Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Rybelsus (Semaglutide). If you are concerned about side effects, discuss the risks and benefits of Rybelsus (Semaglutide) with your doctor.

The following side effects have been reported by at least 1% of people taking Rybelsus (Semaglutide). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• bloating
• burping or gas
• change in sense of taste
• Constipation
• decreased appetite
• Diarrhea
• heartburn
• nausea
• stomach pain
• tiredness
• upset stomach
• vomiting
• weight loss

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• fast heartbeat
• signs of low blood glucose (e.g., anxiety, blurred vision, confusion, difficulty concentrating, difficulty speaking, dizziness, drowsiness, fast heartbeat, feeling jittery, headache, hunger, irritability, nausea, nervousness, numbness or tingling of the lips or tongue, sweating, tiredness, trembling, weakness)
• symptoms of gallstones (e.g., intermittent, severe, dull pain in the upper right part of the abdomen; nausea; vomiting; intolerance of fatty or greasy foods)
• changes caused by diabetic retinopathy (e.g., blurred or changing vision, floaters, changes in colour vision)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• severe Hypoglycemia (e.g., disorientation, loss of consciousness, seizures)
• signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, Fever, chills, rapid heartbeat, swollen abdomen)
• symptoms of a serious allergic reaction (e.g., swelling of the face or throat, difficulty breathing, wheezing, or itchy skin rash)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Rybelsus (Semaglutide).

3 mg
Each white-to-light-yellow, oval-shaped tablet, debossed with "3" on one side and "novo" on the other side, contains 3 mg of Rybelsus (Semaglutide). Nonmedicinal ingredients: magnesium stearate, microcrystalline cellulose, povidone K 90, and salcaprozate sodium (SNAC).

7 mg
Each white-to-light-yellow, oval-shaped tablet, debossed with "7" on one side and "novo" on the other side, contains 7 mg of Rybelsus (Semaglutide). Nonmedicinal ingredients: magnesium stearate, microcrystalline cellulose, povidone K 90, and salcaprozate sodium (SNAC).

14 mg
Each white-to-light-yellow, oval-shaped tablet, debossed with "14" on one side and "novo" on the other side, contains 14 mg of Rybelsus (Semaglutide). Nonmedicinal ingredients: magnesium stearate, microcrystalline cellulose, povidone K 90, and salcaprozate sodium (SNAC).

Do not take Rybelsus (Semaglutide) if you:

• are allergic to Rybelsus (Semaglutide) or any ingredients of the medication
• are pregnant
• are breast-feeding
• have multiple endocrine neoplasia syndrome type 2 (a disease where people have tumours in more than one gland in their body)
• have a personal or family history of thyroid cancer

There may be an interaction between Rybelsus (Semaglutide) and any of the following:

• acetylsalicylic acid (ASA)
• antipsychotics (e.g., aripiprazole, cariprazine, clozapine, olanzapine, quetiapine, risperidone)
• basiliximab
• beta adrenergic blockers (e.g., acebutolol, atenolol, carvedilol, labetalol, propranolol, sotalol)
• bismuth subsalicylate
• buserelin
• corticosteroids (e.g., beclomethasone, cortisone, dexamethasone, hydrocortisone, prednisone)
• danazol
• decongestants (e.g., phenylephrine, pseudoephedrine)
• diazoxide
• disopyramide
• diuretics (e.g., furosemide, hydrochlorothiazide, indapamide)
• elagolix
• epinephrine
• estrogens (e.g., estradiol, ethinyl estradiol, conjugated estrogen)
• everolimus
• GLP-1 agonists (e.g., dulaglutide, liraglutide)
• glucagon
• goserelin
• Hepatitis C antivirals (e.g., elbasvir and grazoprevir, glecaprevir and pibrentasvir, ledipasvir, velpatasvir, voxilaprevir)
• HIV protease inhibitors (e.g., atazanavir, lopinavir, ritonavir, tipranavir)
• hydroxychloroquine
• insulin and insulin secretagogues (e.g., gliclazide, glimepiride, glyburide)
• leuprolide
• levothyroxine
• linezolid
• mifepristone
• monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
• niacin
• pegvisomant
• progestins (e.g., cyproterone, levonorgestrel, medroxyprogesterone, norethindrone, progesterone)
• protein kinase inhibitors (e.g., bortezomib, ceritinib, dabrafenib, nilotinib, sunitinib)
• quinolone antibiotics (e.g., ciprofloxacin, levofloxacin, moxifloxacin, norfloxacin)
• selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, paroxetine, sertraline)
• sirolimus
• somatostatin analogues (e.g., lanreotide, octreotide, pasireotide)
• somatrogon
• somatropin
• sulfamethoxazole
• tacrolimus
• temsirolimus
• terbutaline
• testosterone
• tramadol
• venetoclax
• vilazodone
• vorinostat

