Taking Semaglutide: Oral Tablets vs. Injections

Is oral semaglutide as effective as the injectable version for weight loss?

The authors of a 2021 research review looked at several clinical studies on GLP-1 receptor agonists and concluded that in comparison with injectable versions of semaglutide, once-a-day oral semaglutide is equally effective or more effective for weight loss and for reducing A1C in people with diabetes.

The authors stated that the oral tablets had a distinguishing feature that allowed for “similar or better efficacy and similar tolerability” compared with most injectable GLP-1 receptor agonists.

However, not all semaglutides are FDA cleared for weight loss use. And because these are relatively new medications, more research is needed to accurately compare the oral and injectable versions.

The 2021 review looked specifically at people with diabetes who were receiving insulin, which could have affected the data. More research in this area is still necessary.

The importance of these medications for obesity is more pronounced these days. Obesity increases the risk of a variety of serious health conditions, some of which can be potentially fatal. Treatment options can range from dietary changes and exercise to medications and surgery.

How often do you have to take semaglutide?

You’ll typically inject semaglutide once per week, on the same day each week. Your doctor may increase your dose after 4 weeks if necessary.

It’s important not to stop taking semaglutide without discussing it with your doctor first.

If you miss a dose of Ozempic, you should inject the missed dose as soon as you remember, as long as it has been less than 5 days since your last dose. Otherwise, you should stick to your usual dosing schedule. You should not give yourself an extra dose or a double dose to account for the missed shot.

If you miss a dose of Wegovy and your next dose is more than 2 days away, you should take the missed dose as soon as possible. Otherwise, you should skip the missed dose and stay on your regular schedule.

If you’ve missed more than 2 weeks’ worth of the medication, it’s important to contact your doctor or pharmacist. One of the labeling nuances of semaglutide is that it needs to be taken long-term to be effective and maintain weight loss results.

Oral semaglutide tablets

You’ll take oral semaglutide tablets once per day. Healthcare professionals typically recommend taking these tablets as soon as you wake up in the morning, at least 30 minutes before eating or consuming other medications, and with only a small amount of water.

If you take other medications in the morning that require an empty stomach, you’ll want to discuss this with your doctor.

You can switch from one of these medications to the other with your healthcare team’s approval and guidance. The manufacturer notes that people can switch from Ozempic 0.5 milligrams (mg) to Rybelsus 7 mg or 14 mg. Additionally, those taking Rybelsus 14 mg can switch to Ozempic. A transition dose is not currently available.

Pros and cons of oral and injection semaglutide

There are benefits and drawbacks to both oral tablets and injected semaglutide.

Oral tablets

• do not require the use of needles
• are typically taken daily
• can result in side effects such as nausea, vomiting, and abdominal pain
• must be taken on an empty stomach first thing in the morning, without eating for 30 minutes afterward

Injections

• require the use of needles
• are typically taken once per week
• may cause side effects such as injection site reactions
• can be taken regardless of whether you consume food or liquid beforehand or afterward

Where do you inject?

You can inject semaglutide into your upper arm, thigh, or stomach.

You can inject it into the same area of your body as insulin, but you should not inject the two medications next to each other.

It’s also important to rotate the injection site after each shot. Injecting in the same spot repeatedly can cause scar tissue to develop on that site, and your body may not absorb the medication effectively.

Can you take semaglutide for weight loss if you do not have diabetes? 

The FDA has approved Wegovy for weight loss in people with and without diabetes.

The same does not apply to Ozempic and Rybelsus, which are not FDA cleared for weight loss and are labeled for use only in people with type 2 diabetes. However, doctors can still choose to prescribe these medications off-label for weight loss use.

Research has shown that semaglutide injections are effective for weight loss in people without diabetes.

However, regardless of whether you have diabetes, you might experience side effects from semaglutide injections.

Takeaway

Semaglutide is a drug that the FDA has approved for appetite suppression and weight loss under the brand name Wegovy. Semaglutide is also currently available in both oral tablet and injectable forms under other brand names to treat type 2 diabetes.

Research comparing the oral tablet and injectable forms of semaglutide is still fairly new. While oral tablets offer an option without needles, you need to take them in a very specific way.

If your doctor believes that you are a good candidate for semaglutide, they can help you determine the best semaglutide form for your lifestyle and health needs.