The Ozempic pill: what happened to Rybelsus in the US

The Ozempic pill is the new US name for Rybelsus. On 30 January 2026 the FDA approved changing the name of the newer 1.5, 4 and 9 mg Rybelsus tablets to Ozempic (semaglutide) tablets, and they went on sale on 4 May 2026.⁴⁶ The medicine is the same: semaglutide, for the same uses in adults with type 2 diabetes, taken in the same way.¹ The Rybelsus brand is being phased out in the US: according to an Illinois Medicaid notice, shipments of Rybelsus tablets to wholesalers stopped in May 2026, with remaining stock expected to become limited from July 2026.¹² The US label and the FDA's drug database still listed Rybelsus 3, 7 and 14 mg in September 2026, and Novo Nordisk says Rybelsus continues to be sold outside the US.¹²⁶

The rename timeline

Many news reports give 4 February as the approval date. That was the day of Novo Nordisk's announcement; the FDA approval letter is dated 30 January.⁴⁵ Novo Nordisk says the tablets are made "end-to-end" in the US.⁶

What changed and what stayed the same

What stayed the same. The active ingredient is still semaglutide. The licensed uses are unchanged: blood sugar control in adults with type 2 diabetes, and reducing the risk of major cardiovascular events (cardiovascular death, non-fatal heart attack or non-fatal stroke) in adults with type 2 diabetes at high risk. So are the rules for taking it: an empty stomach, a small sip of water and a wait of at least 30 minutes before food, drink or other tablets.¹ Novo Nordisk says the new tablets have the same efficacy and safety profile as the original formulation, based on a bioequivalence study, a study that checks whether two formulations produce matching levels in the blood.⁵⁷

What changed. The US prescribing information lists four differences:¹

• the brand name: Ozempic tablets instead of Rybelsus;
• the dose numbers: 1.5, 4 and 9 mg instead of 3, 7 and 14 mg;
• the tablet shape: round instead of oval;
• the inactive ingredients: the new tablets contain only SNAC (the absorption enhancer) and magnesium stearate, while the old ones also contain microcrystalline cellulose and povidone.

The dose numbers are lower because more semaglutide is absorbed from the new tablet. Absolute bioavailability, the share of the dose that reaches the bloodstream, is about 1% to 2% for the new tablets against about 0.4% to 1% for the old ones, and blood levels were not clinically different between matching strengths.¹⁷

One source of confusion: in the US the Ozempic name now covers both the weekly injection and the daily tablets. Neither is the same product as the Wegovy pill, which is licensed for weight management.⁶⁸

How Ozempic pill doses match Rybelsus doses

The pairs above are equivalent, but the US label says the products are "not substitutable on a mg-to-mg basis" and gives its own switching rules:¹⁷

• The switching table covers only the maintenance doses: Rybelsus 7 mg to Ozempic tablets 4 mg, and Rybelsus 14 mg to Ozempic tablets 9 mg.
• The label says not to switch during the first 30 days of treatment, the initiation phase.
• After day 30, the new product starts the day after the last dose of the old one.

It is still one tablet a day. Taking two tablets to reach an old dose number is never allowed.¹ Our Rybelsus dosage guide covers the full titration schedule and the maximum dose in other regions.

Do you need a new prescription for the Ozempic pill?

US insurers say you do. Illinois Medicaid told providers in May 2026 that its members "will not be automatically converted from Rybelsus to Ozempic tablets. A new prescription is required for any transition."¹² Priority Health said in August 2026 that members currently prescribed Rybelsus "will need a new prescription for Ozempic tablets", and that existing prior authorisations (the insurer's advance approval) transfer automatically.¹³ Both notices map Rybelsus 7 mg to Ozempic tablets 4 mg and 14 mg to 9 mg, in line with the label.¹²¹

We found no FDA or Novo Nordisk statement on whether a new prescription is a legal requirement rather than insurer policy. Novo Nordisk told Rybelsus patients to continue their medication as directed and to "speak with their healthcare professionals about transitioning" to the Ozempic pill; before the launch, it told them not to stop treatment without speaking to a healthcare professional.⁶⁵ The label also treats the two products as not substitutable milligram for milligram.¹ Rules can differ between insurers and pharmacies, so confirm with your prescriber or pharmacist how your prescription and any prior authorisation will be handled.

How much does the Ozempic pill cost in the US?

When the tablets launched, Novo Nordisk announced these self-pay prices (press release of 1 May 2026) for a bottle of 30 tablets, one month's supply, bought through NovoCare Pharmacy or selected telehealth providers:⁶

• 1.5 mg: $149
• 4 mg: $199 a month
• 9 mg: $299 a month

People covered by government health programmes are excluded from these self-pay prices. With commercial insurance, Novo Nordisk says eligible patients can pay as little as $25 a month for up to 3 months (maximum saving $100 a month), with restrictions.⁶ Prices change after launch, so treat these as dated figures. Our US page lists current prices and suppliers, and Rybelsus prices compares costs across countries.

The Ozempic pill vs the Wegovy pill

Both are once-daily oral semaglutide tablets from Novo Nordisk, taken with the same empty-stomach routine, but they are separate products with different licences:

Some strengths share the same numbers, but the products are not interchangeable, and semaglutide products should not be combined with each other or with other GLP-1 medicines.⁸¹ The Wegovy pill's US label also notes that it has not been studied for weight loss in people with type 2 diabetes, in whom semaglutide levels were lower.⁸ For a fuller comparison, see Rybelsus vs the Wegovy pill.

Rybelsus outside the US

The rename applies only in the US. Novo Nordisk says Rybelsus continues to be marketed outside the US, and the newer round tablets are sold there as Rybelsus.⁶

• UK: Rybelsus 1.5, 4 and 9 mg only. The 3, 7 and 14 mg tablets are listed as discontinued, and the MHRA expected old stock to run out around 31 January 2026.¹⁰
• EU: Rybelsus 1.5, 4 and 9 mg, 3, 7 and 14 mg, and 25 and 50 mg are all authorised.¹¹

The UK made the same move to the new strengths in September 2025, and the MHRA has warned that adding tablets to match an old dose number causes overdosing.¹⁰ Names, strengths, prescription rules and prices differ from country to country, so choose your country for local details, or go straight to the UK or US guide.