Medication reference
Rybelsus dosing schedule in Canada
The Rybelsus tablet strengths, the dose steps, how to take the tablet and the missed dose rule, as the Canadian product monograph states them.
Key facts
- Rybelsus is a semaglutide tablet for use once daily.
- The tablets come as 3 mg, 7 mg and 14 mg (initial formulation) or as 1.5 mg, 4 mg and 9 mg (optimized formulation).
- The starting dose is one 3 mg tablet or one 1.5 mg tablet once a day for 30 days.
- Take the tablet on an empty stomach, with no more than half a glass of water (120 mL).
- Wait at least 30 minutes before the first food, drink or other oral medicine of the day.
Strengths and form
Rybelsus is a semaglutide tablet for oral use.
The product monograph gives the equivalent tablets of the two formulations. The 1.5 mg tablet is equivalent to the 3 mg tablet, 4 mg to 7 mg, and 9 mg to 14 mg.
The product monograph describes two formulations with different strengths:
- Initial formulation: 3 mg, 7 mg and 14 mg tablets.
- Optimized formulation: 1.5 mg, 4 mg and 9 mg tablets.
Dose schedule
The dose increases in steps. The product monograph says that this regimen is intended to mitigate gastrointestinal symptoms during dose escalation.
The 1.5 mg tablet and the 3 mg tablet are for the start of treatment. The product monograph says that they are not intended for glycemic control.
Initial formulation: the starting dose is 3 mg once daily. After 30 days, the dose should increase to a maintenance dose of 7 mg once daily. After at least 30 days on 7 mg, the dose can increase to a maintenance dose of 14 mg once daily. This step is for patients who need additional glycemic control.
Optimized formulation: the starting dose is 1.5 mg once daily. After 30 days, the dose should increase to a maintenance dose of 4 mg once daily. After at least 30 days on 4 mg, the dose can increase to a maintenance dose of 9 mg once daily. This step is also for patients who need additional glycemic control.
Maintenance and maximum dose
The maximum recommended single daily dose is the 14 mg tablet of the initial formulation or the 9 mg tablet of the optimized formulation.
Do not take more than one tablet of Rybelsus daily. Do not take two or more tablets of Rybelsus to obtain a higher dose.
The patient information says: do not change your dose unless your doctor has told you so. It also says: do not stop this medicine without talking to your doctor.
The product monograph recommends no dose adjustment based on age, sex, race, ethnicity, upper gastrointestinal disease or hepatic impairment. No dose adjustment is required for patients with mild, moderate or severe renal impairment.
How to take the tablet
Take Rybelsus on an empty stomach, at least 30 minutes before the first food, beverage or other oral medications of the day. The product monograph says that a wait of less than 30 minutes is likely to decrease the amount of semaglutide absorbed.
Take the tablet with no more than half a glass of water, equivalent to 120 mL. A larger volume of water is likely to decrease the amount of semaglutide absorbed.
Swallow the tablet whole. Do not split, crush or chew it. Take the tablet directly after you remove it from the blister card.
Missed dose
If a dose is missed, the product monograph says to skip the missed dose and to take the next dose the following day.
The patient information says: if you forget to take a dose, just take one tablet on the morning after.
Ask a health professional
This page repeats what the Canadian product monograph says. It is not medical advice. Ask your pharmacist or your prescriber what applies to you.