Rybelsus (Oral Semaglutide 14 mg, Diabetes)

Rybelsus (Oral Semaglutide 14 mg) stands alone as the only oral GLP-1 approved for both glycemic control and cardiovascular risk reduction in type 2 diabetes, a dual indication that expands its therapeutic reach since its September 2019 debut as the first oral GLP-1. By leveraging Novo Nordisk's SNAC absorption enhancer, it overcomes gastric degradation to deliver systemic absorption, and the SOUL trial (n=9,650) confirmed a 14% relative reduction in major adverse cardiovascular events versus placebo over 4 years, earning FDA approval for cardiovascular risk reduction in October 2025. Rybelsus requires strict fasting: an empty stomach, no more than 120 mL of water, and 30 minutes without food or medications. For T2D patients with established cardiovascular disease, Rybelsus remains the definitive oral option, even as oral Wegovy (25 mg) enters the market.