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Navigating the side effects of Rybelsus: What you need to know

No medication is free of side effects.

Rybelsus Side Effects: What You Might Experience and How to Manage Them

No medication is free of side effects. If you're considering Rybelsus as a weight loss medication and want to learn more about how it can impact your body — and specifically, your digestive system — we've got you covered.

Read as we go through some of the most common Rybelsus side effects, how you can manage them at home, and when it may be time to reach out to your doctor.

What is Rybelsus?

Rybelsus is a brand-name prescription medication used to treat type 2 diabetes in adults. It contains the same active ingredient as Wegovysemaglutide — and, as such, can also be used to aid with weight loss.

Rybelsus works by mimicking a naturally-occurring hormone called GLP-1, which your digestive system releases to let your brain know that you're full, preventing you from overeating and snacking late at night or between meals.

It also increases insulin production and suppresses glucagon secretion which, alongside a healthy diet and exercise routine, helps to control blood sugar levels.

How quickly does Rybelsus work for weight loss?

Everyone's weight loss journey is different and being on the same medication as someone else doesn't necessarily mean you'll lose weight at the same pace.

Having said that, research has been conducted that can give us an idea of how quickly Rybelsus can work for weight loss.

A U.S. study that looked at the effects of Rybelsus on people weighing 194-196 pounds found that those taking 7mg of the medication lost an average of 5 pounds, while those on a higher dosage of 14mg lost an average of 8 pounds — and these results were achieved in 26 weeks [1].

What does Rybelsus do to your stomach?

Rybelsus causes food to stay in your stomach for longer than usual and slows down gastric emptying. It prolongs your digestion, which is one of the main reasons why it helps with weight loss.

This is a big change in how your body and stomach are used to working. As such, it can lead to gastrointestinal side effects like nausea and vomiting, particularly when you first start your treatment or after a dosage increase.

The good news is that the side effects of Rybelsus are typically mild and easy to manage. We'll explain how shortly.

Why do I need to take Rybelsus 30 minutes before I eat or drink?

Rybelsus should always be taken once a day on an empty stomach, at least 30 minutes before your first meal of the day — and the reason why is simple.

Your stomach, which is where the absorption of Rybelsus takes place, is only able to absorb up to 1% of the medication, a number that is low to start with [2]. Eating or drinking before taking Rybelsus can further impair the absorption process, preventing the medication from entering your bloodstream and doing what it's supposed to do.

If you forget to take a Rybelsus tablet before you eat, simply skip your missed dose and go back to your regular schedule the following day. Don't take an extra tablet to make up for the one you missed.

What are the most common side effects of Rybelsus?

As with most medications, Rybelsus can cause side effects, though most are mild and possible to treat (and prevent) at home.

These are some of the most common side effects of Rybelsus and what to do if you experience them.

Nausea and vomiting

As you know, Rybelsus works to lower blood sugar levels and encourage insulin production, but that can have an impact on your digestive system. The food that you eat stays in your stomach for longer than usual, which can lead to some discomfort and even vomiting.

Plus, it can take a while for you to get used to your new and reduced appetite. In the initial stages of your treatment, it's easy to still eat more than you need to feel satisfied and end up feeling queasy.

What to do:

  • Eat smaller meals more often
  • Stop eating once you're full, even if there's still food on your plate
  • Opt for plain foods, rather than spicy or greasy meals
  • Drink enough fluids to avoid dehydration (especially if you're experiencing vomiting as a side effect)


Clinical trials have reported constipation to be a potential side effect of Rybelsus, and that's once again, due to the slower emptying of your stomach [1].

Because food stays in your stomach for longer, your body absorbs more water from your stools and that can make them hard and dry, leading to constipation, bloating, and stomach pain.

What to do:

  • Stay hydrated
  • Eat foods that are high in fibre
  • Work out (yoga and Pilates can be particularly helpful for bloating and abdominal cramps)
  • If needed, take an over-the-counter laxative

Interestingly enough, for some people, Rybelsus can have the opposite effect and cause diarrhoea instead. In this case, it is equally important to drink plenty of fluids but you'll want to opt for foods that are low in fibre like plain rice, banana, and applesauce.

Acid reflux and heartburn

Although this is a rarer side effect, Rybelsus can cause acid reflux, particularly as you lie down and stomach acid travels into your esophagus, causing that uncomfortable burning sensation in your chest and back of your throat (in other words, heartburn).

