Prescription Rybelsus (semaglutide) in the UK

Rybelsus is the brand name for oral semaglutide, which comes in tablet form. This medication is licensed for the treatment of type 2 diabetes, and has been shown to help patients control blood sugar and achieve weight loss (1). You can buy Rybelsus for the treatment of type 2 diabetes in the UK if you have a prescription, or get it via the NHS if you’re eligible.

Rybelsus is not currently licensed for weight loss in the UK.

About Habitual:

  • Habitual provides two types of programmes:
  • Medication-based weight loss programmes which include a prescription, medication, and access to our behavioural resources including a mobile app and community support.
  • Type 2 diabetes remission programmes which combine total diet replacement with the same digital services included in medication plans.
  • This advice in this page is with regards to Rybelsus as a treatment for type 2 diabetes.

More information about Rybelsus (oral semaglutide)

What is Rybelsus (semaglutide)?

Rybelsus (semaglutide) is a medication that was originally used to control blood sugars for the treatment of type 2 diabetes. It belongs to a class of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists.

GLP-1 hormones are normally produced by the body to help to regulate glucose levels in the blood. They work by telling the pancreas to produce more insulin (a hormone that helps the body use glucose for energy) and slowing the absorption of glucose from the stomach.

Rybelsus mimics the effects of natural GLP-1 by binding to GLP-1 receptors in the pancreas, which triggers the pancreas to produce more insulin and slows down the absorption of glucose in the stomach. This helps to lower the levels of glucose in the blood, thus improving glucose control.

Additionally, Rybelsus also suppresses appetite by binding to receptors in the brain, which can lead to weight loss.

Can Rybelsus be used for weight loss?

Rybelsus (the brand name for once-daily, oral semaglutide tablets) when prescribed to patients with type 2 diabetes has been shown to lead to weight loss. (1) (2)

Rybelsus is currently not licensed for the treatment of weight loss, but oral semaglutide is currently being studied for weight loss, at a higher dose.(3)

Can I take Rybelsus and total diet replacement simultaneously?

If you would like to start a total diet replacement programme it is important for you to speak to your GP before starting. In research trials (5) all type 2 diabetic medication was stopped on the day that patient started the 800 kcal programme, however ultimately this decision is up to your GP or diabetes care team and you should not make any medication adjustments without speaking to them.

How do I take Rybelsus?

Rybelsus is an oral medication (tablets) which should be taken daily. You should take your daily tablet on an empty stomach, but it can be taken at any time of the day.

Is it possible to achieve T2D remission if I’m on Rybelsus?

Technically the definition of type 2 diabetes remission is having blood sugars within the normal range, without glycaemic medications. As Rybelsus is intended to help control blood sugar levels, it is not possible to be in remission whilst taking the medication.

Is Rybelsus approved for weight loss in the UK?

At present, Rybelsus is only licensed for the treatment of type 2 diabetes in the UK.

Will there be a version of Rybelsus available for weight loss?

Oral semaglutide at a higher dose than Rybelsus is currently being studied for weight loss (3), however at present this medication is not commercially available nor has it been licensed for use for weight loss in the UK.

Who can use Rybelsus?

Rybelsus is recommended for adults with type 2 diabetes that cannot be controlled by other glycaemic medications. For example:

  • When a patient is unable to take metformin due to intolerance or contraindications
  • Rybelsus may be used in addition to other diabetes medicines

Rybelsus should be used alongside a healthy diet and regular exercise. You should not use Rybelsus if you are allergic to any of its ingredients, including semaglutide. It is also not suitable if you have type 1 diabetes.

What are the side effects of semaglutide?

The most common side effects of semaglutide, including in its oral form (Rybelsus), are gastrointestinal, such as nausea, stomach pain, diarrhoea, decreased appetite, vomiting, and constipation. Semaglutide can cause more serious complications such as pancreatitis and kidney injury, but these are infrequent.

How much weight do patients typically lose on Rybelsus?

In one study, patients with type 2 diabetes lost an average of 4.4kg after 26 weeks. These patients also experienced significantly greater decreases in HbA1c compared to those on liraglutide (another type of GLP-1 medication) and those in the placebo group. (4)

What dosages of Rybelsus are available?

The typical Rybelsus treatment plan involves increasing dosage once per month until you reach the maximum dose. This is done to reduce the risk of side effects, which tend to be worse around dose escalation. All Rybelsus patients start on 3mg. If, after one month, your side effects have been manageable and you'd like to increase dosage, the next would be 7mg. After another month you'll have the option to increase to 14mg. Dose changes should always be made between yourself and your prescriber.

Can you buy Rybelsus online?

You may be able to buy Rybelsus online from an online pharmacy if you have a prescription. You should check that any online pharmacy you purchase from is registered with the General Pharmaceutical Council (GPhC).

Is Rybelsus available on the NHS?

Yes, patients who are eligible for treatment of type 2 diabetes with Rybelsus may be able to access it through the NHS, though this is dependent on local policies and protocols.


[1] Vanita R. Aroda, Julio Rosenstock, Yasuo Terauchi, Yuksel Altuntas, Nebojsa M. Lalic, Enrique C. Morales Villegas, Ole K. Jeppesen, Erik Christiansen, Christin L. Hertz, Martin Haluzík, PIONEER 1 Investigators; PIONEER 1: Randomized Clinical Trial of the Efficacy and Safety of Oral Semaglutide Monotherapy in Comparison With Placebo in Patients With Type 2 Diabetes. Diabetes Care 1 September 2019; 42 (9): 1724–1732. (Reference
[2] Helena W. Rodbard, Julio Rosenstock, Luis H. Canani, Chaicharn Deerochanawong, Janusz Gumprecht, Søren Østergaard Lindberg, Ildiko Lingvay, Anette Luther Søndergaard, Marianne Bach Treppendahl, Eduard Montanya, PIONEER 2 Investigators; Oral Semaglutide Versus Empagliflozin in Patients With Type 2 Diabetes Uncontrolled on Metformin: The PIONEER 2 Trial. Diabetes Care 1 December 2019; 42 (12): 2272–2281.(Reference)
[3] Filip K Knop, Vanita R Aroda, Ruben D do Vale, Thomas Holst-Hansen, Peter N Laursen, Julio Rosenstock, Domenica M Rubino, W Timothy Garvey; Oral semaglutide 50 mg taken once per day in adults with overweight or obesity (OASIS 1): a randomised, double-blind, placebo-controlled, phase 3 trial. The Lancet, 2023. ISSN 0140-6736 (Reference)
[4] Pratley R, Amod A, Hoff ST, Kadowaki T, Lingvay I, Nauck M, Pedersen KB, Saugstrup T, Meier JJ; PIONEER 4 investigators. Oral semaglutide versus subcutaneous liraglutide and placebo in type 2 diabetes (PIONEER 4): a randomised, double-blind, phase 3a trial. Lancet. 2019 Jul 6;394(10192):39-50. doi: 10.1016/S0140-6736(19)31271-1. Epub 2019 Jun 8. Erratum in: Lancet. 2019 Jul 6;394(10192):e1. PMID: 31186120.
[5] Leslie, W.S., Ford, I., Sattar, N. et al. The Diabetes Remission Clinical Trial (DiRECT): protocol for a cluster randomised trial. BMC Fam Pract 17, 20 (2016). (Reference)