Rybelsus is a type of medication you might need to take if you have type 2 diabetes.
- What is Rybelsus?
- How does Rybelsus work?
- How to take Rybelsus
- Who can take Rybelsus?
- Your prescription
- Rybelsus side effects
- More information and support
What is Rybelsus?
Rybelsus, a brand name for semaglutide, belongs to a group of drugs called GLP-1 receptor agonists (GLP-1 Ras or GLP-1s). They can also be known as GLP-1 analogues, GLP-1 agonists, or incretin mimetics.
There are several different GLP-1 agonists available in the UK.
Rybelsus is a treatment for type 2 diabetes, which can help you to manage blood sugar levels. You can take it on its own or with other diabetes medications such as metformin, SGLT-2 inhibitors, sulphonylureas or insulin.
New formulation of Rybelsus
A new generation formulation of Rybelsus has started to be introduced since 22 September 2025.
Novo Nordisk is reformulating Rybelsus, and if you take Rybelsus, then you will be automatically moved on to the new formulation, which means you will see a change in the dose you are taking. The changes will be as follows:
- If you're currently prescribed 3mg, you will move to 1.5mg
- If you're currently prescribed 7mg, you will move to 4mg
- If you're currently prescribed 14mg, you will move to 9mg.
You will also see changes with the new tablet as well as the box, as both the tablets and the box they come in will be smaller. But the effectiveness of Rybelsus will remain the same.
This will be a phased introduction, which means some people will not be moved to the new tablets immediately.
Novo Nordisk have said that the previous generation of Rybelsus tablets are likely to be available until 31 January 2026. If you are taking this medication, you will not have to do anything as the changeover will happen automatically when it becomes available in your local prescribing system.
How does Rybelsus work?
Glucagon-like peptide GLP-1 is a naturally occurring hormone in the gut and is released after eating. Rybelsus is a medication that mimics the natural action of GLP-1.
It works by helping your body to produce more insulin when needed. It also reduces the amount of glucose, or sugar, produced by the liver, and slows down how quickly food is digested. This all helps to lower blood sugar levels and HbA1c.
How to take Rybelsus
Rybelsus is a tablet you swallow once a day. Take it on an empty stomach, before your first meal or snack, this is usually when you first wake up. After you have taken it, you should wait at least 30 minutes before having your first meal or drink of the day or any other medications that you take by mouth. It should be taken with a small sip of water and swallowed whole, do not break, crush or chew the tablets.
Always take Rybelsus exactly as your healthcare professional has told you. The Patient Information Leaflet inside the box will tell you how to take it, but always check with a healthcare professional if you are not sure.
Who can take Rybelsus?
Rybelsus can be prescribed to adults aged 18 and over for type 2 diabetes management.
New guidelines from the National Institute for Health and Care Excellence, or NICE for short, recommend earlier use of GLP-1s for some groups of people. You’re more likely to be offered a GLP-1 such as Rybelsus if you’re an adult with type 2 diabetes and:
- You were diagnosed before the age of 40
- Are living with obesity
Your healthcare team will discuss your options to decide if this treatment is right for you based on your individual needs and circumstances. If you think that you would benefit from taking Rybelsus for diabetes management, speak with your healthcare team so that you can make an informed decision together about your treatment.
NICE guidelines are used in England and Wales and tend to be endorsed and adopted in Northern Ireland. If you live in Scotland, care may be based on SIGN guidelines. Please speak to your healthcare team if you have any questions or concerns about your treatment.
Who can’t take Rybelsus?
Some medications might not be suitable for some people, which might be because of medical conditions or other reasons. The list below shows some of the reasons why Rybelsus might not be a suitable treatment for you:
- If you have end-stage kidney disease, you might not be able to take Rybelsus;
- If you have severe liver disease, you might not be able to take Rybelsus;
- You might need to temporarily stop Rybelsus if you’re going to have an operation;
- If you have severe heart failure, you might not be able to take Rybelsus;
- If you’ve had pancreatitis before, Rybelsus might not be suitable for you. Your doctor will tell you to stop taking Rybelsus if you have pancreatitis;
- Your doctor will tell you to stop taking Rybelsus if you develop diabetic ketoacidosis, also called DKA
- You should not take Rybelsus if you are pregnant or breastfeeding. If you’re planning a pregnancy, speak with a healthcare professional if you are using this medication.
