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Alternative to Rybelsus · Injection

Ozempic

Ozempic is Novo Nordisk's once-weekly semaglutide injection for adults with type 2 diabetes. It contains the same active ingredient as Rybelsus but is injected under the skin once a week instead of swallowed every day. Since 2026 the Ozempic name in the US also covers the semaglutide tablets formerly sold as Rybelsus.

Rybelsus vs Ozempic: full comparison

Ozempic
Medicine
semaglutide (injection)
Made by
Novo Nordisk
Form
Injection, once weekly
Class
GLP-1 receptor agonist
Licensed for
Type 2 diabetes; cardiovascular risk reduction
Strengths
0.25 mg · 0.5 mg · 1 mg · 2 mg
First approved
5 December 2017US (FDA)

Key facts

  • First approved by the FDA on 5 December 2017 and authorised by the European Commission on 8 February 2018.
  • Dosing: 0.25 mg once weekly for 4 weeks (a starting dose), then 0.5 mg; it can be increased to 1 mg and then to a maximum of 2 mg, each after at least 4 weeks on the previous dose.
  • US indications: blood sugar control in adults with type 2 diabetes; reducing major cardiovascular events in adults with type 2 diabetes and established cardiovascular disease; and reducing the risk of kidney failure, sustained eGFR decline and cardiovascular death in adults with type 2 diabetes and chronic kidney disease (added 28 January 2025 after the FLOW trial).
  • In the EU and UK the licensed indication is blood sugar control in type 2 diabetes; cardiovascular and kidney trial results are described in the product information rather than as separate indications.
  • SUSTAIN-6: major cardiovascular events 6.6% vs 8.9% with placebo (hazard ratio 0.74). FLOW: 24% lower risk of the main kidney outcome (hazard ratio 0.76).
  • SUSTAIN FORTE (40 weeks): HbA1c fell 2.2 points with 2 mg vs 1.9 points with 1 mg, and weight by 6.9 kg vs 6.0 kg (trial product estimand).
  • Not licensed for weight loss; the semaglutide brand for weight management is Wegovy.
  • In the US the FDA approved the Ozempic name for the 1.5/4/9 mg semaglutide tablets (formerly Rybelsus) on 30 January 2026; these Ozempic tablets launched on 4 May 2026.
  • The US tablet label allows people on Ozempic 0.5 mg injections to switch to tablets (4 mg or 9 mg Ozempic tablets, or 7 mg or 14 mg Rybelsus) one week after the last injection.
  • US labelling carries a boxed warning about thyroid C-cell tumours seen in rodents; the EU and UK labels have no boxed warning.
  • Pens are kept in the fridge until use. Regulators in the US, UK, EU and WHO have reported falsified Ozempic pens since 2023.

