Rybelsus: New Formulation (Updated)
There is a new formulation of Rybelsus coming out and there will be a change-over period where the different formulations will be on the market at the same time, which could lead to confusion.
The following information is available to support the transitional period:
Rybelsus Direct Healthcare Professional Communication
Update: 27th November
The new formulation has improved bioavailability, therefore the dosage strength of the tablets is changing. Please see the table below for equivalencies:
| Initial formulation
(one oval tablet) |
Bioequivalent | New formulation
(one round tablet) |
| 3 mg (starting dose) | = | 1.5 mg (starting dose) |
| 7 mg (maintenance dose) | = | 4 mg (maintenance dose) |
| 14 mg (maintenance dose) | = | 9 mg (maintenance dose) |
Source: NovoNordisk Direct Healthcare Professional Communication, August 2025.
We have been advised that stocks of the old formulation tablets will be exhausted by 31st January 2026. Therefore, patients will need to have their prescriptions reviewed and changed over to the equivalent strength of the new formulation before this date.
As with the original formulation, the new formulation of Rybelsus should be taken on an empty stomach with a small glass of water. No other food, drink or medicines should be taken for at least 30 minutes afterwards. An APC patient information leaflet containing key counselling points for Rybelsus is available here should you wish to reinforce these.
Additional Advice for Patient Review
Please find attached a list of your patients currently prescribed Rybelsus 3mg, 7mg or 14mg. Whilst reviewing these patients to change their prescription, you may wish to consider whether they would benefit from a change to the semaglutide subcutaneous injection (Ozempic) instead of the new oral tablet.
Reasons to consider injectable semaglutide are:
- suboptimal glycaemic control on most recent HbA1c. Studies have shown that the injection is better absorbed so may be more effective.
- previously on an injectable GLP1-RA that was changed due to supply problems. The stock issues with Ozempic have now resolved.
- convenience of dosing – the injectable preparation may be more convenient for patients with its once weekly dosing schedule.
Important prescribing information for injectable semaglutide:
- Exact dose equivalencies between oral and subcutaneous semaglutide are not available. If switching, start at 0.25mg weekly and titrate the dose upwards as clinically appropriate.
- A patient information leaflet for the injectable preparation is available here.
- Please note that one Ozempic pen contains 4 doses (i.e. 4 weeks’ supply).