What to do:

  • Avoid lying down right after eating
  • Sleep in a reclined position, rather than down flat
  • Eat smaller meals
  • Avoid carbonated beverages and foods or drinks that may trigger reflux, like garlic, onions, coffee, and spicy foods

Are there any severe side effects?

In much rarer cases, people taking Rybelsus can experience more serious side effects, which include:

Allergic reactions

It's very uncommon that Rybelsus will lead to an allergic reaction, but it is possible. Symptoms can include swelling of the face, lips, and tongue, skin rashes and itching, and trouble swallowing and breathing — and if you notice any of these, you should contact your doctor right away.

To avoid a severe allergic reaction, be sure to tell your doctor or pharmacist about any allergies that you're aware of, so they can assess your risk of reacting poorly to Rybelsus.

Kidney problems

Rybelsus can hinder kidney function, which may be a consequence of some of the milder side effects we've mentioned before, like nausea, vomiting, and diarrhoea.

The most important thing here is that you stay hydrated and look out for symptoms like difficulty urinating, frequent urination, fatigue, and feet/ankle swelling.


Again, very uncommon, but Rybelsus can cause low blood sugar, especially if you take insulin or another type of diabetes medication. In this case, your doctor may want to keep a close eye on your blood sugar levels and have them checked more often.

Higher risk of thyroid cancer

In some animal studies, semaglutide has been reported to cause thyroid tumours in mice and rats [3]. Although what happens to animals isn't necessarily what happens to humans, your doctor will most likely refrain from prescribing you Rybelsus if you have a personal or family history of medullary thyroid carcinoma (a type of thyroid cancer).

If you notice a lump in your neck, shortness of breath, trouble swallowing, or ongoing hoarseness, be sure to report these symptoms to your healthcare provider.

How long do Rybelsus side effects last?

Most Rybelsus side effects happen because your body is getting used to the medication. This means that they are typically temporary, lasting a few days to weeks, until your body has had time to adjust.

If your side effects haven't improved after a few weeks of taking Rybelsus, you should talk with your doctor. They may advise you to stop the medication and try a different one.

Are there any drug interactions to be mindful of?

Rybelsus can interact with a number of drugs that may reduce its efficacy or even aggravate side effects. These include estrogens, testosterone, medications that control high blood sugar, diuretics, antipsychotics, and other oral medications.

We recommend you tell your doctor about any medicines, vitamins, and even herbal products that you're currently on, so they can identify potential drug interactions, how severe they are, and if you should consider an alternative.

What should you avoid eating on Rybelsus?

Similar to some medications, there are certain foods that can exacerbate the side effects associated with Rybelsus and impact its efficacy. A few things to cut out of your diet (or at least, eat less of) while on Rybelsus include:

  • High-fat foods, like full-fat dairy products, fried snacks, and high-fat meats
  • Spicy foods
  • Refined carbs
  • High-sugar foods and drinks like soda, candy, sugary fruit juice, and sweetened tea or coffee
  • Alcoholic drinks

Instead, focus on foods that won't raise your blood sugar levels and are high in:

  • Healthy, unsaturated fats, like nuts, seeds, and salmon
  • Fibre, like whole grains, berries, and broccoli
  • Protein, like chicken, fish, eggs, and tofu
  • Magnesium, like almonds, edamame, and dark chocolate

Can you suddenly stop taking Rybelsus?

Yes, you can suddenly stop taking Rybelsus, if you experience ongoing side effects or if your doctor advises that it isn't the safest or most effective medication for you.

Although there are some Rybelsus side effects that you should be aware of, most are short-lived and easy to manage.

The best way to avoid them is to follow your doctor's instructions carefully when taking Rybelsus. Do so orally, on an empty stomach, with no more than 4 ounces of water, and without double dosing even in the case of a missed dose.

On top of that, make healthy changes to your diet, exercise habits, and overall lifestyle, and you should see the results you're hoping for.

Unsure where to start? Our Juniper Weight Reset Programme provides you with everything you need to reach your weight loss goals, from the medication itself to 1:1 health tracking, lifestyle coaching, and access to a private community of like-minded women who are on the same journey as you.

Take our quick and easy online quiz and check your eligibility today.