Is Wegovy (semaglutide) 1.5mg tablet the same as Rybelsus (semaglutide)?

Wegovy and Rybelsus Are NOT the Same Medication

No, Wegovy 1.5 mg tablet and Rybelsus are fundamentally different formulations of semaglutide with distinct routes of administration, dosing, and FDA-approved indications, and they cannot be used interchangeably.

Key Differences in Formulation and Administration

Route of Administration

• Wegovy is a subcutaneous injection administered once weekly, available as a pre-filled pen delivering doses of 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg 1
• Rybelsus is an oral tablet taken daily, representing the first oral GLP-1 receptor agonist formulation 2, 3
• These are completely different delivery systems that cannot be substituted for one another 2

FDA-Approved Indications

• Wegovy (2.4 mg weekly) is FDA-approved specifically for chronic weight management in adults with obesity (BMI ≥30 kg/m²) or overweight (BMI ≥27 kg/m²) with weight-related comorbidities 4
• Wegovy also received FDA approval in 2024 to reduce cardiovascular death, heart attack, and stroke in adults with obesity or overweight and established cardiovascular disease 4
• Rybelsus is FDA-approved for type 2 diabetes management, not for weight loss as a primary indication 2

Dosing Differences

Maximum Maintenance Doses

• Wegovy's maximum dose is 2.4 mg once weekly for optimal weight management outcomes 4
• The titration schedule for Wegovy starts at 0.25 mg weekly for 4 weeks, escalating to 0.5 mg, 1.0 mg, 1.7 mg every 4 weeks at each level, reaching the 2.4 mg maintenance dose after 16 weeks 4
• There is no "Wegovy 1.5 mg tablet" - this dose does not exist in the Wegovy formulation 1

Clinical Efficacy Differences

• Wegovy (2.4 mg) produces superior weight loss with mean 14.9% weight loss at 68 weeks versus 2.4% with placebo in the STEP 1 trial 4
• The higher 2.4 mg dose is critical for achieving optimal weight management outcomes compared to lower doses used for diabetes management 4

Cardiovascular Benefits

• Wegovy reduced major cardiovascular events to 6.5% compared with 8% in placebo groups in large cardiovascular outcomes trials, with a number needed to treat of 25 4
• Both formulations share the same active ingredient (semaglutide) and similar cardiovascular benefits in their respective populations 4

Common Pitfalls to Avoid

Dosing Confusion

• Do not confuse Wegovy with Ozempic (another injectable semaglutide formulation with maximum dose of 2.0 mg weekly for diabetes) 4
• The 1.5 mg dose mentioned in your question does not correspond to any standard Wegovy formulation 1
• Wegovy comes in specific doses: 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, and 2.4 mg for injection 1

Administration Requirements

• Oral semaglutide (Rybelsus) requires specific administration instructions that differ completely from injectable formulations 2
• Injectable and oral formulations are not bioequivalent and cannot be directly compared or substituted 2, 3

Shared Safety Concerns

Black Box Warning

• Both formulations carry identical warnings including a black box warning for risk of thyroid C-cell tumors based on rodent studies 4
• Both are contraindicated in patients with personal or family history of medullary thyroid cancer or multiple endocrine neoplasia syndrome type 2 4, 5

Gastrointestinal Side Effects

• Both medications commonly cause nausea, vomiting, and diarrhea with incidence rates of 30-40% 4
• Gradual dose titration is recommended for both formulations to mitigate these adverse effects 4
• Both carry increased risk of pancreatitis and gallbladder disease with relative risk of 2-3 4, 5

Pregnancy Contraindication

• Both formulations are absolutely contraindicated in pregnancy and breastfeeding 5

Clinical Bottom Line

Wegovy and Rybelsus are distinct medications that should never be considered interchangeable. If you are looking for weight management, Wegovy 2.4 mg weekly subcutaneous injection is the FDA-approved formulation with the strongest evidence for weight loss 4, 6. If you are managing type 2 diabetes and prefer an oral medication, Rybelsus is the appropriate choice 2. The "1.5 mg tablet" you mentioned does not exist as a standard formulation of either medication 1.