- What is Rybelsus?
- How does Rybelsus work?
- Foods to avoid with Rybelsus
- Can you drink alcohol with Rybelsus?
- Foods to eat while taking Rybelsus
- Other things to avoid while taking Rybelsus
- Should Rybelsus be taken with food?
- What is the best time to take Rybelsus?
- Any other safety concerns?
- How to reduce the side effects of Rybelsus
If your healthcare provider has prescribed Rybelsus to help manage your type 2 diabetes, you might have some questions about this newer diabetes medication.
Do you need to follow a special diet while taking Rybelsus, and do you have to stop drinking alcohol once you start taking it?
In this article, we’ll discuss foods to eat and avoid while taking Rybelsus and explain how Rybelsus works.
What is Rybelsus?
Rybelsus is an oral form of the drug semaglutide, a type of GLP-1 receptor agonist. The United States Food and Drug Administration (FDA) approved Rybelsus in 2019 to treat type 2 diabetes.
Rybelsus is unique because it’s currently the only oral GLP-1 receptor agonist approved by the FDA. The rest of the GLP-1 receptor agonists are injectables.
Rybelsus comes in 3-, 7-, and 14-milligram tablets. The 3-milligram dosing is only used to initiate treatment and isn’t typically a therapeutic dose.
How does Rybelsus work?
GLP-1 receptor agonists like Rybelsus work to improve blood glucose levels by increasing insulin secretion while also reducing the secretion of glucagon, a hormone that raises your blood sugar levels.
Rybelsus also helps slow the rate of digestion, which can make you feel fuller longer after you eat. Delayed stomach emptying can cause weight loss, which is a potential benefit for patients who are overweight or obese with type 2 diabetes. Rybelsus may also reduce your appetite.
Rybelsus is meant to treat type 2 diabetes. It isn’t meant for people without diabetes or those with type 1 diabetes.
Foods to avoid with Rybelsus
Below, we discuss some foods to limit or avoid while taking Rybelsus (Semaglutide).
If you experience nausea and vomiting from Rybelsus, it can help to avoid fatty foods. High-fat foods take longer to empty from your stomach, which can worsen nausea and vomiting.
Some high-fat foods to avoid while taking Rybelsus include:
- Fried/greasy food
- Large amounts of butter, oil, shortening, etc.
- High-fat meats
- Full-fat dairy products like cheese
- Fried snack foods like chips
If you’re taking Rybelsus, it’s likely because your blood sugar is higher than the desired level. To help Rybelsus better lower your blood glucose levels, you might consider cutting back on sugary drinks if you drink them regularly.
Sugary drinks are quickly digested and turned into blood sugar, which can cause blood sugar spikes.
Some sugary drinks to avoid while taking Rybelsus include:
- Regular soda (not diet); this includes cola and other flavors, including lemon-lime, grape, etc.
- Sweetened tea and coffee drinks
- Fruit-flavored drinks
- 100% fruit juice (contains natural sugar but is still high in sugar)
- Energy drinks
- Sugar-sweetened smoothies (often found at fast food restaurants)
Carbohydrates are a type of nutrient along with protein and fat. Carbs have the greatest impact on your blood sugar levels since they are broken down into blood glucose after you digest them.
Grains are one type of carbohydrate and are either whole or refined. Refined grains are stripped of their nutrient- and fiber-rich parts, leaving behind a lower-fiber, lower-nutrient grain.
These types of grains are more likely to raise your blood sugar levels. They can also negatively impact your cholesterol levels and heart health.
If you suffer from constipation from taking Rybelsus, then low-fiber refined grains can worsen constipation (high-fiber foods help prevent and treat constipation).
Refined carbs can also have added sugar, making them even higher in carbohydrates and more likely to raise blood sugar levels.
Some examples of refined carbohydrates include:
- Bread products made from white flour (bread, tortillas, bagels, etc.)
- Most types of pancake mix (unless it says “whole grain” or “whole wheat)
- Biscuits and other quick-breads
- Pasta/noodles made from refined flour
- Muffins, cookies (also have added sugar)
If you’re suffering from nausea, you’ll probably want to avoid spicy foods and stick with bland foods until you start to feel better. Spicy foods can worsen nausea and cause stomach pain, especially if you have a sensitive stomach.
Can you drink alcohol with Rybelsus?
There aren’t any known interactions between Rybelsus and alcohol. However, Rybelsus works to lower your blood sugar and can cause low blood sugar if you take it with other medications like insulin or sulfonylureas.
If you drink a lot of alcohol in addition to taking diabetes medications, you might be at a greater risk of developing low blood sugar (hypoglycemia).
If you choose to drink alcohol while taking Rybelsus, aim to keep your intake moderate. The current recommendation is to limit your alcohol consumption to two drinks or fewer per day for men and one drink or fewer per day for women.
Foods to eat while taking Rybelsus
Fiber is a type of carbohydrate, but your body doesn’t absorb it. Because it isn’t absorbed, fiber doesn’t raise your blood sugar.
Eating fiber-rich foods can help promote stable blood sugar levels, especially if you replace low-fiber carbohydrates with them. Fiber-rich foods can also help prevent and ease constipation, which is a potential side effect of Rybelsus.
Bland foods (for nausea/vomiting)
Rybelsus is most likely to cause side effects like nausea and vomiting when you first start taking it and when you increase your dose.
An empty stomach can worsen nausea, so try to eat small meals and snacks throughout the day.
Eating bland foods can help with nausea, such as:
- Plain rice/pasta
Having diabetes means you’re at a greater risk of having high cholesterol and developing heart disease. One heart-healthy diet tip is to choose unsaturated fats over saturated fats more often.
