RapMet: I ordered Rybelsus semaglutide from Jagdish Nikose at RLPharma in India. The meds were packed as “strips”, each strip containing ten pills, each pill individually packed in a blister. I ordered both 3 and 7 mg. The box containing the strips has the Novo Nordisk label. Am planning to re-order.
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Let us know whether 3 mg or 7 mg is preferable after your experiment! 
adssx
#430
3 mg is the starting dose, described as “non therapeutic”, to get used to the drug. So I’m not using it.
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How much is Jagdish selling the 7 mg pills for?
For Rybelsus Jagdish quoted $55 for ten pills, 7 mg and $45 for ten pills 3 mg.
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cl-user
#433
FYI. Just ordered that from Maulik (maulik7@gmail.com)
Rybelsus Semaglutide Tablets 14 mg x 30 - 129$
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Davin8r
#434
I hope you guys tolerate Rybelsus better than I did. I was so sleepy/exhausted I could barely keep my eyes open, and even then the appetite suppression wasn’t dramatic. Subcutaneous tirzepatide, even at very low doses, worked SO much better (although increased HR and fatigue were still an issue to some extent).
That being said, there is a huge amount of variability in both responses and side effects with the GLP meds from person to person, so you may do just fine.
@cl-user you only ordered the 14mg tablets? I hope you aren’t planning on starting at that dose if you’re new to GLP meds because you could end up in the hospital. Splitting the tablets may or may not work since they have a special delivery system through the stomach wall.
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adssx
#435
How long did you stay on rybelsus? No improvement over time? (I have almost zero appetite suppression on 7 mg.)
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RapMet
#436
You might have gotten the placebo version of it.
Davin8r
#437
I managed to hang in there for 2 months and lost about 10 pounds, but definitely not worth the side effects for me. 3mg wasn’t too bad, but 7mg was just way too much to handle, even after a month. You’re probably already aware that the clinical trials with Rybelsus don’t show much weight loss compared to injectable versions of GLPs, thus the rationale for Novo Nordisk currently doing phase 3 trials of 25mg and 50mg oral doses for obesity.
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adssx
#438
I don’t know if this is a joke, but you might not know that only 10% of people experience appetite suppression on GLP1RAs (but still lose weight!):
I’m in this case: no appetite suppression but lost 5% weight.
This is incorrect; see this:
Rybelsus 14 mg is approximately equivalent to Ozempic/WeGovy 0.5 mg (source). The max dose of WeGovy is 2.4 mg. So, to achieve the same with Rybelsus you need 14 x 2.4/0.5 = 67 mg. That’s why they chose 50 mg. They found the same weight loss as semaglutide s.c. 2.4 mg: Effect of oral semaglutide on energy intake, appetite, control of eating and gastric emptying in adults living with obesity: A randomized controlled trial 2024
Consistent with the reduction in energy intake, participants receiving QD oral semaglutide 50 mg experienced a reduction in body weight of 9.8% (10.1 kg) over 20 weeks compared with 1.5% (1.6 kg) for participants receiving placebo. This is consistent with a previous study, which reported a 9.9% (10.4 kg) reduction in body weight over 20 weeks with QW s.c. semaglutide 2.4 mg.
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cl-user
#439
I’ve looked at that and I don’t see any reasons to not split the tablets. The following paper explains the mechanism of oral semaglutide absorption and the role of SNAC. SNAC is not on the coating but co-formulated with the semaglutide.
Worst case I could apply wax on the cut if needed. But everything I’ve read on the topic says it’s co-formulated not coated.
A Review on Semaglutide: An Oral Glucagon-Like Peptide 1 Receptor Agonist in Management of Type 2 Diabetes Mellitus
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RapMet
#440
Find this very interesting and most likely works.
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Davin8r
#441
It is correct, if you read what I said. Oral Rybelsus (which only goes up to 14mg) causes less weight loss than injectable GLPs (since Rybelsus is “capped” at 14mg, equivalent to 0.5mg Wegovy which is quite a small dose and less than most people need). The higher dosed 25mg/50mg won’t be called Rybelsus but will have a new name for the new indication of weight loss.
If you’re a hyper-responder and don’t get side effects, then congratulations.
Davin8r
#442
They’re easy to split in half, but trickier to split into fourths. Good luck!
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Davin8r
#443
Self-reported appetite suppression. The only known mechanism for pure GLP-1 agonist drugs like semaglutide is decreased calorie intake, whether people are consciously aware of their appetite suppression or not.
adssx
#444
You wrote: “Rybelsus don’t show much weight loss compared to injectable versions of GLPs”
This is incorrect. Oral and subcutaneous semaglutide lead to IDENTICAL weight loss as long as you use the equivalent doses (14 <> 0.5 or 50 <> 2.4).
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adssx
#445
You’re correct. However, at 0.5 mg s.c., what’s the average reduction of energy intake in people without diabetes who are neither obese nor overweight? I assume not much, if anything.
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Davin8r
#446
But you can’t use identical doses of Rybelsus past the equivalent of 0.5mg Wegovy, which is too low for most people. This is why they are doing studies of the 25mg and 50mg tablets.
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adssx
#447
Yes, of course.
By the way, this page says: “In the EU, a new formulation of 1.5 mg, 4 mg and 9 mg doses of Rybelsus® are approved and are bioequivalent to the original formulation of Rybelsus®.”
Apparently, Novo Nordisk reformulated Rybelsus last year and removed two excipients: Novo Nordisk changes Rybelsus recipe to free up semaglutide for top sellers (does anyone have access to the article?)
However, I’ve never seen these doses in the EU. They’re also approved in Canada: Regulatory Decision Summary for Rybelsus - Drug and Health Products Portal
I wonder how they did this. And do the 25 and 50 mg tablets use the old or new formulation?
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