Rybelsus is now FDA-approved for managing cardiovascular health.Doctors say oral GLP-1s may reduce heart attack and stroke risk through inflammation control.The pill form is effective but may cause more side effects than the injectable version.
The U.S. Food and Drug Administration (FDA) recently approved Rybelsus for use in managing cardiovascular health. While Novo Nordisk, the pharmaceutical company behind the drug, may be best known for manufacturing an injectable form of the GLP-1, Ozempic, doctors say the oral form makes it available to a wider range of patients and treatment plans. Here’s what to know.
“Oral and injectable semaglutide contain the same active ingredient, and comparison studies have shown that they are similarly effective, so it comes down to factors such as personal preference and the best GLP med fit since patients are each unique,” says Florence Comite, M.D. “For those at elevated risk for diabetes [who] won’t use injectable GLP-1s due to fear of needles, the oral version of semaglutide is a game-changer, effectively addressing carbohydrate metabolism to reverse their risk of diabetes and cardiovascular disease.”
Preventive cardiologist, Sirisha Vadali, M.D., further explains that GLP-1s may help reduce cardiac events, such as stroke and heart attack, by making the endovascular and endothelial lining of the arteries less prone to inflammation.
“We [in the cardiometabolic space] believe that the inflammation reduction is truly what is driving the reduction of major adverse cardiac events because this drives the idea that platelets—which tend to cause blood clots—are less sticky, [helping prevent new plaque from forming on] arterial walls. In addition, Rybelsus has direct lipid-lowering and diuretic properties, which make it ideal to help cardiovascular patients with high cholesterol and even heart failure.”
Vadali says that in a world where GLP-1s are widely seen as tools for managing weight loss, the newly approved use of Rybelsus for cardiovascular health provides a major step forward in the treatment of both patients with and without prior cardiac event history. Previously, Rybelsus had only been approved to improve glycemic control in adults with type 2 diabetes, according to the FDA.
Still, the oral form doesn’t come without its drawbacks. According to Comite, the oral version requires a higher daily dose since it is partially broken down in the liver—unlike the injectable version that enters directly into the bloodstream. Comite also pointed to a 2024 study that reported an increase in adverse side effects when taking the oral version, as well as a greater likelihood of discontinuation. But, like Vadali, Comite believes the FDA approval will allow the drug to further improve the health of patients, comparing GLP-1s to the discovery of antibiotics in the 20th century.
“This marks a pivotal moment as another major application of GLP-1s for proactive medicine—reducing major cardiovascular events. I’ve been prescribing Rybelsus to patients to stop disorders of aging, to reverse prediabetes, diabetes and cardiovascular disease for many years with great success,” says Comite.
Of course, there’s no guarantee that any one medicine will work for you. If you’re curious about the idea of taking a GLP-1 for your heart health, bring the idea up with a trusted healthcare professional to get their advice. In the meantime, aim for heart-healthy habits and meals, like taking walks during the day, noshing on nuts at snack time and enjoying a bowl of Chicken Fajita Soup at dinner.