A pill version of the popular weight management drug Wegovy has been approved by the Food and Drug Administration (FDA) and is now available through various pharmacies and telemedicine services in the United States.
The drug has been available by prescription as a once-weekly injection in the U.S. since 2021. Like the injection, Wegoby’s new pill contains the same active ingredient as Ozempic, semaglutide. It works by mimicking glucagon-like peptide-1 (GLP-1), a hormone in the body that helps control appetite and blood sugar levels.
Both forms of Wegovy, when combined with a reduced-calorie diet and increased physical activity, are approved to help adults with obesity and adults who are overweight and have associated health conditions, such as high blood pressure, lose weight and keep it off. However, only the injectable version is approved for obese children over 12 years of age. The pill version has not yet been approved for that age group.
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Here’s what you need to know about Wegovy’s new pill and who will benefit most from it.
Are semaglutide tablets as effective as injections?
The main difference between Wegovy pills and injections is the way the drug enters the bloodstream.
When semaglutide is injected subcutaneously, it is absorbed directly into the bloodstream. However, when taken as a pill, the drug must first pass through the stomach and intestines, where some of the active ingredients are broken down by digestive enzymes before being absorbed through the intestinal lining and into the blood.
For this reason, “only a small portion” [of the pill] Dr. Chika Anneke, Clinical Director of Obesity Medicine at Massachusetts General Hospital Weight Center and Lecturer in Medicine at Harvard Medical School, explained that this is a generally expected difference between injectable and oral medications.
Although the pill exposes the gastrointestinal tract to more semaglutide than the injection, the local effect on the intestines is smaller, Anekwe explained. That’s because “significant effects still require absorption and systemic signaling,” and the drug only becomes effective once it reaches the bloodstream, she said.
To compensate for that digestive process, the tablet version of Wegovy is taken at a much higher dose than the injectable version. The maximum dose for the tablet is 25 milligrams, and weekly injections are 2.4 milligrams, Anekwe told LiveScience via email.
Anekwe said the pill also comes with strict instructions on when to take it. The drug label states that it should be taken on an empty stomach in the morning with a small amount of water, and that patients should wait at least 30 minutes before eating, drinking or taking other medications. This ensures that the drug is properly absorbed at the intended dose. The injectable version does not have these limitations. It can be taken at any time of the day and does not require fasting.
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Dr. Priya Jaisinghani, an endocrinologist and obesity medicine expert at New York University Langone Health, discussed the effectiveness of the two formulations at an Endocrine Society webinar on GLP-1 tablets in December 2025.
So far, “no long-term head-to-head trials have been conducted” comparing once-daily 25-milligram tablets versus once-weekly 2.4-milligram injections in obese adults, Jaisinghani said. However, results from clinical trials that tested the drugs separately suggest that the two versions lead to very similar weight loss when taken as directed.
In the STEP-1 trial, a study of 2.4 mg semaglutide injection, participants lost an average of about 14.4% of their body weight. In the OASIS 4 trial, a study of 25 mg tablets, participants lost an average of about 13.9% of their body weight. Jaisinghani said these results showed that the pill and the injection were “comparably effective in weight management.”
Are Wegovy pills as safe as injections?
The study also suggests that Wegovy tablets and injections have similar side effects.
“Oral and injectable Wegovy have very similar, primarily gastrointestinal side effects,” Anekwe said. These include, for example, nausea, diarrhea, vomiting, and constipation.
Anekwe said about three-quarters of Wegovy users experience mild to moderate gastrointestinal symptoms. However, trial data suggest that for either form of the drug, a small number of patients (about 7% to 10%) stop taking the drug because of these effects.
(Some real-world data suggests that a high proportion of patients stop taking GLP-1 within the first year, but this may be due to a combination of factors, such as side effects and drug costs.)
Which will benefit you more: pills or injections?
Patients considering Wegovy may choose the pill or injection for a variety of reasons. For example, “pills may be better for people who don’t like injections,” Anekwe says.
She says the pill version may be more appealing to people who don’t have reliable access to a refrigerator, such as frequent travelers. That’s because tablets can be stored at room temperature, unlike injectables, which need to be refrigerated. In general, Wegovy injections should be kept at 36 to 46 degrees Fahrenheit (2 to 8 degrees Celsius). If desired, the pen can be stored uncapped at 46 to 86 F (8 to 30 C) for up to 28 days.
However, some people may find it difficult to stick to a strict daily schedule of taking pills on an empty stomach and restricting the timing of meals. These people may prefer the convenience of once-a-week injections.
Cost and insurance coverage can also influence which version a user chooses. Annekwe said the pill may be good for people who don’t have insurance because it has a low out-of-pocket cost.
And in addition to lifestyle factors and cost, there is another important difference that determines who can use each version. The injectable form of Wegovy is approved for adolescents 12 years and older with obesity, while Wegovy tablets are currently approved only for adults.
This article is for informational purposes only and does not provide medical advice.
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