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Rybelsus vs. Jardiance: A Comprehensive Comparison for Weight Loss

Written by Andrew Le, MD

UpdatedSeptember 12, 2024

Rybelsus (semaglutide) and Jardiance (empagliflozin) have emerged as two significant players in diabetes management, not just in controlling blood sugar but also in weight loss.

While neither of them is officially approved as a dedicated weight loss medication, both Rybelsus and Jardiance have demonstrated weight loss effects in individuals with type 2 diabetes.

In this comprehensive comparison, we will explore the mechanisms of these drugs, their impact on weight loss, and their approved uses.

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🔑 Key Takeaways:

  • Rybelsus and Jardiance, originally designed for diabetes management, have shown potential for weight loss in individuals with type 2 diabetes.
  • Rybelsus, containing semaglutide, belongs to the GLP-1 receptor agonist class, primarily focusing on blood sugar control.
  • Rybelsus mimics incretin hormones, leading to increased insulin release, reduced glucagon secretion, and delayed gastric emptying, potentially causing weight loss.
  • Clinical trials indicate that Rybelsus can lead to weight loss ranging from 2 kg to 4 kg in diabetes patients.
  • Rybelsus is officially approved for blood sugar control in adults with type 2 diabetes and may seek FDA approval for weight loss.
  • Jardiance, with empagliflozin, falls under the SGLT-2 inhibitor class, working by blocking glucose reabsorption in the kidneys to lower blood sugar.
  • Jardiance has exhibited weight reduction effects in clinical trials, with an average weight loss of 2.8% to 3.2% from baseline within 24 weeks.

Rybelsus: A Breakdown

Rybelsus, containing the active ingredient semaglutide, belongs to the class of medicines known as GLP-1 receptor agonists or incretin mimetics.

Designed to improve blood sugar control in adults with type 2 diabetes, it's a valuable tool in diabetes management.

Below are key insights into Rybelsus and its potential impact on weight management.

How Rybelsus Works

Rybelsus operates by mimicking the functions of natural incretin hormones in the body, particularly after a meal.

Incretin hormones are gut peptides released from the stomach during food consumption. They stimulate insulin secretion and lower glucose levels. Rybelsus, being a synthetic GLP-1 receptor agonist, closely resembles human GLP-1 and binds to GLP-1 receptors.

This stimulation leads to increased insulin release from the pancreas, reduced glucagon secretion by the liver, and delayed gastric emptying, creating a feeling of fullness.

Weight Loss with Rybelsus

Though not officially a weight loss drug, Rybelsus has demonstrated potential for weight loss in those with type 2 diabetes.

Research indicates that individuals taking Rybelsus experience weight losses ranging from 2 kg to 4 kg. In a study spanning 26 weeks, it was observed that:

  • Rybelsus 7mg led to an average weight loss of 2.3 kg (5 pounds).
  • Rybelsus 14mg resulted in an average weight loss of 3.7 kg (8.1 pounds).

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These findings suggest that Rybelsus can contribute to weight reduction in diabetes patients. Those with higher initial body weight and experience more digestive symptoms are more likely to shed pounds upon initiating treatment.

Official Uses of Rybelsus

It's important to note that Rybelsus is primarily intended for blood sugar control in adults with type 2 diabetes.

It may be prescribed as a first-line therapy with diet, exercise, or other conventional medications for type 2 diabetes. However, it is not recommended for the treatment of type 1 diabetes.

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The Future of Rybelsus for Weight Loss

In recent developments, Rybelsus has ventured into the realm of weight loss.

Clinical trials exploring higher doses of Rybelsus, up to 50 mg, have demonstrated weight loss effects comparable to those seen with the dedicated weight loss medication, Wegovy (semaglutide).

Based on these promising findings, the manufacturer of Rybelsus plans to seek FDA approval for a weight loss indication in 2023. If approved, it may be marketed under a different brand name, solidifying its role in the weight management landscape.

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Jardiance: A Comprehensive Examination

Jardiance, with the active ingredient empagliflozin, is another notable player in diabetes management.

It's an SGLT-2 inhibitor designed to manage blood sugar in adults and children (10 years and older) with type 2 diabetes.

How Jardiance Works

Jardiance blocks kidney glucose reabsorption, increasing glucose excretion in urine. This mechanism effectively lowers blood sugar levels in individuals with type 2 diabetes.

Here, we delve into the inner workings of Jardiance and its intriguing potential for weight management.

