage Frequency |
Typically Weekly |
Daily |
|
Convenience |
Requires Injection |
Oral Administration |
|
Lifestyle Impact |
May require more planning and adherence |
Easier to incorporate into daily routine |
|
Cost |
May be more expensive |
Cost may vary |
|
Adherence |
May require fewer administrations |
Requires daily dosing |
Semaglutide Tablets vs Injection: Weight Loss And Diabetes
When Novo Nordisk created the oral semaglutide tablet, they ran the PIONEER trials (Peptide Innovation for Early Diabetes Treatment) that tested Ozempic and Rybelsus. They also used the SUSTAIN (Semaglutide Unabated Sustainability in Treatment of Type 2 Diabetes) clinical trial, which tested Ozempic, to compare the two.
In patients with type 2 diabetes being treated with diet and exercise, 1.0 mg of subcutaneous semaglutide (Ozempic) reduced body weight by an average of 4.5 kg (9.9 lbs) compared to 3.7 kg (8.1 lbs) in patients with 14 mg of oral semaglutide (Rybelsus). While both medicines are very effective at losing body weight, the average weight loss with Ozempic is greater than with Rybelsus.
The SUSTAIN and PIONEER trials also tested the effectiveness of diabetes treatment. The trials showed a reduction in HbA1c by an average of 1.5-1.8% after 30-56 weeks of 1.0 mg subcutaneous injection (Ozempic) weekly. The PIONEER trials showed that 26 weeks of 14 mg of once-daily oral semaglutide (Rybelsus) resulted in an HbA1c drop of 1.0-1.4%.
That is the maximum dosage of Rybelsus, whereas the Ozempic is a maintenance dose. In relation to hitting their glycemic targets and the estimated treatment difference, 1.0 mg of Ozempic had 66-80% success, whereas 14 mg of Rybelsus had 55-77% success. This explains why users can switch from 0.5 mg of semaglutide injections to 7 or 14 mg of Rybelsus without affecting blood sugar levels3.
Semaglutide injection reviews
Here at SET FOR SET, we believe anecdotal evidence of human testimonials is nearly as important as scientific research. Readers like to hear patient reported outcomes from people with similar body types rather than reading an anonymous study. In the r/Diabetes subReddit, a post shares several positive experiences with semaglutide injections for weight loss.
One user stated: “I have not changed my diet and do not exercise. I lost 43 pounds in about six months and have kept it off.” (source)
Another user had success with weight loss and lowering blood sugar levels, posting, “Started on it in March a1c was down to 6.8 when i started. Have lost 19kg (42lb) and my latest a1c was 5.9.” (source)
Semaglutide injections have been proven effective in clinical trials and human testimonials support its effectiveness in treating obesity and poor blood sugar levels.
Oral semaglutide reviews
Like the injectable version, people have found great success with semaglutide tablets for weight loss.
In the r/LoseIt subReddit, a thread titled “Dr put me on Rybelsus for weight loss,” has several positive testimonials. One user stated, “I’ve been on it for a couple of months, 3mg and now 7mg dose every morning. It’s a lot easier to take and much better on my system and body than Ozempic which I had developed bad side effects to.” (source)
While the side effect differences are due to individual reactions, several people have found oral semaglutide more effective and easier on the body than injectable semaglutide. Another user posted, “Just started month three and graduated up to 14mg. In three months, lost 21 lbs. BP is better and close to normal range.” (source)
Similarly, user lilbrowngirl2000 posted, “On day 20 today, I am down ~10.5 lbs. Still on 3 mg for another ten days.” (source)
Reader Takeaway: These testimonials show that people lose weight just as quickly and efficiently using oral semaglutide compared to injectable semaglutide, so it truly comes down to your preference!
Where To Buy Semaglutide
Obtaining a prescription through your doctor is one of the ways in which you can get the weight loss medication. However, it isn't the only way to get semaglutide, which is great news, as due to its demand, you may not have the best of luck obtaining it through your pharmacy.
The other more convenient option is to purchase it through Fountain GLP, a telemedicine clinic that offers a thorough GLP-1 evaluation to assess your eligibility. Once you obtain a prescription, their cost-effective semaglutide medication is shipped right to your home.
FountainGLP is one of the only telemedicine services in the United States that offers an all-inclusive membership for GLP-1 weight loss treatment. Enjoy the benefits of semaglutide...
