Wegovy now comes in pill form — here’s what to know
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 telehealth services in the United States
The drug has been available by prescription as a weekly injection in the United States since 2021. Like the injection, the new Wegovy pill contains semaglutide, the same active ingredient as Ozempic. It works by mimicking a hormone in the body – glucagon-like peptide-1 (GLP-1) – which helps control appetite and blood sugar.
Both forms of Wegovy are approved to help obese adults – as well as adults who are overweight and have related health problems, such as high blood pressure – lose weight and maintain it, in combination with a low-calorie diet and increased physical activity. However, only the injectable version is approved for children 12 years and older with obesity; the pill version is not yet authorized for this age group.
Here’s what you need to know about the new Wegovy pill and who could benefit most from it.
Do semaglutide pills work as well as injections?
The main difference between the Wegovy pill and the injection is how the medication enters the bloodstream.
When semaglutide is injected under the skin, it is absorbed directly into the bloodstream. However, when taken in pill form, the medication must first pass through the stomach and intestines, where some of its active ingredient is broken down by digestive enzymes before it can be absorbed through the intestinal lining and into the bloodstream.
For this reason, “only a small fraction [of the pill] reaches the blood circulation,” explained Dr Chika Anekweclinical director of obesity medicine at the Massachusetts General Hospital Weight Center and instructor of medicine at Harvard Medical School. This is an expected difference between injected and oral medications in general.
Although the pill exposes the digestive tract to more semaglutide than the injection would, its local effects on the gut are minor, Anekwe explained. This is because “the key effects still require systemic absorption and signaling,” so they only become apparent once the drug reaches the bloodstream, she explained.
To compensate for this digestive process, the pill version of Wegovy is taken at a much higher dose than the injectable form. The highest dose of the pill is 25 milligrams, compared to 2.4 milligrams for the weekly injection, Anekwe told Live Science in an email.
The pill also comes with strict instructions on when to take it, Anekwe said. It should be taken in the morning on an empty stomach with a small amount of water and patients should wait at least 30 minutes before eating, drinking or taking other medications. its medicine label says. This ensures that the medication will be properly absorbed at the intended dose. The injectable version does not have these restrictions; it can be taken at any time of the day and without fasting.
Dr Priya Jaisinghaniendocrinologist and obesity medicine specialist at NYU Langone Health, discussed the effectiveness of both formulations during a Endocrinology Society Webinar on GLP-1 pills in December 2025.
So far, “there has not been a long-term head-to-head trial” comparing the once-daily 25 mg pill to the once-weekly 2.4 mg injection in obese adults, Jaisinghani said. However, results from clinical trials that tested the drugs separately suggest that both versions lead to very similar weight loss when taken as directed.
In the STEP-1 trial, a study of 2.4 mg of injectable semaglutide, participants lost an average of about 14.4% of their body weight. In the OASIS 4 trial, a study of the 25 mg pill, participants lost an average of about 13.9% of their body weight. Jaisinghani said these results indicate that the pill and injection “offered comparable effectiveness for weight management.”
Is the Wegovy pill as safe as the injection?
Trials also suggest that Wegovy pills and injectables have similar side effects.
“Oral and injectable Wegovy have very similar side effects, mainly gastrointestinal,” Anekwe said. These include, for example, nausea, diarrhea, vomiting and constipation.
About three-quarters of Wegovy users experience mild to moderate gastrointestinal symptoms, Anekwe said. But for both forms of the drug, a minority of patients — about 7 to 10 percent — stop taking the drug because of these effects, according to trial data.
(Some real-world data suggests that a higher percentage sick people stop taking GLP-1s within a year of starting them, but this may be due to a mix of factors, including side effects and cost of the drugs.)
Who might benefit more from the pill or injection?
Patients considering Wegovy may opt for the pill or injection for different reasons. For example, “the pill may be better for someone who is reluctant to use injections,” Anekwe said.
The pill version could also be more attractive to people who don’t have reliable access to refrigeration, such as frequent travelers, she said. In fact, the pill can be stored at room temperature, unlike the injection, which must be refrigerated. Generally, the Wegovy injectable products should be stored between 36 and 46 degrees Fahrenheit (2 to 8 degrees Celsius). And if necessary, pens can be stored at 46 to 86 F (8 to 30 C) for up to 28 days, if their caps have not been removed.
That said, the strict daily schedule of taking a pill on an empty stomach with restrictions on meal timing can be difficult for some people to stick to. These people may prefer the convenience of a once-a-week injection.
Cost and insurance coverage can also influence which version you choose. The pill may be better for someone who doesn’t have insurance coverage because it costs less, Anekwe said.
And aside from lifestyle and cost factors, there’s another important difference that determines who can use each version: Unlike the injectable form of Wegovy, which is approved for adolescents ages 12 and older with obesity, the The Wegovy pill is currently approved only for adults.
This article is for informational purposes only and is not intended to offer medical advice.
