Rybelsus With Food. Is This Ok?

I was asked this question the other day and I wanted to specifically address it. What should I do if I didn’t take Rybelsus (semaglutide) 30 minutes before I ate because the package insert says I’m supposed to be taking Rybelsus with food?

Rybelsus has very low systemic absorption in comparison to injectable semaglutide (Ozempic). Absorption of the injection is reported at 89% while oral absorption is in the range of 0.4-1%. That is a huge difference and helps explain why the injectable dose is so much lower than the oral dose. The oral starting dose is 3 mg DAILY while the injectable starting dose is 0.25 WEEKLY. Looking for more info on GLP-1s, here’s a table we put together.

As you could imagine, any significant change in oral absorption could dramatically impact the effectiveness of the oral medication. It is recommended to take Rybelsus at least 30 minutes prior to eating, drinking (other than 4 oz. of plain water), and taking any oral medication. The reason for this is absorption. Taking Rybelsus with food would potentially reduce the absorption and make the drug less effective.

This leads us to the question of what to do if we forget to take the drug prior to eating? The prescribing information recommends waiting until the following day to take the next dose if your time period prior to eating is missed.

If we also think about the half-life of this medication, it makes sense that we can get away with skipping the dose. The half-life is approximately a week. Even if a dose is missed, we are still going to have a significant amount of drug in the systemic circulation.

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Written By Eric Christianson

October 4, 2020

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