Semaglutide: Daily Pill vs. Weekly Shot for Weight Loss

A new daily pill containing semaglutide offers an alternative to the weekly injection for weight loss. Previously available only as a shot, the oral version of Wegovy was released in January by Novo Nordisk. Both the pill and the shot utilize the active ingredient semaglutide to activate GLP-1 receptors.

These medications work by regulating blood sugar and appetite, slowing digestion to promote a feeling of fullness. The oral form requires a higher daily dose of 25 mg due to digestive absorption, taken in the morning on an empty stomach. In contrast, the weekly injection, at 2.4 mg, bypasses the digestive system and can be administered anytime.

Clinical trials indicate comparable weight loss outcomes. A 2025 trial reported an average loss of 13.6% body weight with the tablets over 64 weeks, while a 2021 study found 14.9% weight loss with injections over 68 weeks.

Financially, out-of-pocket costs are similar with insurance, as low as $25 monthly. Without coverage, the pills are initially less expensive, starting at $149 per month compared to $199 for injections. Costs increase with higher doses for both forms.

Gastrointestinal side effects like nausea and diarrhea are common to both semaglutide forms. However, the oral medication might exacerbate stomach issues due to its digestive pathway. Serious risks such as pancreatitis remain rare and similar for both.

Choosing between the daily pill and weekly shot largely depends on individual preferences. The pill may suit those intimidated by injections or seeking moderate weight loss, offering easier travel convenience. Conversely, the weekly shot might appeal to individuals preferring less frequent administration or aiming for greater weight loss, due to its predictable absorption.