Saturated fat (typically found in animal fat and some plant sources like coconuts) is likely fine to consume in moderation. Still, diets high in saturated fat might encourage high levels of LDL cholesterol, or “bad” cholesterol, which can increase your heart disease risk.
Some foods that are high in unsaturated, heart-healthy fats to eat while taking Rybelsus include:
- Seeds (especially flaxseed and chia seeds)
- Vegetable and plant-based oils (olive oil, flaxseed oil, canola oil, etc.)
- Fatty fish like salmon, mackerel, herring
Type 2 diabetes stems from insulin resistance, which is when your body doesn’t use insulin effectively. Interestingly, magnesium supplementation has been shown to help improve insulin sensitivity which helps to lower blood sugar levels.
People with diabetes tend to have lower blood levels of magnesium than those non-diabetics. Eating magnesium-rich foods while taking Rybelsus might improve your blood sugar levels more significantly.
Some foods rich in magnesium include:
- Pumpkin seeds
- Black beans
- Dark chocolate
- Peanut butter
- Whole wheat bread
Protein doesn’t raise your blood sugar levels as carbohydrates do. Therefore, eating protein with meals and snacks is important. Protein also helps you feel full, which can help prevent nausea once your stomach becomes more empty.
Eating protein with carbohydrates can help slow the release of carbohydrates into blood sugar. Some great protein sources to eat while taking Rybelsus include:
- Poultry (chicken, turkey)
- Dairy products (cheese, yogurt, milk)
- Soybeans/soy products (edamame, tofu, etc.)
Most vegetables are considered non-starchy, which means they are low in carbohydrates. Non-starchy vegetables are rich in fiber, vitamins, and minerals, which can help boost your satiety without raising your blood sugar levels.
While starchy vegetables aren’t bad to eat when you have diabetes, they should be treated more like grains in terms of how they raise your blood sugar. Examples of starchy vegetables include potatoes, corn, green peas, and winter squash.
Here are some non-starchy vegetables to include in your diet when taking Rybelsus – there are plenty of options to cater to your preferences!
- Beans (green, wax, Italian)
- Brussels sprouts
- Cabbage (green, bok choy, Chinese)
- Green leafy vegetables (collard, kale, mustard, turnip)
- Salad greens (chicory, endive, escarole, lettuce, romaine, spinach, arugula, radicchio, watercress)
- Squash (cushaw, summer, crookneck, spaghetti, zucchini)
- Sugar snap peas
- Swiss chard
Other things to avoid while taking Rybelsus
- You shouldn’t take Rybelsus if you’re pregnant or plan to become pregnant shortly after starting it.
- Avoid breastfeeding while taking Rybelsus.
- Avoid taking Rybelsus with other GLP-1 receptor agonists or medications that can cause low blood sugar (insulin, sulfonylureas) unless otherwise directed by your healthcare provider.
Should Rybelsus be taken with food?
Rybelsus should not be taken with food. You must take Rybelsus on an empty stomach at least 30 minutes before eating or drinking.
Be sure not to drink more than four ounces of water with Rybelsus, and avoid all vitamins, supplements, and other medications for at least 30 minutes after you take your dose of Rybelsus.
Taking Rybelsus with food will impede its absorption and likely reduce its effectiveness. If you suffer from nausea while taking Rybelsus, you can eat something light, like crackers, as soon as you hit the 30-minute mark. Alternatively, make sure you don’t go to bed on an empty stomach, which can worsen morning nausea.
What is the best time to take Rybelsus?
The best time to take Rybelsus is in the morning, shortly after waking up, since that’s when you’re most likely to have an empty stomach. You’ll need to wait at least 30 minutes after taking Rybelsus before eating, drinking, or taking other medications or supplements.
Any other safety concerns?
Be on the lookout for signs of rare but potentially serious complications from taking Rybelsus, which can include:
- Changes in your vision (a sign that you might be developing diabetic retinopathy)
- A lump or swelling in your neck (a sign of a thyroid tumor)
- Severe abdominal pain (a symptom of pancreatitis)
- Sudden upper right abdominal pain and/or sudden pain in between your shoulder blades (potential gallbladder issue)
How to reduce the side effects of Rybelsus
Some of the most common side effects of Rybelsus include:
- Stomach (abdominal) pain
- Decreased appetite
More rarely, GLP-1 receptor agonists can increase your risk of more serious health problems like thyroid tumors, pancreatitis, gallbladder problems, and kidney problems.
To help reduce these side effects:
- Take Rybelsus as prescribed.
- Modify your diet as needed to alleviate side effects.
- Avoid taking an extra dose if you forgot your previous dose.
- Increase your dose of Rybelsus gradually under the guidance of your healthcare provider.
- Avoid taking Rybelsus if you have a history (family or personal) of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
- Seek medical attention if you become dehydrated from severe nausea and vomiting.
Rybelsus is currently the only oral GLP-1 receptor agonist on the market (the rest of the GLP-1 receptor agonists are daily or weekly injectables).
There aren’t any known food interactions with Rybelsus, so it isn’t considered dangerous to eat or drink anything in particular while taking it.
To help promote healthy blood sugar levels while taking Rybelsus, opt to include whole grains, high-fiber carbohydrates, healthy fats, and protein sources with meals and snacks while avoiding refined carbohydrates and sugar-sweetened beverages.
If you’re experiencing nausea and vomiting from Rybelsus, it can help to eat bland foods and avoid spicy and high-fat/greasy foods.
If you choose to drink alcohol while taking Rybelsus, it’s ideal to keep your intake low- to moderate to prevent hypoglycemia.