Talking to your patients about RYBELSUS® at the pharmacy

RYBELSUS® is the first and only oral GLP-1 RA. Here is some important information to be sure to discuss with your patients when they come to pick up their prescription.

Indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes.

What is RYBELSUS®? (reb-EL-sus)

RYBELSUS® is the world’s first and only oral glucagon-like peptide-1 (GLP-1) receptor agonist1

See Section 17: Patient Counseling Information in the Prescribing Information

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Gradual dose escalation is designed to help patients adjust to therapy

For once-daily RYBELSUS® to work as planned, patients should take as directed. If a patient misses a dose, the missed dose should be skipped, and the next dose should be taken the following day.1

RYBELSUS® Gradual Dose Escalation

aThe 3-mg dose is intended for treatment initiation and is not effective for glycemic control.

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Important storage and administration instructions to share with patients

Be sure your patients understand how to take RYBELSUS®, in order for the medication to work as intended.

Storing RYBELSUS®1

The blister pack helps to protect the tablet, so patients will need to follow specific instructions for use

Storing RYBELSUS® - keep tablet in blister pack in a dry place, away from moisture, until ready to take it

Keep tablet in the blister pack in a dry place, away from moisture, until ready to take it

Storing RYBELSUS® - push tablet out of blister. Do not cut from the packaging

Push tablet out of blister. Do not cut from the packaging

Storing RYBELSUS® - swallow tablet whole. Do not split, crush, or chew

Swallow tablet whole.
Do not split, crush, or chew

Store at room temperature 68°F–77°F (20°C–25°C).

Taking RYBELSUS®1

Taking RYBELSUS® - Take RYBELSUS® upon waking on an empty stomach

Take RYBELSUS® upon waking

Patients must take RYBELSUS® on an empty stomach

Taking RYBELSUS® - Take with no more than 4oz of plain water

Take with no more than 4 oz of water

Patients should take RYBELSUS® with a sip of plain water

Taking RYBELSUS® - Wait 30 minutes before the first food, beverage, or other oral medications

Wait 30 minutes before the first food, beverage, or other oral medications

Waiting less than 30 minutes or taking with food, beverages (other than plain water), or other oral medications will lessen the effect of RYBELSUS®. Waiting more than 30 minutes to eat may increase the absorption of RYBELSUS®

See Prescribing Information »

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We’re committed to patient savings and support

Eligible Patients Pay As Little As $10 For 30-Day RYBELSUS® Prescription

aFor commercially insured patients only.
Additional eligibility and restrictions apply.

Patients can get the savings offer in 2 ways:

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Patients can text READY to 21848

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or download a savings card at SaveOnR.comb

Signing up for savings allows patients to enroll in patient support—either by text if they texted for savings, or by email if they downloaded a savings card online.

aFor commercially insured patients only. Additional eligibility and restrictions apply.
bMessage and data rates may apply. Check with mobile service provider. See Terms and Conditions of Use at RYBELSUS.com.

bMessage and data rates may apply. Check with mobile service provider. See Terms and Conditions of Use at RYBELSUS.com.

Have questions about processing the RYBELSUS® savings offer?

Call Pharmacy Connect at 1-888-401-0112 or email RpharmacyConnect@connectiverx.com if you need assistance processing the RYBELSUS® Savings Card.

Available Monday to Friday, 8:00 am – 8:00 pm ET, except holidays.

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How to dispense RYBELSUS®

All the information you need to order RYBELSUS® for your pharmacy

How to Dispense RYBELSUS®

aThe 3-mg dose is intended for treatment initiation and is not effective for glycemic control.

aThe 3-mg dose is intended for treatment initiation and is not effective for glycemic control.

Pharmacy Times® Perfect Consult video series

Watch this 2-part video series to prepare for counseling patients who are starting or currently taking RYBELSUS® as part of their type 2 diabetes treatment plan.

This is an industry-sponsored promotional video distributed by Pharmacy Times®. It was developed under the direction of, and paid for by, Novo Nordisk Inc.

Pharmacist counseling patient

Important Counseling Information and Dispensing Considerations for RYBELSUS®

Find out what you need to know to counsel patients about RYBELSUS® dosage, storage, administration, and savings support programs.

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Pharmacist consulting patient

A Pharmacy Consult for RYBELSUS®

Watch a pharmacist walk a patient through key information about RYBELSUS®, including when and how to take it, how to store it, common side effects, and more.

Watch video

Stay in the know about RYBELSUS®

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Selected Important Safety Information

WARNING: RISK OF THYROID C-CELL TUMORS

  • In rodents, semaglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures. It is unknown whether RYBELSUS® causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined
  • RYBELSUS® is contraindicated in patients with a personal or family history of MTC and in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk for MTC with the use of RYBELSUS® and inform them of symptoms of thyroid tumors (e.g. a mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with RYBELSUS®

Indications and Usage

RYBELSUS® (semaglutide) tablets 7 mg or 14 mg is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes.

