The Wegovy Pill is Here!
- Valerie Sutherland, MD
- 3 days ago
- 3 min read
Wegovy was recently approved in tablet form in December 2025. What are the important things to know about this new treatment option?
There are two differences in the FDA approval between the Wegovy injections and the Wegovy tablets which may or may not make a difference for you. The tablets are only FDA approved for weight management and for the reduction of major cardiovascular events in adults with known cardiovascular disease and overweight or obesity and the tablets are only approved in patients ages 18 and older. The two differences are that the Wegovy injections are FDA approved also to treat metabolic associated fatty liver disease and the injections are approved for ages 12 years and older.
The weight loss results between the tablets and injections are similar: about 15% at 64 weeks, which is about 12 weeks of dose titration and then 52 weeks of treatment dose, approximately.
The cost of the tablets and injections is similar, although the tablets may be about $50 less per month. The tablets are currently on a special of $149 a month for the first two months and then $299 a month after that. The injections are currently on a special of $199 a month for the first two months, and then $349 a month after that. Prices and specials are subject to change by the manufacturer, of course! These are out of pocket costs with no insurance.
With administration, the tablets are taken once a day, or about 30 times per month. Of course, the injections are once a week, or about 4 times per month.
There are four different strengths of the tablets and five different strengths of the injections. The tablets come in 1.5 mg, 4 mg, 9 mg and 25 mg tablets. The injections come in 0.25 mg, 0.5 mg, 1 mg, 1.7 mg and 2.4 mg strengths.
Note, while this is news that Wegovy tablets are newly FDA approved, semaglutide was approved in oral form as Rybelsus in 2019 to treat Type 2 Diabetes. The maximum strength of Rybelsus is 14 mg. I do not know yet if Rybelsus and Wegovy tablets are biochemically identical with just differences in strength. My experience is that Rybelsus did not become very popular. I will do more research.
The tablets may be considered as either a weight maintenance strategy for people who have lost weight on the injections and transition to the tablets to prevent weight recurrence, or as an initial weight loss strategy for people who have not used the injections or lost weight yet.
The prescribing information for Wegovy tablets notes that oral medication absorption may be affected more than the injections. For example, levothyroxine exposure increased by a third in people taking the tablets. The label recommends consideration of monitoring for medications when changes in absorption may have an impact. It does not state that a second form of contraception is needed with oral contraceptives like the label on another weight loss injection does, but oral contraceptives come in small doses measured in micrograms instead of milligrams like levothyroxine, so it is a question that I have.
Side effects of Wegovy tablets are similar to those of the injections and include, but are not limited to, in addition to the commonly known GI side effects, depression or thoughts of suicide, dysesthesia (sensitive skin), gallbladder problems, increased heart rate, changes in vision in people with type 2 diabetes, and dehydration that can lead to kidney problems. Nausea occurred in 42% of people, vomiting in 36%, diarrhea in 22%, for example.
To take Wegovy tablets, the medication is taken once daily on an empty stomach with water. Patients need to wait at least 30 minutes before eating food, drinking beverages, or taking other oral medications.
Nearly half of people lost 15% or more of their starting weight. Of course, this means that a little over half of people lost less than 15% of their starting body weight. It is fantastic news that there is another treatment option that may be preferred by some people. As always, work with your healthcare provider to monitor and tailor for you for the best results with the lowest risk and best tolerability. If you are having expected weight loss results but want more weight loss or other health outcome goals, too, remember this is just one part of a comprehensive approach. There are still serious barriers we are facing with successful long term weight management, most predominantly high discontinuation rates (more than half of people stop these within a year currently). We will see if having a tablet option helps or not!
Let us know if we can help!
Take Back Your Health,
Valerie Hope-Slocum Sutherland, MD
Artificial Intelligence I was NOT used in the writing of this blog. It is solely the thoughts and naturally curated intelligence over the last 21 years of practice of Valerie Sutherland, MD, for better or for worse!
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wonder if insurance will ever cover these