Rybelsus vs Wegovy Pill: Same Drug
Rybelsus and Wegovy contain the same medicine, semaglutide, from Novo Nordisk, but carry different approvals: Rybelsus for type 2 diabetes and heart risk, Wegovy for weight loss, heart risk and MASH liver disease.
Rybelsus and Wegovy: a brief overview
Side-by-side look at Rybelsus and Wegovy
| Rybelsus | Wegovy | |
|---|---|---|
| Medicine | Rybelsus |  Wegovy |
| Active ingredient | semaglutide | semaglutide |
| Manufacturer | Novo Nordisk | Novo Nordisk |
| How it is taken | Daily tablet | Weekly injection or daily tablet |
| Approved for | Type 2 diabetes and heart risk | Weight loss, heart risk and MASH liver disease |
| First FDA approval | 2019 | 2021 |
| Average weight loss in trials | Not listed | 14.9% (STEP 1, 68 weeks) |
| Most common side effect | Nausea 20% vs 6% on placebo | Nausea 44% vs 16% on placebo |
| List price | $1,027.51 per 30 tablets | $1,349.02 per month |
| Self-pay from | Not listed | $149 per month |
| Medicare GLP-1 Bridge | Not listed | $50 per month, eligible Part D |
| FDA shortage | Resolved February 21, 2025 | Resolved February 21, 2025 |
Sources: FDA label, FDA label (DailyMed), Novo Nordisk pricing, TrumpRx.
How the weight loss compares
Because no trial has directly compared these drugs, the results come from separate trials that had different participants and durations
| Trial | Who took part | Length | Group | Average weight loss | Placebo |
|---|---|---|---|---|---|
| OASIS 4 | Adults with obesity or overweight, without diabetes | 64 weeks | Wegovy pill 25 mg daily | 13.6% | 2.4% |
| STEP 1 | Adults with obesity or overweight, without diabetes | 68 weeks | Semaglutide 2.4 mg weekly | 14.9% | 2.4% |
| STEP 2 | Adults who have type 2 diabetes and either have obesity or are overweight | 68 weeks | Semaglutide 2.4 mg weekly | 9.6% | 3.4% |
The trial results are drawn from OASIS 4 (FDA label (DailyMed)), STEP 2 (PubMed), and STEP TEENS (PubMed).
How the side effects compare
Start by comparing each drug with its own placebo group.
| Side effect | Rybelsus | Placebo (Rybelsus trials) | Wegovy | Placebo (Wegovy trials) |
|---|---|---|---|---|
| Nausea | 20% | 6% | 44% | 16% |
| Abdominal Pain | 11% | 4% | 20% | 10% |
| Diarrhea | 10% | 4% | 30% | 16% |
| Decreased appetite | 9% | 1% | Not listed | Not listed |
| Vomiting | 8% | 3% | 24% | 6% |
| Constipation | 6% | 2% | 24% | 11% |
| Headache | Not listed | Not listed | 14% | 10% |
| Fatigue | Not listed | Not listed | 11% | 5% |
| Dyspepsia | Not listed | Not listed | 9% | 3% |
Prices and coverage compared
| Medicine | How you pay | Price |
|---|---|---|
| Rybelsus | List price before insurance | $1,027.51 per 30 tablets |
| Rybelsus | RYBELSUS Savings Offer (insured) | choose a fill of 1, 2, or 3 months, with pricing starting at $25 |
| Wegovy | List price before insurance | $1,349.02 per month |
| Wegovy | Wegovy Savings Offer (insured) | from $25 per month |
| Wegovy | Self-pay: Wegovy pill 1.5 mg | $149 per month |
| Wegovy | Self-pay: Wegovy pill 4 mg | $199 per month |
| Wegovy | Self-pay: Wegovy pill 9 mg and 25 mg | $299 per month |
| Wegovy | Self-pay: for the first 2 fills, the Wegovy pen intro covers 0.25 mg and 0.5 mg | $199 per month |
| Wegovy | Self-pay: Wegovy pen 0.25 mg to 2.4 mg | $349 per month |
| Wegovy | Self-pay: Wegovy HD 7.2 mg pen | $399 per month |
| Wegovy | Self-pay via TrumpRx | $149 per month |
| Wegovy | Medicare GLP-1 Bridge (Wegovy, eligible Part D) | $50 per month |
Prices checked November 2026 (7)
Novo Nordisk pricing, rybelsus.com, TrumpRx 1 2, NovoCare 1 2, CMS.
Who should pick which?
- No needles: Rybelsus is a tablet, while Wegovy is a weekly injection or daily tablet.
- Only Wegovy is approved for weight loss without diabetes.
- Rybelsus alone has approval for type 2 diabetes.
- For MASH liver disease, Wegovy has approval as a treatment.
- Wegovy has approval for some children below 18.
- Wegovy is one of the options included in Medicare GLP-1 Bridge.
- Cash payment: Wegovy's published price is $149 each month.
Your prescriber looks at your health history, other medicines and coverage, then decides whether you should switch between them