A GLP-1 pill for weight loss is now on the market. On Monday, drugmaker Novo Nordisk released a pill version of Wegovy, which until now the company had offered only as a weekly injectable, alongside Ozempic. The new pill, taken once a day and available by prescription, is the first alternative to injectable GLP-1 drugs for weight loss.
“This is an exciting and very promising development in obesity care—an effective oral GLP-1 with meaningful weight loss outcomes expands access in a way we haven’t had before,” Arti Thangudu, MD, board-certified endocrinologist and founder of Complete Medicine, told Health. “Shelf stability, easier storage, and the potential for improved pricing, combined with strong clinical results, make this a win for patients.”
Here are six important things to know about the Wegovy pill.
Like other GLP-1 medications, the Wegovy pill promotes weight loss by activating glucagon-like peptide-1 (GLP-1) receptors, which play a role in regulating blood sugar and appetite. These drugs slow digestion, helping you feel full for longer, and tell your brain that you’re satisfied, reducing hunger.
The pill version of Wegovy contains semaglutide, the same active ingredient as the injectable drug, and appears to be similarly effective. In a recent trial, patients taking the pill lost an average of 13.6% of their body weight after 64 weeks, compared to about 2% for the placebo group. In a 2021 study of semaglutide injections, participants lost an average of 14.9% of their weight after 68 weeks.
Be prepared for it to take a few months before you start seeing results on the GLP-1 pill, Rozalina McCoy, MD, a practicing endocrinologist and associate professor at the University of Maryland School of Medicine, told Health. Unlike injections, which go directly into the bloodstream, the tablets must first be digested. As a result, the oral medication requires a much higher dose: 25 milligrams (mg), compared with 2.4 mg for the injections.
McCoy said she doesn’t expect patients to see much weight loss until around the third month, compared with just a few weeks for those using the injection. The recommended dosing schedule starts at 1.5 mg for the first month, increases to 4 mg in the second month, and then jumps to 9 mg before eventually reaching 25 mg—the highest dose (and the one used in the study mentioned above).
McCoy said she had hoped that a GLP-1 pill would be more affordable than injections, which are sold as pens that cost more to produce, ship, and store than tablets. However, the current price of the Wegovy pill is about the same as the shots. For patients with insurance, the 25-mg dose is available for as little as $25 a month—the same price as the injectable version. Without insurance, the cost jumps to $299 per month, which is $50 cheaper than the injections.
“That was, I admit, a bit disappointing,” McCoy said. “But it’s a start. This is the first one. As it’s used more, and as more orals become available, I do hope that the cost will continue to go down.”
In the clinical trials, patients on the Wegovy pill reported side effects similar to the shot, including nausea, diarrhea, and vomiting. Both versions of semaglutide slow digestion, which can cause gastrointestinal (GI) upset. Other common side effects include headache, fatigue, dizziness, and heartburn.
Weekly Wegovy injections can be taken at any time, but the pill regimen is more specific. The recommendation is to take the Wegovy pill in the morning on an empty stomach and wait at least 30 minutes before eating, drinking, or taking other oral medications. This timing is meant to ensure the pill absorbs properly, McCoy explained. Otherwise, people “may have more GI side effects, or it may not work as well,” she said.
As with any GLP-1 medication, maintaining a healthy lifestyle is also important to reap the most benefits of the Wegovy pill. That means eating well-balanced, nutritious meals, drinking enough water, and strength training to preserve muscle and bone while losing weight, McCoy advised. McCoy also emphasized that obesity is a chronic condition, and once you start a GLP-1, you’ll have to continue taking it to keep off the weight.
It’s true that the Wegovy pill is the only GLP-1 tablet approved for weight loss, but another semaglutide pill, Rybelsus, is already on the market—green-lit only for the treatment of type 2 diabetes. And another GLP-1 pill for weight loss is also on its way: Eli Lilly, maker of Zepbound and Mounjaro and a Novo Nordisk competitor, is developing a tablet called orforglipron, which is expected to receive FDA approval this spring.