Where Ozempic is available

CountryStatusNotes
US United States Available Once-weekly semaglutide injection for type 2 diabetes, FDA-approved in December 2017. NovoCare Pharmacy self-pay: $199 a month for the first two months of 0.25 mg or 0.5 mg for new patients (offer through 31 December 2026), then $349 a month for 0.25 mg, 0.5 mg or 1 mg and $499 a month for 2 mg.
UK United Kingdom Available Weekly semaglutide injection licensed for type 2 diabetes only (0.25 mg to 2 mg). NICE's 2026 update of NG28 specifically recommends it, at up to 1 mg a week, for people with type 2 diabetes and atherosclerotic cardiovascular disease. The GPhC notes that it is sometimes prescribed off-label for weight loss.
CA Canada Available Weekly semaglutide injection for type 2 diabetes. Since the generics arrived, Ontario treats Ozempic and generic semaglutide as interchangeable: the ODB price for an Ozempic pen is CAD 227.94 but the plan pays up to the generic price of CAD 78.141. BC PharmaCare covers it with Special Authority.
AU Australia Available Weekly semaglutide injection for type 2 diabetes, PBS-subsidised under restriction criteria (Chemist Warehouse lists it at the $25.00 PBS general co-payment). It is not registered for weight loss, and the TGA says advertising it for weight loss is illegal. A new 0.68 mg/mL 3 mL starter pen replaced the older 0.25/0.5 mg pen, which was deleted from the market on 31 December 2025.
IE Ireland Available Weekly semaglutide injection for type 2 diabetes. It is reimbursed by the HSE and appears on the July 2026 list of approved diabetes medicines, so it is free under the Long-Term Illness Scheme and covered by the medical card and the Drugs Payment Scheme when prescribed for type 2 diabetes.
NZ New Zealand Unconfirmed We found no Ozempic data sheet in Medsafe's index and semaglutide is not on the Pharmac Schedule, so Ozempic does not appear to be marketed in New Zealand. We could not confirm its consent status.
DE Germany Available Weekly semaglutide injection for type 2 diabetes. Covered by GKV for diabetes with the EUR 5-10 co-payment; not covered when used for weight loss.
FR France Available Weekly semaglutide injection. Reimbursed at 30% for type 2 diabetes in combination with metformin or a sulfonylurea; EUR 77.60 per 1 mg pen including the dispensing fee.
ES Spain Available Weekly semaglutide injection. SNS-funded with visado for type 2 diabetes (funded since 1 June 2019 for the 1 mg pen); not funded for weight loss.
IT Italy Available Weekly semaglutide injection. Class A for type 2 diabetes under Note 100; EUR 168.82 per pen (AIFA list, 30 April 2026).
NL Netherlands Available Weekly semaglutide injection. Fully reimbursed for type 2 diabetes under the same GVS Bijlage 2 conditions as Rybelsus (cost counts toward the eigen risico); not covered for weight loss.
AE United Arab Emirates Available Ozempic pens are on sale at UAE pharmacies: AED 743.50 for the 0.25 mg and 0.5 mg pens, AED 1,146 for 1 mg and AED 1,550 for 2 mg (September 2026).
IN India Available Launched in India on 12 December 2025. Novo Nordisk cut Ozempic prices by up to 36% in 2026 after generic semaglutide launched.
SG Singapore Approved, not launched Registered with HSA (Novo Nordisk Pharma (Singapore) Pte Ltd) for type 2 diabetes. Semaglutide is excluded from MAF subsidy.
ZA South Africa Available Registered on 7 July 2020 (53/21.13/0497). Single Exit Price R1,826.78 or R3,352.03 depending on the pack, plus dispensing fee.

Sources

  1. Drugs@FDA: NDA 209637 (Ozempic injection) accessdata.fda.gov
  2. DailyMed: Ozempic (semaglutide) injection prescribing information dailymed.nlm.nih.gov
  3. FDA approval letter NDA 209637/S-025 (FLOW kidney indication), 2025-01-28 accessdata.fda.gov
  4. EMA: Ozempic product information ema.europa.eu
  5. Marso SP et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes (SUSTAIN-6). N Engl J Med 2016;375:1834-1844 nejm.org
  6. Perkovic V et al. Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes (FLOW). N Engl J Med 2024;391:109-121 nejm.org
  7. Frias JP et al. Semaglutide 2.0 mg vs 1.0 mg in type 2 diabetes (SUSTAIN FORTE). Lancet Diabetes Endocrinol 2021;9:563-574 doi.org
  8. FDA approval letter NDA 213051/S-030 (Ozempic tablets name), 2026-01-30 accessdata.fda.gov
  9. DailyMed: Rybelsus and Ozempic (semaglutide) tablets prescribing information dailymed.nlm.nih.gov
  10. FDA: Counterfeit Ozempic (semaglutide) found in U.S. drug supply chain fda.gov
  11. WHO Medical Product Alert N2/2024: Falsified Ozempic (semaglutide) (2024-06-19) who.int
  12. NHS: Semaglutide (last reviewed 2026-05-15) nhs.uk