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Rybelsus (Semaglutide). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Rybelsus (Semaglutide).

Diabetes identification: It is important to either wear a bracelet (or necklace) or carry a card indicating you have diabetes and are taking medication to manage your blood glucose levels.

Dizziness/reduced alertness: Rybelsus (Semaglutide) may cause episodes of low blood glucose which can cause dizziness or reduced alertness. Avoid driving, operating machinery, or performing other potentially hazardous tasks when you are experiencing low blood glucose levels.

Heart problems: Rybelsus (Semaglutide) may increase heart rate and may affect how electrical impulses travel through the heart muscle. If you have heart disease or an abnormal heart rhythm (e.g., heart block or fast heart rate), discuss with your doctor how Rybelsus (Semaglutide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Rybelsus (Semaglutide), and whether any special monitoring is needed.

Kidney function: Rybelsus (Semaglutide) may cause decreased kidney function. If you have reduced kidney function or Kidney Disease, discuss with your doctor how Rybelsus (Semaglutide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Rybelsus (Semaglutide), and whether any special monitoring is needed.

Low blood glucose (hypoglycemia): People who use Rybelsus (Semaglutide) and are also taking a sulfonylurea (e.g., glyburide, gliclazide) or insulin to control high blood sugar are more at risk of experiencing hypoglycemia (low blood sugar). If you experience symptoms of hypoglycemia such as a cold sweat, nervousness or shakiness, fast heartbeat, headache, hunger, confusion, lightheadedness, weakness, and numbness or tingling of the tongue or lips, contact your doctor. Your doctor may need to adjust the dose of your medication(s).

Pancreatitis (inflammation of the pancreas): Rybelsus (Semaglutide) can cause pancreatitis. If you experience symptoms of pancreatitis such as severe and persistent abdominal pain that may move to the back with or without vomiting, contact your doctor immediately. If you have previously had pancreatitis, discuss with your doctor how Rybelsus (Semaglutide) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Rybelsus (Semaglutide), and whether any special monitoring is needed.

Risk of thyroid cancer: In rare cases, people have developed thyroid cancer while using medications similar to Rybelsus (Semaglutide). People with a personal or family history of thyroid cancer or people who have multiple endocrine neoplasia syndrome type 2 (a disease where people have tumours in more than one gland in their body) should not use Rybelsus (Semaglutide). If you develop difficulty swallowing or breathing, hoarseness or notice a mass developing in your neck, contact your doctor as soon as possible.

Vision: Diabetic retinopathy is a complication of diabetes that results from uncontrolled blood glucose levels. When blood glucose levels are brought under control quickly, symptoms of retinopathy may become worse for a short period of time. If you experience vision changes with the use of Rybelsus (Semaglutide), talk to your doctor.

Pregnancy: Rybelsus (Semaglutide) should not be used during pregnancy unless the benefits outweigh the risks. Those who plan on becoming pregnant should talk to their doctor and are advised to stop taking Rybelsus (Semaglutide) for at least 2 months before becoming pregnant. If you become pregnant while taking Rybelsus (Semaglutide), contact your doctor immediately.

Breast-feeding: It is not known if Rybelsus (Semaglutide) passes into breast milk. If you are breast-feeding and taking Rybelsus (Semaglutide), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Rybelsus (Semaglutide) have not been established for children.