Wegovy Pill Approved by FDA
A pill version of the popular weight-management drug Wegovy has received approval from the Food and Drug Administration (FDA) and is now accessible through various pharmacies and telehealth services in the U.S.
This medication has been available as a weekly injection since 2021. Like its injectable counterpart, the new Wegovy pill contains semaglutide, which is the same active ingredient found in Ozempic. The drug functions by mimicking the glucagon-like peptide-1 (GLP-1) hormone, which aids in regulating appetite and blood sugar levels.
Both the pill and the injection are approved for helping adults with obesity, as well as those who are overweight and face related health issues like high blood pressure, in losing weight and maintaining that loss, especially when combined with a reduced-calorie diet and increased physical activity. However, it’s important to note that only the injectable version is approved for use in children aged 12 and older with obesity; the pill hasn’t received such clearance yet.
Comparing Effectiveness: Pills vs. Injections
One of the major differences between the Wegovy pill and the injection is in how the drug enters the bloodstream. When injected, semaglutide goes directly into the blood. In contrast, the pill must first pass through the stomach and intestines, where some of the active ingredient can be broken down before absorption occurs.
This means that “only a small fraction [of the pill] reaches the bloodstream,” as noted by Dr. Chika Anekwe, an obesity medicine specialist at Massachusetts General Hospital and an instructor at Harvard Medical School. While the pill does introduce more semaglutide to the digestive tract, its effects there are minimal. Most of the benefits are only realized once the drug reaches systemic circulation.
In order to compensate for this, the pill version of Wegovy is administered at a considerably higher dose—25 milligrams compared to the 2.4 milligrams of the injectable form. Dr. Anekwe emphasized that the pill needs to be taken on an empty stomach with a small amount of water and requires waiting at least 30 minutes before consuming anything else. This is to ensure the medication is absorbed as intended, a restriction that doesn’t apply to the injection, which can be taken at any time of day.
Dr. Priya Jaisinghani, another expert in the field, pointed out that there hasn’t yet been a long-term, direct comparison trial between the daily pill and the weekly injection for adults with obesity. However, preliminary findings from separate trials suggest that both forms lead to similar levels of weight loss.
For instance, during the STEP-1 trial, participants using the 2.4 mg injectable lost an average of about 14.4% of their body weight, while those in the OASIS 4 trial, using the 25 mg pill, lost an average of about 13.9%. This suggests comparable effectiveness between the two options for weight management.
Safety Profiles of Both Forms
As for safety, both Wegovy pills and injections appear to share a similar side effect profile. “Oral and injectable Wegovy have very similar, predominantly gastrointestinal side effects,” according to Dr. Anekwe. Commonly reported effects include nausea, diarrhea, and vomiting. Around three-quarters of users report mild to moderate gastrointestinal symptoms, though only about 7% to 10% discontinue the medication due to these side effects.
Interestingly, some real-world data indicate that a higher percentage of patients may stop taking GLP-1 medications within a year, possibly due to a combination of side effects and costs.
Choosing Between the Pill and Injection
When it comes to choosing between the pill and the injection, patients might have different considerations. The pill could be a better option for someone who dislikes needles, or for frequent travelers who lack reliable refrigeration; it can be stored at room temperature, unlike the injectables that need to be kept cold. On the flip side, the strict regimen required for taking the pill—daily dosing on an empty stomach—might be tough for some to maintain, making the weekly injection a more convenient option.
Additionally, the cost and insurance coverage can influence the decision. If someone is uninsured, the pill may be a more affordable choice. However, it’s worth noting that the injectable form is approved for adolescents aged 12 and older, while the pill is only approved for adults. So that’s another factor to consider.
This article is for informational purposes only and is not meant to offer medical advice.
