Ozempic tablets reach US pharmacies, replacing Rybelsus

Novo Nordisk started shipping Ozempic (semaglutide) tablets to US pharmacies on Monday, May 4, 2026, in 1.5 mg, 4 mg and 9 mg strengths for adults with type 2 diabetes ^[3][4]. The tablets replace Rybelsus, the oral semaglutide brand sold in the US since 2019, which the company says will be retired as a US brand ^[5].

This is more than a name swap. The pill itself is a reformulated version of oral semaglutide that the FDA approved in December 2024 and that was rebranded as Ozempic tablets on January 30, 2026 ^[2]. Novo says the new formulation improves absorption, so the same effect is delivered in a smaller tablet at a lower milligram number ^[5]. Michael Radin, MD, Novo's executive director of diabetes medical affairs, told Fierce Pharma that the 3 mg, 7 mg and 14 mg Rybelsus doses correspond to the new 1.5 mg, 4 mg and 9 mg Ozempic tablet strengths, respectively ^[5]. Clinicians are being told directly that the two products are not interchangeable milligram for milligram ^[4][6].

The indications are narrower than for the Ozempic injection. Ozempic tablets are approved to improve blood sugar along with diet and exercise in adults with type 2 diabetes, and to reduce the risk of major cardiovascular events — cardiovascular death, non-fatal heart attack or non-fatal stroke — in adults with type 2 diabetes at high risk for those events ^[2][4]. The injection carries an additional kidney indication ^[2][3]. Neither form is approved for children ^[3]. Like other semaglutide products, the tablets carry a boxed warning for thyroid C-cell tumors, and the most common side effects include nausea, vomiting, diarrhea, abdominal pain, constipation and decreased appetite ^[2][3]. The tablets are taken once daily in the morning on an empty stomach ^[2].

Prices and where to get it

Novo says the pill will be available through more than 70,000 US pharmacies, plus select telehealth providers and its direct-to-patient NovoCare Pharmacy — the first time oral semaglutide for type 2 diabetes has been offered through that channel ^[3][5]. The company says most insured patients with type 2 diabetes will pay as little as $25 for up to a three-month prescription, though government beneficiaries are excluded and restrictions apply ^[3]. Self-pay prices through NovoCare Pharmacy or select telehealth partners are $149 for the 1.5 mg starting dose, $199 a month for 4 mg and $299 a month for 9 mg, with one month defined as a bottle of 30 tablets ^[3][4]. Novo says it can change or cancel the program at any time ^[3].

The pill is manufactured end to end in the US, largely through Novo's North Carolina operations, and executives say they are confident in supply ^[5].

Why it matters for patients

If you take Rybelsus, the number on your bottle is about to change even if your treatment does not. Because the strengths do not line up one to one, a prescription written for Rybelsus 7 mg does not translate directly into a bottle of Ozempic tablets at the same number ^[4][5][6]. Novo's guidance is that current Rybelsus patients "should continue their medication as directed" and talk to their health care professional about transitioning to the Ozempic pill "as appropriate" ^[3][5]. The exact pharmacy mechanics — including how long existing Rybelsus stock will last at individual pharmacies and when wholesaler shipments stop — are not spelled out in these sources.

Insurance coverage is also worth watching, since a rebranded product with new strengths carries new product codes and may sit differently on a plan's formulary. The sources do not describe how individual plans are handling the switch.

Rybelsus continues to be marketed outside the United States, so this change is US-only ^[3][5].

What happens next

Novo filed a supplemental application earlier in 2026 for Ozempic tablets at 25 mg for adults with type 2 diabetes and expects an FDA decision by the end of 2026 ^[3].

Separately, a tablet form of Wegovy (semaglutide) for weight management was approved December 22, 2025 in 1.5 mg, 4 mg, 9 mg and 25 mg strengths, and Eli Lilly's orforglipron pill, Foundayo, has launched as a competitor in obesity ^[2][5].