Short answer: Both contain semaglutide. Rybelsus is a daily tablet for type 2 diabetes, up to 14 mg, that also lowers heart-event risk in high-risk adults with type 2 diabetes.1 Wegovy is for weight loss and heart-risk reduction, as a weekly injection up to 7.2 mg or a daily 25 mg tablet.2 Both tablets are taken the same fasting way. Neither label compares the two.
| Rybelsus | Wegovy | |
|---|---|---|
| Approved for | Blood sugar control in adults with type 2 diabetes; lower risk of major heart events in high-risk adults with type 2 diabetes1 | Weight reduction and lower heart-event risk in adults; the injection also for ages 12 and up and for MASH with liver fibrosis2 |
| Forms | Once-daily tablet1 | Once-weekly injection, or once-daily tablet2 |
| Tablet steps | 3 mg for days 1 to 30, then 7 mg; 14 mg from day 61 if more control is needed1 | 1.5 mg for days 1 to 30, 4 mg, then 9 mg; 25 mg from day 912 |
| How tablets are taken | Morning, empty stomach, up to 4 ounces of plain water; wait 30 minutes before food, drink or other pills1 | Morning, empty stomach, up to 4 ounces of water only; wait 30 minutes before food, drink or other pills2 |
| Missed tablet | Skip it and take the next dose the following day1 | Skip it and take the next dose the following day2 |
| Nausea in label trials | 11% on 7 mg and 20% on 14 mg vs 6% on placebo, in type 2 diabetes1 | 44% vs 16% on placebo with the 2.4 mg injection; the label calls 25 mg tablet side effects similar2 |
| Boxed warning | WARNING: RISK OF THYROID C-CELL TUMORS1 | WARNING: RISK OF THYROID C-CELL TUMORS2 |
Neither label gives a conversion from Rybelsus to Wegovy or back. The Wegovy label does not recommend using it with other semaglutide products.2 The switches the labels do describe are within each brand: the Rybelsus label moves people from the 0.5 mg Ozempic injection to Rybelsus 7 mg or 14 mg one week after the last shot, and the Wegovy label moves people from the 2.4 mg injection to 25 mg tablets one week after the last shot.12
Rybelsus is not approved for weight loss. In the Wegovy label's 64-week trial of the 25 mg tablet in adults with obesity or overweight and a weight-related condition, weight fell 13.6% vs 2.4% on placebo.2 Both labels say to stop at least 2 months before a planned pregnancy.12 These numbers come from separate trials with different people, lengths and methods, so they are not a head-to-head comparison.
Which, if either, fits is for your prescriber. More detail: Rybelsus side effects, Wegovy side effects, the Rybelsus and Wegovy dosing schedules, the Rybelsus and Wegovy missed-dose pages, the Wegovy pill page, the semaglutide guide, and Rybelsus vs Ozempic: how does the pill compare with the shot?.