Top Takeaways
- Once daily oral semaglutide (Wegovy) is the first GLP-1 agonist pill FDA-approved for obesity.
- Don’t automatically substitute semaglutide products for weight loss with those for type 2 diabetes.
- Help ensure patients understand oral semaglutide’s strict administration requirements.
Patients are asking about Rx semaglutide tablets (Wegovy), the first ORAL GLP-1 agonist FDA-approved for obesity and overweight.
It’s the same med in injectable Wegovy for weight loss...or injectable Ozempic or oral Rybelsus for type 2 diabetes.
But oral Wegovy is taken DAILY...versus weekly with the injection.
New oral semaglutide for obesity appears to work as well as the injectable...and better than most other po weight loss meds (naltrexone/bupropion ER, etc). But there aren’t any head-to-head studies.
When you get an Rx for oral semaglutide, check strengths closely. Oral Wegovy comes as 1.5 mg, 4 mg, 9 mg, and 25 mg tablets.
Look for most patients to start with one 1.5 mg tab daily...and increase the dose each month, until the 25 mg/day max is reached. This slow titration can help limit stomach side effects (nausea, etc).
Include all prescriber directions on the Rx label...and ensure patients get pharmacist counseling on proper use. New oral semaglutide tablets have very tricky administration...similar to Rybelsus.
For example, patients must swallow oral semaglutide whole with a sip or NO MORE than 4 oz of water...at least 30 minutes before the first food, other beverage, or oral meds of the day. Not doing so reduces efficacy.
Expect prior auths for new oral semaglutide...it costs about $1,350/month, the same as the injectable. But patients may be able to get these Rxs for less with manufacturers or direct-to-consumer programs.
Don’t automatically substitute oral Wegovy for injectable Wegovy, Ozempic, or Rybelsus...or vice versa. They aren’t considered equivalent.
But watch for changes in therapy. For instance, patients on injectable semaglutide 2.4 mg who prefer an oral med may switch to semaglutide 25 mg po daily 1 WEEK after the last injection.
On the other hand, patients on oral semaglutide 25 mg daily who need additional weight loss or who can’t tolerate the tabs may switch to semaglutide 1.7 mg injection weekly the DAY after stopping the tabs.
Keep oral semaglutide in its original container at room temp...and tell patients to do the same. The tabs are sensitive to moisture.
Anticipate that more oral GLP-1s will be approved this year... including once daily orforglipron which can be taken at any time withOUT specific food or water dosing restrictions.
Find more details about oral semaglutide in our GLP-1 and GIP/GLP-1 Receptor Agonist Interactive Comparison Chart. And use our resource, Comparison of Weight Loss Products, to review other meds for obesity.
- Wharton S, Lingvay I, Bogdanski P, et al; OASIS 4 Study Group. Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity. N Engl J Med. 2025 Sep 18;393(11):1077-1087.
- Santulli G. From needles to pills: oral GLP-1 therapy enters the obesity arena. Cardiovasc Diabetol Endocrinol Rep. 2025 Oct 6;11(1):31.
- Saeed ZI, Apovian CM. Semaglutide and Tirzepatide for the Treatment of Obesity and Weight-Related Comorbidities: A Narrative Review. Curr Atheroscler Rep. 2025 Dec 18;28(1):2.
- Medication pricing by Elsevier, accessed January 2026.