The patient information leaflet that comes with the medication will have an up to date list of warnings and precautions. When you start a new medication, always check with your healthcare team that it’s suitable for you to take. You can discuss any other medical conditions you have and any other medications you are taking.
Your prescription
You should only be given a prescription for Rybelsus following an assessment by your healthcare team to make sure that you meet the criteria and that you’ll benefit from its use.
This should be an individual assessment that includes how Rybelsus will fit into your current treatment plan and considers any diet or activity programme that you are following, as well as the risk of side effects, the dose you’ll need, and your personal choices.
Your healthcare team should explain your prescription to you, but it's important to make sure you ask if you don't feel you know enough.
And make sure you talk to your GP or your diabetes team if you struggle to take Rybelsus. They might be able to help by giving you a different dose.
In England, if you need to take any medication to manage your diabetes, your prescriptions will be free. Ask your healthcare team about a prescription exemption certificate if you don't have one, to make sure you don't get charged for your medication. Prescriptions are already free for everybody in the rest of the UK, so you shouldn't pay for your medication.
Rybelsus side effects
Common side effects of Rybelsus can include:
- feeling sick (nausea)
- diarrhoea
- risk of low blood sugar
- risk of worsening retinopathy
Risk of low blood sugar
When taken on its own, Rybelsus does not usually cause blood sugar levels to become too low, also called hypoglycaemia or hypos. However, hypos are more likely to happen when you take this medication with other diabetes medications such as insulin or a sulphonylurea.
Your healthcare team may advise reducing the dose of your sulphonylurea or insulin medicine when you start taking Rybelsus to reduce the risk of hypos.
Risk of high blood sugar
If you take insulin and it is reduced too quickly, it can cause high blood sugar levels, this is also called hyperglycaemia, and there is an increased risk of diabetic ketoacidosis, also called DKA. Your healthcare team should discuss with you the signs and symptoms of DKA.
Risk of worsening retinopathy
If you have diabetic eye disease, known as diabetic retinopathy, and you’re using insulin, then your retinopathy could get worse when you start Rybelsus, and this might need treatment.
Tell your doctor if you have diabetic eye disease or if you experience eye problems during treatment with Rybelsus.
Risk of Non-arteritic anterior ischemic optic neuropathy (NAION)
NAION is a condition that affects the optic nerve in the eye. NAION happens when blood flow to the optic nerve is reduced. This can cause sudden loss of vision, typically in one eye. It’s often described as a blurring or cloudiness of vision. Semaglutide (Ozempic, Rybelsus, Wegovy) has been associated with very rare reports of NAION. If you notice a sudden change in your eyesight, such as sudden vision loss, or your eyesight gets worse very quickly in one or both of your eyes during treatment with Rybelsus, seek urgent medical advice.
These are not all the side effects. You will find a full list of known side effects in the Patient Information Leaflet. This comes in the medication box.
Like all medications, Rybelsus can cause side effects. But when side effects are listed as common in the Patient Information Leaflet, it doesn’t mean that everyone who takes the medication will get them. Read more about GLP-1 agonist side effects.
The information about side effects is based on the likelihood of people having them. For example, if a side effect is very common, then it can affect more than one in ten people, and if a side effect is very rare, then it affects fewer than one in 10,000 people.
Because medicines can affect people differently, your healthcare team will speak to you about what’s best for you and discuss any side effects.
It’s also important that you take individual advice from your healthcare team before starting treatment and report any side effects to your healthcare professionals if you experience any.
You can also report these side effects to the Yellow Card Scheme, which is the government system used for recording side effects with medicines in the UK.
Rybelsus and weight loss
Some people lose weight when they take Rybelsus as part of their type 2 diabetes treatment. This is because this medication slows down how quickly food is digested and can reduce your appetite, so you eat less.
More information and support
If you're worried about your medication, struggling with side effects, or want to know if it's right for you, speak with your healthcare team.
Still have more questions? Or is there anything you're not sure about Rybelsus after reading this page? Contact our helpline on 0345 123 2399.
You can visit the NHS website for more information.