Limitations of Use

  • RYBELSUS® is not recommended as a first-line therapy for patients who have inadequate glycemic control on diet and exercise because of the uncertain relevance of rodent C-cell tumor findings to humans
  • RYBELSUS® has not been studied in patients with a history of pancreatitis. Consider other antidiabetic therapies in patients with a history of pancreatitis
  • RYBELSUS® is not indicated for use in patients with type 1 diabetes or for the treatment of patients with diabetic ketoacidosis

Important Safety Information

WARNING: RISK OF THYROID C-CELL TUMORS

  • In rodents, semaglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures. It is unknown whether RYBELSUS® causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined
  • RYBELSUS® is contraindicated in patients with a personal or family history of MTC and in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk for MTC with the use of RYBELSUS® and inform them of symptoms of thyroid tumors (e.g. a mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with RYBELSUS®

Contraindications

  • RYBELSUS® is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), and in patients with known hypersensitivity to semaglutide or to any of the components in RYBELSUS®

Warnings & Precautions

  • Risk of Thyroid C-Cell Tumors: Patients should be further evaluated if serum calcitonin is measured and found to be elevated or thyroid nodules are noted on physical examination or neck imaging
  • Pancreatitis: Has been reported in clinical trials. Observe patients carefully for signs and symptoms of pancreatitis (including persistent severe abdominal pain, sometimes radiating to the back and which may or may not be accompanied by vomiting). If pancreatitis is suspected, discontinue RYBELSUS® and initiate appropriate management; if confirmed, do not restart RYBELSUS®
  • Diabetic Retinopathy Complications: In a pooled analysis of glycemic control trials with RYBELSUS®, patients reported diabetic retinopathy related adverse reactions during the trial (4.2% with RYBELSUS® and 3.8% with comparator). In a 2-year trial with semaglutide injection involving patients with type 2 diabetes and high cardiovascular risk, more events of diabetic retinopathy complications occurred in patients treated with semaglutide injection (3.0%) compared to placebo (1.8%). The absolute risk increase for diabetic retinopathy complications was larger among patients with a history of diabetic retinopathy at baseline than among patients without a known history of diabetic retinopathy.
    Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy. Patients with a history of diabetic retinopathy should be monitored for progression of diabetic retinopathy
  • Hypoglycemia: The risk of hypoglycemia is increased when RYBELSUS® is used in combination with insulin secretagogues (e.g., sulfonylureas) or insulin. Patients may require a lower dose of the secretagogue or insulin to reduce the risk of hypoglycemia in this setting
  • Acute kidney injury: There have been postmarketing reports of acute kidney injury and worsening of chronic renal failure, which may sometimes require hemodialysis, in patients treated with GLP-1 receptor agonists, including semaglutide. Some of these events have been reported in patients without known underlying renal disease. A majority of the reported events occurred in patients who had experienced nausea, vomiting, diarrhea, or dehydration. Monitor renal function when initiating or escalating doses of RYBELSUS® in patients reporting severe adverse gastrointestinal reactions
  • Hypersensitivity: Serious hypersensitivity reactions (e.g., anaphylaxis, angioedema) have been reported with GLP-1 receptor agonists, including semaglutide. If hypersensitivity reactions occur, discontinue use of RYBELSUS®, treat promptly per standard of care, and monitor until signs and symptoms resolve. Use caution in a patient with a history of angioedema or anaphylaxis with another GLP-1 receptor agonist

Adverse Reactions

  • The most common adverse reactions, reported in ≥5% of patients treated with RYBELSUS® are nausea, abdominal pain, diarrhea, decreased appetite, vomiting and constipation

Drug Interactions

  • The risk of hypoglycemia may be lowered by a reduction in the dose of concomitantly administered secretagogues or insulin
  • RYBELSUS® delays gastric emptying and has the potential to impact the absorption of other oral medications. Closely follow RYBELSUS® administration instructions when coadministering with other oral medications and consider increased monitoring for medications with a narrow therapeutic index, such as levothyroxine

Use in Specific Populations

  • Pregnancy: Available data with RYBELSUS® are not sufficient to determine a drug-associated risk for major birth defects, miscarriage, or other adverse maternal or fetal outcomes. Based on animal reproduction studies, there may be risks to the fetus from exposure to RYBELSUS®. Use only if the potential benefit justifies the potential risk to the fetus
  • Lactation: There are no data on the presence of semaglutide in human milk, the effects on the breastfed infant, or the effects on milk production. Because of the unknown potential for serious adverse reactions in the breastfed infant due to the possible accumulation of salcaprozate sodium (SNAC), an absorption enhancer in RYBELSUS®, from breastfeeding and because there are alternative formulations of semaglutide that can be used during lactation, advise patients that breastfeeding is not recommended during treatment with RYBELSUS®
  • Discontinue RYBELSUS® in women at least 2 months before a planned pregnancy due to the long washout period for semaglutide
  • Pediatric Use: Safety and efficacy of RYBELSUS® have not been established in pediatric patients (younger than 18 years)

Please click here for Prescribing Information, including Boxed Warning.

Reference:

  1. RYBELSUS® [package insert]. Plainsboro, NJ: Novo Nordisk Inc; January 2020.

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