Rybelsus (semaglutide) is a prescription drug that’s used to manage blood sugar levels in adults with type 2 diabetes. Rybelsus comes as a tablet that you’ll swallow with a little water each day.
Rybelsus is used in adults with type 2 diabetes to manage high blood sugar levels. It belongs to a group of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists. Note that Rybelsus is not meant for use to treat type 1 diabetes.
The active ingredient in Rybelsus is semaglutide. An active ingredient is what makes a drug work.
This article describes the dosages of Rybelsus, as well as its strengths and how to take it.
Rybelsus is a tablet you’ll swallow daily before eating or drinking anything. For many people, this will be every morning before breakfast. The drug comes in several strengths.
Note: This table highlights the basics of Rybelsus’s dosage. Doses are listed in milligrams (mg).
| Starting dosage (first 30 days) | Lowest effective dosage | Maximum dosage | |
|---|---|---|---|
| Formulation R1 | 3 mg once daily | 7 mg once daily | 14 mg once daily |
| Formulation R2 | 1.5 mg once daily | 4 mg once daily | 9 mg once daily |
What is Rybelsus’s form?
Rybelsus comes as a tablet that you swallow.
It’s available in two different formulations: R1 and R2.
What strengths does Rybelsus come in?
Rybelsus formulation R1 is available in three strengths:
- 3 mg
- 7 mg
- 14 mg
Rybelsus formulation R2 is also available in three strengths:
- 1.5 mg
- 4 mg
- 9 mg
The following information describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.
Formulation R1
When you’re first prescribed Rybelsus formulation R1, you’ll take a starting dose of 3 mg. You’ll take this every day for the first 30 days. This lower dose allows your body to get used to the drug.
After 30 days, your doctor will increase your dosage to 7 mg taken once daily.
While taking formulation R1, your doctor will carefully monitor your blood sugar level. Depending on how your blood sugar level responds to the medication, they may keep your dosage at 7 mg daily or increase it to 14 mg daily. Dosage increases are only made after you’ve taken your current dosage for at least 30 days. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.
The maximum dosage of formulation R1 is 14 mg once daily.
Formulation R2
If you’re prescribed Rybelsus formulation R2, you’ll take a starting dose of 1.5 mg once daily for the first 30 days. This lower dose isn’t effective for managing type 2 diabetes, but it helps your body get used to the drug.
After 30 days, your doctor will increase your dosage to 4 mg taken once daily.
Depending on how your blood sugar levels respond to Rybelsus, your doctor may keep your dosage at 4 mg daily or increase it to 9 mg daily.
Your doctor will likely only adjust your dose once every 30 days, if necessary. They’ll ultimately prescribe the smallest dosage that provides the desired effect.
The maximum dosage of formulation R2 is 9 mg once daily.
Switching between Rybelsus formulations
After the first 30 days of treatment with Rybelsus, it may be possible to switch between formulations. However, it’s important to note that Rybelsus formulations are not equivalent by weight. For example, two 1.5-mg tablets of formulation R2 are not the same as one 3-mg tablet of formulation R1.
The following table outlines the equivalent strengths recommended by the drug’s manufacturer.
| Formulation R1 | Formulation R2 |
|---|---|
| 7 mg once daily | 4 mg once daily |
| 14 mg once daily | 9 mg once daily |
For specific instructions on how to switch between Rybelsus formulations, talk with your doctor.
Note: You may only switch Rybelsus formulations if you’re currently taking a maintenance dose of Rybelsus. Your doctor will not switch your formulation if you’re still taking the starting dose.
Switching from Ozempic to Rybelsus
If your doctor decides to change your treatment from Ozempic to Rybelsus, your dosage of Rybelsus will depend on:
- your current dose of Ozempic
- the Rybelsus formulation you’ll be switching to
The following table outlines the typical doses prescribed when switching between Ozempic and Rybelsus.
| Ozempic | Rybelsus R1 | Rybelsus R2 | |
|---|---|---|---|
| Dosage | 0.5 mg weekly | 7 or 14 mg daily | 4 or 9 mg daily |
Your doctor will likely instruct you to start taking Rybelsus 1 week after your last dose of Ozempic.
For more specific details on how to safely switch from Ozempic to Rybelsus, talk with your doctor or pharmacist.
Is Rybelsus used long term?
Yes, Rybelsus is usually used as a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely take it long term.
