What is the maximum recommended dose of Rybelsus (semaglutide)?

From the Research

The maximum recommended dose of Rybelsus (semaglutide) is 14 mg taken once daily. Patients typically start with a lower dose of 3 mg once daily for 30 days, then increase to 7 mg once daily for at least 30 days before considering an increase to the maximum 14 mg daily dose if additional glycemic control is needed 1, 2, 3, 4. Rybelsus should be taken at least 30 minutes before the first food, beverage, or other oral medications of the day, with no more than 4 ounces of plain water, as food can significantly reduce its absorption. This dosing schedule is important because semaglutide is a GLP-1 receptor agonist that works by enhancing insulin secretion, suppressing glucagon release, and slowing gastric emptying to improve blood glucose control in type 2 diabetes.

Key Considerations

• The dose escalation is crucial to minimize gastrointestinal side effects such as nausea and vomiting 3, 4.
• Dose adjustments should be made under medical supervision, as some patients may achieve adequate glycemic control at lower doses while minimizing potential side effects like nausea, vomiting, and diarrhea 1, 2.
• The safety and efficacy of oral semaglutide have been demonstrated in various clinical trials, including the PIONEER program, which showed significant improvements in HbA1c and body weight in patients with type 2 diabetes 1, 3, 4.

Important Safety Information

• Gastrointestinal events, mainly mild-to-moderate nausea, were more common with oral semaglutide than with placebo 3, 4.
• Adverse events led to premature treatment discontinuation in some patients, highlighting the need for careful monitoring and dose adjustment as needed 3, 4.