Semaglutide (oral)

Status

FDA-approved. Approved as Rybelsus for type 2 diabetes. An oral semaglutide product for chronic weight management has also been approved. Boxed warning for thyroid C-cell tumors. The administration conditions are part of the label, not a suggestion — taken with food, the tablet largely does not absorb.

What it is

Semaglutide in a daily tablet, absorbed with the help of a carrier molecule.

What published research measured

Oral semaglutide is co-formulated with SNAC, an absorption enhancer that raises local gastric pH and lets a fraction of the peptide cross the stomach lining before it is digested. Bioavailability is low and variable, which is why the tablet is taken on an empty stomach with no more than half a glass of water and nothing else for at least thirty minutes. PIONEER established glycaemic efficacy; OASIS studied higher doses for weight management.

Source

Husain M et al. 2019 — Oral Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes · Pratley R et al. 2019 — Oral semaglutide versus subcutaneous liraglutide and placebo in type 2 diabetes (PIONEER 4): a randomised, double-bli… · Aroda VR et al. 2019 — PIONEER 1: Randomized Clinical Trial of the Efficacy and Safety of Oral Semaglutide Monotherapy in Comparison With Pl…

Sources

• Half-life source for Semaglutide (oral)
• Wegovy prescribing information (Novo Nordisk)