Weight Loss with Jardiance

Like Rybelsus, Jardiance is not officially approved as a weight-loss medication, but it has exhibited weight-reduction effects in clinical trials.

In studies involving adults, Jardiance demonstrated an average weight loss of approximately 2.8% with the 10 mg dose and 3.2% with the 25 mg dose from their baseline weight within 24 weeks.

A 200-pound individual could potentially lose around 5.6 pounds with the 10 mg dose and approximately 6.4 pounds with the 25 mg dose.

Notably, the group receiving a placebo in these trials experienced a modest weight loss of 0.4%.

Official Uses of Jardiance

Jardiance is primarily indicated for blood sugar control in adults with type 2 diabetes, both as a monotherapy and in combination with other diabetes medications.

It's approved to manage cardiovascular events in adults with type 2 diabetes and established cardiovascular disease.

Jardiance is also versatile, approved for treating heart failure in adults with reduced ejection fraction, even without diabetes.

Key Differences Between Rybelsus and Jardiance

Rybelsus and Jardiance stand apart in several crucial ways. Let's delve into these distinctions to understand which might be the right choice for you. Here are the key differences to consider:

Drug Class

  • Rybelsus is classified as a GLP-1 receptor agonist.
  • Jardiance belongs to the SGLT-2 inhibitor class.

Mode of Administration

  • Rybelsus is available in oral tablet form.
  • Jardiance is also available in tablet form, taken orally.

Clinical Approvals

  • Jardiance has received FDA approval for blood sugar management, cardiovascular disease reduction, and heart failure management.
  • Rybelsus is primarily approved for blood sugar control in adults with type 2 diabetes and may seek FDA approval for weight loss.

Magnitude of Weight Loss

  • In clinical trials, Rybelsus has shown slightly more significant weight loss effects than Jardiance, but individual responses may vary.

Side Effects

  • Both medications can cause gastrointestinal symptoms such as nausea, vomiting, and diarrhea, although the specific side effect profile may differ among individuals.

Final Words

Originally designed for managing blood sugar in type 2 diabetes, Rybelsus and Jardiance show potential for weight loss.

Rybelsus, a GLP-1 receptor agonist, boosts insulin release and reduces glucagon secretion, promoting weight loss. Jardiance, an SGLT-2 inhibitor, increases kidney glucose excretion, lowering blood sugar and facilitating weight loss.

When choosing between these medications, several factors come into play, including drug class, method of administration, clinical approvals, and the magnitude of weight loss. While Rybelsus has demonstrated slightly more significant weight loss effects in clinical studies, Jardiance stands out with its broader FDA approvals, encompassing cardiovascular disease and heart failure management.

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FAQs on Rybelsus and Jardiance

Which is better for weight loss, Rybelsus or Jardiance?

The weight loss results are similar for Rybelsus (14 mg) and Jardiance (25 mg). In a 6-month study involving 822 adults with type 2 diabetes, the weight loss outcomes were comparable when either Rybelsus or Jardiance was added to another diabetes medication.

What is the best combination with Jardiance?

Jardiance can be combined with metformin to effectively lower blood sugar levels in people with type 2 diabetes. Clinical studies have demonstrated the effectiveness of using Jardiance and metformin together in managing diabetes.

Can you take Januvia and Rybelsus together?

Rybelsus can be combined with other diabetes drugs, but it is not commonly paired with Januvia. Januvia is an alternative treatment for type 2 diabetes and may be used instead of Rybelsus for certain individuals.

What drug can replace Jardiance?

If you need an alternative to Jardiance, consider Farxiga (dapagliflozin) if you have heart failure. For individuals with Type 2 diabetes and heart disease, options like Invokana (canagliflozin) or certain medications known as glucagon-like peptide-1 (GLP-1) agonists may be suitable replacements.

How long should you be on Jardiance?

Typically, lifelong medication is necessary to lower the risk of complications and death when taking Jardiance for heart failure. Therefore, you will likely continue using it for the long term.

What to avoid with Jardiance?

Jardiance should not be taken with diuretics ("water pills"), insulin, or drugs that stimulate insulin release. It may also interact with lithium (Lithobid). Generally, Jardiance interactions can be managed through dosage adjustments.

Is Rybelsus a good diabetic medicine?

Rybelsus is a potent diabetes and weight loss medication available in oral form. It has demonstrated effectiveness in promoting weight loss and improving blood sugar control in various patient populations, both as a standalone treatment and in combination with other diabetes medications.