10 Pros and Cons of Oral vs. Injectable Semaglutide

Semaglutide comes in two forms: a daily pill and a weekly injection. Both are effective and can help patients lose weight. Each has their advantages and drawbacks which should be weighed against the patient’s risk factors and medical history. Let’s explore some of the pros and cons of each option. 

Oral Semaglutide: Pros & Cons

Oral semaglutide—sometimes known under the brand name Rybelsus—is the oral form of semaglutide. It is less commonly prescribed for medical weight loss but can be a good option if certain factors exist. 

Pro: Convenience

Taking a pill every day is often easier for patients since they likely already take medications daily. There is no need to remember to take the medication once per week like there is with the injectable.  

Con: Lower Dosage

The oral form of semaglutide contains a lower dose of the medication that is then administered more frequently. This can be a con for some patients who want to see results quickly or whom may benefit from an increased dose. 

Pro: Fewer Side Effects

Because the oral form has a lower dosage, patients tend to experience fewer and less severe side effects than the injectable. This will vary between patients, but the pill usually does not come with intense side effects like the injectable sometimes does. 

Con: Potentially Less Effective

While the pill form of semaglutide has been shown to help patients lose weight, it is believed to be about 80% as effective as the injectable. This is still exceptionally effective, but given natural variances in biology and patient reaction to the medications, some patients may not see the best results with the pill version of semaglutide. 

Pro: More Approachable

Injecting yourself can be daunting and even scary for some patients. Taking a pill is much more familiar and approachable than injectable medications. 

Con: Must Pass Through The Digestive System

The digestive system can reduce the efficacy of medications by breaking down certain components that could otherwise offer benefits. The injectable form bypasses this which may be one reason why it is sometimes more effective. 

Pro: May Experience Fewer Shortages

Semaglutide and other GLP-1 medications have experienced shortages since 2022 when they first became available for weight loss. While all GLP-1s do still experience occasional shortages, oral semaglutide is largely in supply and meeting demand, especially in comparison to injectable semaglutide. 

Con: Must Be Taken At Strict Intervals

While more convenient to take a daily pill, it must be taken with food and simultaneously every day. This can be difficult to achieve with a busy lifestyle. 

Pro: No Risk Of Infection

Injectable semaglutide comes with a small risk of injection or skin irritation due to the administration of the medication. Oral semaglutide does not come with these risks. 

Con: Less Customizable Doses

Injectable semaglutide is highly customizable based on dosage. Oral semaglutide does not come with that same flexibility. 

Injectable Semaglutide: Pros & Cons

Injectable semaglutide may be best known under the brand names Ozempic and Wegovy. It is most commonly prescribed for medical weight loss. 

Pro: Highly Effective

Injectable semaglutide is extremely effective for patients looking to start a weight loss journey. Studies have shown patients to lose up to 15% of their body weight within the trial period. 

Con: Side Effects

When starting semaglutide, patients may experience gastrointestinal side effects that can be uncomfortable and more intense than expected. These should resolve once a patient’s body becomes used to the medication. 

Pro: Bypasses Digestive System

Bypassing the digestive system allows a patient to get the full benefits of semaglutide and may also result in faster delivery and results.  

Con: Not As Easy To Remember

As a weekly injection, it can be more difficult for patients to remember to administer their medication than with a daily pill. Setting alarms and reminders may be necessary. 

Pro: Customizable Dosing

As patients adjust to taking semaglutide, their provider can alter the dosage to fit them, their needs, and the initial results they see. This can help stave off side effects and allow patients to see better overall results. 

Con: More Difficult To Administer

While many patients get used to giving themselves injections, it does involve instruction and practice. For some, it can be difficult to become comfortable with and others may rely on someone else to give them the injection. It also requires more supplies like needles, alcohol pads, and a sharps container for safe disposal. 

Pro: May Be Better For People With Gastrointestinal Issues

The injectable Semaglutide form can cause gastrointestinal side effects, but for patients with existing gastrointestinal diseases or issues, the injectable form may be a better option. This is because it does not have to pass through the digestive system. 

Con: Possible Shortages

As previously mentioned, many GLP-1 medications have faced shortages on and off since 2022. This has affected injectable semaglutide medications like Ozempic and Wegovy the most. While the shortages are getting better, patients may still face this difficulty going forward. 

Pro: Stronger Dosages Available

Stronger does and more dose flexibility is available with the injectable form of semaglutide than with the oral form. This may make it more effective for weight loss in certain people. 

Con: Small Risk Of Infection

Infection and skin irritation are possible at or around the injection site. This can be prevented with proper injection protocol and rotation of the injection site. 

Conclusion

Semaglutide—no matter the form of the medication—has offered a game-changer in the medical weight loss world. It can help patients lose weight while improving their lifestyle with fewer setbacks than with traditional weight loss methods. It also comes with potential cardiovascular benefits not available long term with other weight loss techniques.