The price you’ll pay for Rybelsus can vary. Your cost may depend on your treatment plan, the pharmacy you use, and any insurance coverage you have.
To save money on your Rybelsus treatment, explore the following coupon options.
Here are answers to some commonly asked questions about Rybelsus’s dosage.
Is there a 3-mg daily dose of Rybelsus?
Yes, the 3-mg daily dose of Rybelsus is used as a starting dose. You’ll take the 3-mg dose each day for the first 30 days of your treatment. Starting doses give your body time to get used to a drug and can lower the risk of Rybelsus side effects. But the 3-mg dose is not enough to manage your blood sugar level. After taking 3 mg each day for 30 days, your doctor will increase your dose.
Can Rybelsus be used for weight loss? If so, what’s the dosage?
Rybelsus is not approved by the Food and Drug Administration (FDA) for weight loss. Although it’s a glucagon-like peptide-1 (GLP-1) agonist, it’s used specifically to manage blood sugar levels in adults with type 2 diabetes.
Because Rybelsus isn’t recommended for weight loss, the drug’s manufacturer doesn’t provide recommended dosages for this use.
Wegovy (semaglutide) is a GLP-1 agonist that’s specifically made for weight loss. If you want to learn more about Wegovy for weight loss, talk with your doctor.
What is Rybelsus 14 mg used for?
Your doctor may prescribe the 14-mg strength of Rybelsus if the 7-mg dose is not managing your blood sugar well.
When you start Rybelsus, you’ll take the 3-mg strength for 30 days. Then you’ll take the 7-mg dose. Depending on how your blood sugar level responds to the medication, your doctor may increase your dosage to 14 mg per day. They will wait to increase your dosage until you’ve taken the 7-mg dose for at least 30 days.
The maximum dosage of Rybelsus is 14 mg per day.
Your dosage of diabetes medications, including Rybelsus, may need to change if you experience:
- weight gain or loss
- changes in diet
- changes in your level of physical activity or exercise
- increased mental stress
- illness, infection, or fever
- physical injury, trauma, or surgery
- changes in other medications you take
If any of these apply to you, talk with your doctor. They may ask you to check your blood sugar level more often and may decide to adjust your Rybelsus dosage.
Rybelsus is a tablet that’s taken once per day. It should be taken alone, without other medications, on an empty stomach (before consuming any food or drinks for the first time in a day). Most people will take Rybelsus in the morning. But for some, the best time to take the drug will depend on their schedule.
Before you eat, it’s important to wait at least 30 minutes after taking Rybelsus. If you wait less than 30 minutes, your body may not absorb enough of the drug. This can make Rybelsus less effective. However, if you wait more than 30 minutes, this can increase the amount of Rybelsus your body absorbs. As a result, your risk of side effects, including low blood sugar, increases.
You should also wait 30 minutes after taking Rybelsus before taking other medications that you swallow. This helps avoid possible drug interactions. See this article to learn more about Rybelsus’s interactions.
Rybelsus should not be chewed, crushed, or split. Take Rybelsus with no more than 4 ounces (1/2 cup) of water. If you have difficulty swallowing tablets, talk with your doctor about ways to make taking Rybelsus easier.
Accessible drug containers and labels
Some pharmacies provide medication labels that:
- have large print or use braille
- feature a code you can scan with a smartphone to change the text to audio
Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.
If you have difficulty opening medication bottles, let your pharmacist know. They may be able to supply Rybelsus in an easy-open container. They may also have tips to help make it simpler to open the drug’s container.
If you miss a dose of Rybelsus, you should skip the dose. Then, take your next dose the following day at the usual time. You should not take two doses at once to make up for a missed dose.
If you need help remembering to take your dose of Rybelsus on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.
Do not take more Rybelsus than your doctor prescribes as this can cause harmful effects.
What to do in case you take too much Rybelsus
Call your doctor right away if you think you’ve taken too much Rybelsus. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.
The earlier sections describe the usual dosages provided by the drug’s manufacturer. If your doctor recommends Rybelsus for you, they’ll prescribe the dosage that’s right for you.
Remember, you should not change your dosage of Rybelsus without your doctor’s recommendation. Only take Rybelsus exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.
Here are some examples of questions you may want to ask your doctor:
- How will I know if my current dosage of Rybelsus is working?
- If I exercise more, will my dosage of Rybelsus be decreased?
- Should I expect an increase in side effects with higher doses of Rybelsus?
To learn more about Rybelsus, see these articles:
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.