A pill version of the class of drugs that includes Ozempic, Wegovy and others, which have become known for their ability to induce weight loss quickly, may be available in the near future.
Ozempic and its sister drug Wegovy are currently administered as once-weekly injections, which can make them costlier and more intimidating than an oral alternative. The results of two clinical trials presented at the American Diabetes Association's 2023 scientific sessions over the weekend indicate these pills, not yet on the market, could be as effective as the injectable versions.
"The injections themselves have been wildly popular, but there are many people who are either ... can't stand needles or they just would much prefer a pill, so now we're going to be opening up access to many more people," Dr. Roshini Rajapaksa, a gastroenterologist with NYU Langone, said on TODAY on June 26.
For example, Ozempic and Wegovy injections require refrigeration and the pen to administer them is an additional expense, Rajapaksa noted. But with a pill, there can be a risk of patients not using them as recommended, Dr. Christopher McGowan, an obesity medicine specialist in Cary, North Carolina, previous told TODAY.com.
Here's what to know about the new oral weight loss pills that could be on the market in the coming years.
Does Ozempic come in pill form?
There is currently a pill version of Ozempic's main ingredient, semaglutide, available under the name Rybelsus, which, like Ozempic, is approved to treat Type 2 diabetes and made by Novo Nordisk. But it’s a lower dose than what’s being tested in recent clinical trials, and it tends to cause worse side effects than the injections, Dr. Shauna Levy, a specialist in obesity medicine at the Tulane Bariatric Center in New Orleans, told NBC News.
Ongoing clinical trials are investigating what some are calling an "Ozempic pill" because they can induce weight loss, which is what Ozempic has become known for, despite only being approved by the Food and Drug Administration to manage Type 2 diabetes. Novo Nordisk previously told TODAY.com in a statement that “we do not promote, suggest or encourage off-label use of our medicines.”
There are three versions of pills being studied that may be as effective for weight loss as Ozempic, all with different ingredients — one by Novo Nordisk, one by Eli Lilly and one by Pfizer. However much more research is needed, obesity medicine experts say.
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What is the new pill for Ozempic?
Novo Nordisk, the maker of Ozempic, is expected to seek approval in 2023 for an oral pill version of semaglutide, the main ingredient in Ozempic, NBC News reported. It is a higher dose than Rybelsus, which is already on the market to treat Type 2 diabetes. A phase 3 trial of Novo Nordisk's oral semaglutide in people who are obese or overweight and do not have Type 2 diabetes found that the average participant lost 15% of their body weight after 68 weeks — similar to the clinical trial results of Novo Nordisk's injectable semaglutide.
Dr. Mico Guevarra, who is leading Novo Nordisk's oral semaglutide research, told NBC News the side effects were also reported to be similar to what's seen in the injection: 80% experienced mild to moderate gastrointestinal problems (as opposed to 46% in the placebo group) and 6% stopped the trial due to side effects.
Trial participants took oral semaglutide in the morning on an empty stomach, NBC News reported.
Drug manufacturer Eli Lilly also recently released phase 2 clinical trial results for its weight loss pill, orforglipron, in people with obesity or who were overweight but did not have Type 2 diabetes. The drug is in the same class as Ozempic, GLP-1 receptor agonists, because they both release a synthetic version of the hormone GLP-1, which the body releases during eating, making the person feel full.
The Eli Lilly trial found that participants, on average, lost 9.4% to 14.7 of their body weight after 36 weeks. Lead study author Dr. Sean Wharton told NBC News that orforglipron's effectiveness, based on the trial, seems to be “comparable to approved GLP-1s.”
Wharton said the medication is taken daily in the morning and can be taken within 30 minutes of eating.
Pfizer is also studying an oral medication that can induce weight loss for people with obesity and diabetes, called danuglipron, also a GLP-1 antagonist. According to the results of a phase 2 clinical trial of people with Type 2 diabetes published in May, participants, who took the pill twice daily, saw their body weight “statistically significantly reduced” compared to a placebo after 16 weeks. Study participants did not fast before taking the pill.
These medications all have the same mechanism of action to Ozempic and Wegovy, NBC News medical correspondent Dr. Natalie Azar said in a June 26 segment on TODAY, adding they seem to be comparably effective but will likely not surpass injections' efficacy.
What is the oral version of Ozempic used for?
Rybelsus, the pill version of Ozempic that is currently on the market and made by the same manufacturer, is approved to treat Type 2 diabetes, just like Ozempic.
Novo Nordisk's oral weight loss medication being studied that contains the same ingredient as Ozempic, semaglutide, will be for obesity. Lilly's oral weight loss pill that's in clinical trials is also for patients with obesity. Pfizer's pill still undergoing trials is a Type 2 diabetes and obesity treatment.
How much does Ozempic cost in pill form?
The cost of Rybelsus — and any of the weight loss pills currently being studied, should they be approved and become available — depends on your health insurance. Azar said that the list price of Rybelsus, a once-daily pill, is about $1,000 a month.
That said, Rajapaksa said pills generally cost less than injections, which will likely be the case for weight loss medications, too.
"Many injections have to be stored at cold temperatures, just putting it in the pen itself, all of that is an expense whereas with the pill, it should be significantly cheaper," she said.
Ozempic weight loss side effects
The most common side effects of taking Ozempic, according to Novo Nordisk's website, include:
- Nausea
- Vomiting
- Diarrhea
- Stomach pain
- Constipation
Clinical trial data for Ozempic show nausea is the most common side effect, followed by vomiting, diarrhea and abdominal pain. Azar said that ongoing research into Novo Nordisk's other oral version of Ozempic, as well as Lilly's and Pfizer's versions, show the adverse effects of the pills are similar to the injections — nausea, vomiting, diarrhea and constipation.
CORRECTION (June 29, 2023, 8:19 a.m. ET): A previous version of this story misstated that Ozempic's class of medication is called GLP-1 receptor antagonists. The correct term is GLP-1 receptor agonists.