What Are The Side Effects Of Rybelsus?

GLP-1 receptor agonists are among the newer medications used to treat type 2 diabetes. 

Most GLP-1 receptor agonist medications are injectable, which might not appeal to all patients.

Rybelsus is unique as it is the only medication in its class that comes in oral form.

This, therefore, makes it more accessible to people who otherwise wouldn’t have wanted to or been able to take the injectable versions.

In this article, we’ll cover what Rybelsus is, how it works, its most common side effects, and how to deal with any side effects from taking it.

What is Rybelsus (Semaglutide)? 

Rybelsus is the brand name for oral semaglutide, a GLP-1 receptor agonist. GLP-1 agonists like Rybelsus are used to treat type 2 diabetes.

Rybelsus is one of the new type 2 diabetes medications. The Food and Drug Administration (FDA) approved Rybelsus in 2019. 

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 or maintenance dose.

The dosing for Rybelsus is usually as follows:

  • Start taking Rybelsus at a dose of 3 milligrams daily for 30 days.
  • After you’ve been taking the 3-milligram dose for 30 days, increase your dose to 7 milligrams daily.
  • If you’re not meeting your blood sugar targets after 30 days on the 7-milligram dose, increase your Rybelsus dose to 14 milligrams daily, which is the maximum dose.

How does Rybelsus work?

GLP-1 receptor agonists like Rybelsus work by increasing your natural insulin secretion while reducing the secretion of glucagon, a hormone that raises blood sugar levels. By boosting your natural insulin secretion, your blood sugar levels will decrease.

GLP-1 receptor agonists slow the rate of digestion, which can make you feel fuller longer after you eat. Delayed stomach emptying can cause weight loss, which is considered a potential benefit for patients with type 2 diabetes who are also overweight or obese. Losing 5% of your body weight can significantly improve blood sugar control.

Rybelsus is unique as a GLP-1 receptor agonist because it’s the only kind that comes in oral form. Other GLP-1 receptor agonists like Januvia, Victoza, and Ozempic are injectable medications taken once daily or once weekly, depending on the kind.

A six-month clinical trial observed the changes in hemoglobin A1c levels with both 7- and 14-milligrams of Rybelsus. 

With an average starting A1c of 8%, 7 milligrams of Rybelsus lowered A1c levels by an average of 1.2%, and 14 milligrams of Rybelsus reduced A1c levels by an average of 1.4%.

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What are the side effects of Rybelsus? 

The most commonly reported side effects of taking Rybelsus include:

  • Nausea
  • Stomach (abdominal) pain
  • Diarrhea
  • Decreased appetite
  • Vomiting
  • Constipation

While rare, there are serious complications that can arise from taking Rybelsus. Some potentially serious complications include gallbladder problems, thyroid tumors, kidney problems, and vision problems related to diabetic retinopathy.

If you experience yellowing of your skin or eyes, a lump or swelling in your neck, or changes in your vision while taking Rybelsus, you should contact your healthcare provider immediately, as these can be signs of gallbladder or thyroid problems.

Rybelsus doesn’t usually cause hypoglycemia (low blood sugar) on its own. However, your risk of low blood sugar will be higher if you take Rybelsus with other diabetes medications, especially insulin and sulfonylureas.

Common symptoms of low blood sugar include:

  • Fast heartbeat 
  • Shaking
  • Sweating
  • Feeling nervous or anxious
  • Irritability or confusion
  • Dizziness
  • Hunger

How long do Rybelsus’ side effects last?

The side effects of Rybelsus are more likely to occur when you first start taking it or when you increase your dose.

How long these side effects last will vary among people taking Rybelsus. If you’ve been taking your maintenance dose for at least one month and the side effects aren’t improving and/or are interfering with your quality of life, you should contact the prescribing healthcare provider.

Any time you have severe side effects such as dehydration from chronic vomiting or diarrhea, you should also seek medical advice.

Will the side effects of Rybelsus go away?

The side effects of Rybelsus should likely lessen and eventually go away as your body gets used to the medication. While there’s no way to estimate how long the side effects will last, doctors generally advise you to take a new medication for at least a few weeks before deciding if you’ll tolerate it long-term.

Some people might have persistent side effects even after taking Rybelsus for a long time, so you might need to try another medication. 

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Ways to reduce the side effects of Rybelsus

The best ways to reduce the side effects of Rybelsus are to take it as prescribed and increase your dose slowly. 

If you’re experiencing stomach-related side effects while taking Rybelsus, here are some more specific ways to reduce them.

