The Wegovy Pill: A Needle-Free GLP-1 Weight Loss Option

Written By Eli Luft, PA-C

Medically Reviewed by Dr. Paul Rivas

Evidence-based

If you have been avoiding GLP-1 weight loss drugs because of a fear of needles, you are not alone – at least 25 percent of Americans suffer from the same such fear, known scientifically as “trypanophobia.”

The good news for you and other trypanophobiacs is that the next wave of GLP-1 medications will be available in pill form, starting exactly now.

Novo Nordisk kicked off the tablet era of GLP-1s by releasing its Wegovy tablet earlier this month. Previously only available via injection, you can now take Wegovy – the brand name for semaglutide – as a pill just like you would with birth-control pills.

To learn more about semaglutide, check out this article: Semaglutide: A Game-Changer in Weight Loss and Type 2 Diabetes Management.

If you’ve ever dreaded a shot so much that your heart races and you break out in a cold sweat just thinking about it, believe me, you are not alone. As providers, we’ve seen it all; it’s not unusual for a patient to bolt across the room in panic or vasovagaling – nearly fainting – from the sheer stress of an injection. That’s why the new Wegovy pill is such a breakthrough. For the millions held back by needle fear, this needle-free GLP-1 option could finally make effective weight loss accessible.

So the new tablet form of Wegovy will make it more convenient, but there’s a catch: You have to take it first thing in the morning on an empty stomach with only a half-glass of water at most and not consume other foods, liquids or medications for at least 30 minutes. Also, the tablet must be swallowed whole; you can’t split it in half and take one today and one tomorrow to save money. Moreover, the increased daily dosage compared to the injections may cause an increase in side effects for some. 

All told, is this a small price to pay for avoiding needles? That will be up to you to decide.

From our standpoint at Rivas Medical Weight Loss, we believe the pills will serve as more of a gateway to the injections than as a permanent solution for most patients. See below for more facts and details on what to expect from this new form of GLP-1s and see if you agree. 

Here are some more details on the newly released Wegovy pill:

• Does the Wegovy Pill work as well as the injection?
  • The manufacturer claims that in testing the effectiveness is the same – patients will lose about 16% to 17% of their starting body weight.
• When will the Wegovy Pill be released?
  • It has been released and is available now.
• How much does it cost with and without insurance?
  • For newcomers to GLP-1s, they can get started with the 1.5 mg “Starter” dose of the pill that costs $149 a month if you are not using insurance. This is the most affordable entry price to date.
  • The 4 mg dose costs the same amount until April 15, but then $199 after that date. The larger doses for regular users of the drug – 9 mg and 25 mg – will be $299 a month.
  • If you can use health insurance, the price may be as low as $25 per month.
  • The price that affects insurance coverage, called a “list price,” is the same as the Wegovy injection: $1,349 a month.
• Practically speaking, what dosage schedule should I expect as a new customer for Wegovy?
  • Although you will start at 1.5 mg once a day, the “starter” dosage mentioned above, in practice most patients will have to escalate – or “titrate” – their  dosage every 30 days until they get to the standard dose of 25 mg daily. 
  • Indeed, according to Novo Nordisk’s educational material, the recommendation is 25 mg dosage orally once daily for cardiovascular risk reduction and weight reduction in adults.
  • From what we have seen at Rivas Medical Weight Loss, we predict that the majority of patients that switch to pills will need to be on the maximum dose of 25 mg per day.
  • That being said, some patients are able to see desired results at lower dosage amounts. Pinpointing the proper titration schedule requires the assistance of a qualified provider. Book an appointment today to speak with a qualified professional.
• What are the side effects of the Wegovy pill?
  • According to Novo Nordisk, users can expect the same side effects as from the injection form of Wegovy – nausea, diarrhea and vomiting.
  • Because the pill is taken daily and requires higher doses to be absorbed, some patients find it harder to tolerate or harder to take consistently. This is a major reason why, as I stated above, you may find that the weekly injections are more tolerable and more convenient.
• Where can I get Wegovy Pills?
  • Prior to purchasing, you will need a prescription. Once you have the prescription, you can purchase at more than 70,000 pharmacies including CVS and Costco or certain telehealth providers. However, your safest bet would be having a weight loss practice such as Rivas Medical Weight loss order it directly from Novocare.
• How can I get a prescription for the new Wegovy pill?
  • You can book an appointment with Rivas in the Maryland/Virginia area or use our Telehealth service to acquire the prescription. At Rivas, we’ve helped thousands of customers transition from phentermine to semaglutide to tirzepatide and back. Metformin or topamax as well. Book an appointment with us in-person or on telehealth to learn more about which drug and which form – pill vs. injection – is right for you.
• How often do you have to take the Wegovy pill?
  • It’s daily, recommended first thing in the morning before eating or drinking anything other than a half-glass of water. This differs from the injection, which is weekly.
• Will there be other GLP-1s offered in pill form as well?
  • Eli Lilly, a competitor of Novo Nordisk, has a tablet called “orforglipron” that is pending FDA approval. The company claims there will be no restrictions on food or water with their pill and it can be taken at any time during the day.
• I am currently taking Wegovy injections. What if I want to switch to pills?
  • For patients already on injections, this is what the dosage translation looks like:
    • ⁠0.25–0.5 mg injection → start 4 mg or 9 mg pill for 30 days
    • 1.0 mg injection → start 9 mg pill for 30 days
    • 1.7 mg injection → start 9 mg pill, then titrate to 25 mg after 30 days
    • ⁠2.4 mg injection (max dose) → stop injection, wait 7 days, then start 25 mg pill
    • Note: There is *no direct milligram-to-milligram equivalence* between injections and pills.