Key Takeaways
\nWegovy is now available as a daily oral pill with the same active ingredient as the injection.For some people, the pill may cause more intense side effects and slightly less weight loss than the injectable version.Real-world data shows drug adherence is especially challenging with the oral formulation.<\/p>\n
Wegovy, the widely popular injectable weight loss medication, is now available as a once-a-day oral pill.\n<\/p>\n
Like the injection, the pill contains semaglutide as its active ingredient<\/a>. Patients also start at a low dose and gradually increase it about every four weeks until reaching the maximum dose for weight loss.\u00a0This slow ramp-up helps the body build tolerance and may reduce common side effects such as nausea, diarrhea, and vomiting, according to Roman Fazylov, PharmD<\/a>, a professor of pharmacy at Touro College of Pharmacy in New York City.\n<\/p>\n For some people, the pill may lead to less weight loss than the injectable version. Side effects may also feel more intense, largely due to how the medication is absorbed when taken orally.\n<\/p>\n How Does the Wegovy Pill Work? <\/p>\n The Wegovy<\/a> pill is absorbed through the stomach, and only a fraction of the active ingredient reaches the bloodstream. To compensate for this, the highest dose of the pill is at 25 mg, much higher than the injectable version\u2019s maximum dose of 2.4 mg. That might result in more intense side effects for some people, Fazylov said.\n<\/p>\n There\u2019s also a major drawback of the pill. \u201cIt isn’t actually more convenient for many people,\u201d said Y. Tony Yang, ScD, LLM, MPH,<\/a> associate dean for Health Policy and Population Science at the George Washington University School of Nursing.\n<\/p>\n \u201cYou must take it first thing in the morning on an empty stomach with only 4 ounces of water, then wait 30 minutes before eating, drinking, or taking other medications,” Yang added. “Miss that window? You’ve potentially torpedoed your dose. For shift workers, travelers across time zones, or anyone without regimented mornings, the injection’s flexibility might actually win.\u201d\u00a0\n<\/p>\n While the Wegovy pill and injection were not tested in a head-to-head trial, both drugs were tested in insimilar ways, according to Andrea Traina, PharmD, senior medical director for obesity and liver health at Wegovy’s drugmaker, Novo Nordisk.<\/p>\n \u201cWith the injection, we see on average 15%-17% weight loss at 68 weeks and with the pill we see on average, 14%-17% weight loss at 64 weeks,\u201d Traina told Verywell.\u00a0\n<\/p>\n Is the Wegovy Pill More Convenient? <\/p>\n According Novo Nordisk data,<\/a> patients who were able to stay on the drug despite side effects achieved an average of 16.6% weight loss at 64 weeks, with about one-third losing at least 20% of their body weight.\n<\/p>\n However, when the data includes both patients who continued and those who stopped treatment, average weight loss drops to 13.6%, Yang explained. \u201cThis mirrors what we see with injectables,\u201d he said. \u201cThe medication works brilliantly if you can stay on it.\u201d\n<\/p>\n Real-world data shows that only 56% of patients on injectable semaglutide stayed on the drug for a full year, and the average weight loss was 10.9% among those patients.\n<\/p>\n Drug adherence may be even more difficult with the oral version. In another real-world study, only 27.2% of patients stayed on the oral formulation of GLP-1<\/a> through the first year, significantly lower than rates seen with weekly injections.\n<\/p>\n “The rigid dosing requirements create multiple daily failure points. So yes, the pill can deliver recommended weight loss goals if patients stay on it, but the ‘if’ is doing heavy lifting in that sentence,” Yang said.\n<\/p>\n Who May Benefit Most From the Wegovy Pill? <\/p>\n Traina said the pill may be a good option for patients who dislike needles or travel frequently, Traina said. Unlike the injection, which must be refrigerated, the pill does not require cold storage. Novo Nordisk’s market research also suggests that younger people and those with less weight to lose are particularly interested in the oral option.<\/p>\n She added that lifestyle modifications can help reduce side effects of the pill. These include eating more slowly, choosing smaller portions, stopping when you feel full, avoiding alcohol and high-fat foods.\n<\/p>\n Fazylov said medications can help manage certain side effects as well. \u201cHeartburn is a big issue, and we can prescribe medication to help with that.”\n<\/p>\n Why You Should Not Cut or Split Wegovy Tablets <\/p>\n Many people taking injectable Wegovy have found ways to use lower doses to reduce side effects or save money.<\/p>\n Yang warned against this practice with the oral pill. “The manufacturer and FDA are explicit: the tablet must be swallowed whole,” he said. “Absolutely do not cut, crush, or split these tablets.”\n<\/p>\n The formulation requires the tablet to remain intact for the absorption mechanism to work. Breaking it destroys the delivery system and could reduce bioavailability to near zero.\u00a0\n<\/p>\n Taking the pill every other day to cut costs or limit side effects also won\u2019t work. \u201cTaking it at inconsistent times would create wildly variable drug levels, defeating the purpose of chronic GLP-1 receptor activation<\/a> needed for weight loss,” Yang said.\n<\/p>\n If patients have trouble tolerating the full dose or the dosing schedule, Yang said they should work with their healthcare providers to lower the dosage or switch to an injectable formulation.<\/p>\n Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process<\/a> to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.<\/p>\n Medhati P, Shin TH, Wasden K, et al. GLP-1RA in the real world: 1-year compliance and outcomes of semaglutide use in patients with or without previous history of bariatric surgery<\/a>.\u00a0Ann Surg. doi:10.1097\/SLA.0000000000006748<\/p>\n Gleason PP, Urick BY, Marshall LZ, Friedlander N, Qiu Y, Leslie RS. Real-world persistence and adherence to glucagon-like peptide-1 receptor agonists among obese commercially insured adults without diabetes<\/a>.\u00a0J Manag Care Spec Pharm. 2024;30(8):860-867. doi:10.18553\/jmcp.2024.23332<\/p>\n