Nausea, vomiting and/or diarrhea

Eat bland foods

Bland foods are easier on your stomach if you’re dealing with side effects like nausea and vomiting from taking Rybelsus. 

The BRAT diet is often recommended for nausea and vomiting and includes foods like bananas, rice, applesauce, and toast.

Crackers are another food that can be better tolerated when you have an upset stomach, as are broth-based soups.

Eat and drink clear liquids

Losing too many fluids from persistent vomiting can cause dehydration, worsening existing kidney problems. Replenish lost fluids by drinking clear liquids like water, sports drinks, apple juice, and broth.

Drink cold liquids

Ice cold beverages can be soothing when you’re nauseous. Popsicles and drinks with ice will likely be more appealing than room temperature or hot drinks when you have an upset stomach.

If you have diabetes, try to be mindful of the sugar content of liquids and popsicles, as they can add up and might cause high blood sugar levels. Another option is to suck on frozen fruit, which will be lower in sugar than popsicles and sports drinks.

Eat smaller meals

Larger meals probably won’t sound appealing to you if you suffer from nausea and vomiting. Instead, try to eat small snacks throughout the day to help meet your calorie and nutrient needs until you’re feeling better.


Constipation is a potential side effect of taking Rybelsus. If you’re experiencing constipation instead of nausea and vomiting, here are some tips to help.

Drink plenty of fluids

Similar to dealing with diarrhea and vomiting, drinking plenty of fluids is important for treating constipation. 

Eat high-fiber foods

Fiber-rich foods can help promote more regular bowel movements and prevent constipation. Here are some of the highest fiber foods you can eat to help prevent constipation:

  • Legumes (lentils, beans)
  • Fruit with skin and seeds, such as raspberries and pears
  • Dried fruit
  • Nuts and seeds
  • Vegetables (sweet potatoes, green leafy vegetables, and artichokes are especially high in fiber)

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Things to avoid while taking Rybelsus

Excessive alcohol intake

Drinking excessive amounts of alcohol while taking Rybelsus can increase your risk of developing severe hypoglycemia (low blood sugar). 

Some symptoms of low blood sugar include sweating, dizziness, hunger, a fast heartbeat, irritability, and nervousness.

To minimize your risk of low blood sugar while taking Rybelsus, aim to limit your alcohol consumption to no more than one drink per day if you’re a woman and no more than two drinks per day if you’re a man.

Greasy/fried foods

Since stomach issues are among the most common side effects of taking Rybelsus, you might want to avoid any fried or greasy foods when you start taking it or increase your dose.

Rybelsus already causes your stomach to empty more slowly, which can worsen nausea and vomiting. If you eat greasy foods, it takes a long time to digest them and can worsen these unpleasant side effects.

As you allow time for your body to get used to Rybelsus, try to choose baked, boiled, broiled, and steamed foods to cut out unnecessary fat. 

Some healthier types of fat to include in your Rybelsus diet can come from foods like salmon, nuts, seeds, avocadoes, and vegetable oils.

What are the side effects of stopping Rybelsus? 

If you stop taking Rybelsus, the most likely side effect is that your blood sugar level will be higher than it was while on Rybelsus. Otherwise, there are no known adverse side effects of stopping Rybelsus.

If you experience side effects while taking Rybelsus, they will likely diminish after you discontinue it.


Rybelsus is the only GLP-1 receptor agonist that comes in oral form; the rest are injectable. Rybelsus comes with similar side effects as other GLP-1 receptor agonists. This most often includes side effects like nausea, vomiting, stomach pain, diarrhea, and constipation.

More rarely, Rybelsus might cause thyroid problems (including thyroid carcinoma/tumor), kidney problems, gallbladder issues, and vision problems.

To minimize the potential side effects of Rybelsus, take it only as prescribed. You’ll likely start with a low dose of Rybelsus and gradually increase it to help reduce the risk of potential side effects.

Explore More

rybelsus foods to avoid

Rybelsus Diet: Foods To Eat And Avoid.


  1. Efficacy and Safety of Oral Semaglutide Versus Placebo in Subjects With Type 2 Diabetes Mellitus Treated With Diet and Exercise Only (PIONEER 1). https://clinicaltrials.gov/ct2/show/NCT02906930
  2. Nauck MA, Quast DR, Wefers J, Meier JJ. GLP-1 receptor agonists in the treatment of type 2 diabetes – state-of-the-art. Mol Metab. 2021. https://pubmed.ncbi.nlm.nih.gov/33068776/

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