Learn more about Fountain GLP's process by visiting our article: Where To Buy Semaglutide.
How To Get The Most Out Of Semaglutide
The most important thing to maximize the effects of semaglutide and promote weight loss is following a low-calorie diet of healthy foods and exercising regularly. In fact, the FDA approval for all three drugs states that each medication is to be used in addition to diet and exercise1.
Another major factor is how closely the person follows the dosing protocol. Oral semaglutide needs to be taken at the same time every day, first thing in the morning, with water at least 30-60 minutes before the day's first meal.
Injectable semaglutide medications are not as strict with the dosing protocol as long as the shot is done on the same day of the week. Make sure you work with your doctor to ensure the prescription you're taking supports treatment adherence.
Several other factors also have an effect on your results with semaglutide. Other factors include too low of a dose, poor individual response, poor diet, too much stress, not being on long enough, poor sleep schedule, using drugs or alcohol, not following the dosing protocol, and not drinking enough water. Avoiding foods high in sugar and empty calories is especially important for semaglutide users with type 2 diabetes.
Make sure you're setting yourself up for success by following a proper workout plan and diet! Check out our article on Best Workout Splits and our Meal Plan For Weight Loss to help you stay on track.
FAQs
In this section, we will answer some of the most common questions related to semaglutide injections vs. pills.
Is oral semaglutide approved for weight loss?
No, semaglutide in pill form (Rybelsus) is not FDA-approved for weight loss, only for type 2 diabetes. However, it is commonly prescribed off-label for weight loss.
Can you lose weight in 4 weeks on semaglutide?
Yes! Patients treated with semaglutide typically lose a few pounds in the first week and will continue to lose weight. Learn more about this in our article: How Much Weight Can You Lose On Semaglutide?
Why am I not losing any more weight on semaglutide?
There are several possible reasons why you aren't losing more weight on semaglutide, including too low of a dose, individual response, poor diet, lack of exercise, having been on long enough, using drugs or alcohol, not taking your dose at the proper time, or not drinking enough water. For more information, check out our article 7 Reasons You're Not Losing Weight On Semaglutide.
Can I stay on semaglutide forever?
Semaglutide is safe for long-term use, however, studies have only shown safety for up to two years. People who use semaglutide to treat diabetes may stay on it forever to control blood sugar levels, but people seeking weight loss likely do not need to stay on forever. It would be best to listen to your doctor, but we do not recommend using semaglutide for longer than two years.
Semaglutide Pill vs Injection: Key Takeaways
Semaglutide is a remarkable medication with proven efficacy that has helped thousands of people fight type 2 diabetes and weight reduction. The decision between an injectable medication or oral version mainly depends on personal preference, but injections have been found to be slightly more efficient.
The clinical trials run by Novo Nordisk showed that injection semaglutide is more effective at a lower dose than oral semaglutide. In fact, patients can switch from 0.5 mg of semaglutide injections to 7 or 14 mg of Rybelsus without any harm. So, if you prefer to take the lowest dose possible while being effective, injection semaglutide is the better choice.
On the other hand, several people hate needles and prefer a tablet option. Regardless of which form of semaglutide you choose, you can expect significant improvements in weight loss and glycemic control.
Interested in taking semaglutide? Learn more about how and where to buy it online in our article: Where To Buy Semaglutide.
FountainGLP is one of the only telemedicine services in the United States that offers an all-inclusive membership for GLP-1 weight loss treatment. Enjoy the benefits of semaglutide...
References:
- Research, Center for Drug Evaluation and. “Medications Containing Semaglutide Marketed for Type 2 Diabetes or Weight Loss.” FDA, 31 May 2023, www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/medications-containing-semaglutide-marketed-type-2-diabetes-or-weight-loss.
- Chubb B, Gupta P, Gupta J, Nuhoho S, Kallenbach K, Orme M. Once-Daily Oral Semaglutide Versus Injectable GLP-1 RAs in People with Type 2 Diabetes Inadequately Controlled on Basal Insulin: Systematic Review and Network Meta-analysis. Diabetes Therapy. Published online March 16, 2021. doi:https://doi.org/10.1007/s13300-021-01034-w
- Meier, Juris J. “Efficacy of Semaglutide in a Subcutaneous and an Oral Formulation.” Frontiers in Endocrinology, vol. 12, 25 June 2021, https://doi.org/10.3389/fendo.2021.645617.
Kyle Ustach
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