Oral Semaglutide: How the Wegovy Tablet Works

Oral semaglutide is the same medicine as the Wegovy injection, semaglutide, in a once-daily tablet. In the UK, Wegovy tablets were authorised by the MHRA for weight management on 11 June 2026, the first GLP-1 tablet licensed for this use. The tablet works by mimicking the gut hormone GLP-1 to reduce appetite and increase fullness. To be absorbed, it must be taken on an empty stomach with a small sip of water, followed by a 30-minute wait before food, drink or other medicines. In the OASIS 4 trial, people taking the 25mg dose lost an average of 13.6% of their body weight over 64 weeks.

What oral semaglutide is

Semaglutide is a GLP-1 receptor agonist, a lab-made version of a natural hormone released by the gut after eating. It has been available for years as a weekly injection, sold as Ozempic for type 2 diabetes and Wegovy for weight management, and as a daily tablet, Rybelsus, for type 2 diabetes.

Wegovy tablets use the same molecule as these products, at doses developed for weight management. They are licensed, alongside a reduced-calorie diet and increased physical activity, for adults with:

• a BMI of 30 or more (obesity), or
• a BMI of 27 to under 30 (overweight) with at least one weight-related condition, such as high blood pressure, type 2 diabetes, abnormal blood fats or obstructive sleep apnoea.

Our semaglutide guide explains how the different semaglutide products relate to one another.

How the tablet gets semaglutide into your body

Semaglutide is a peptide, a small protein. Peptides are usually broken down in the stomach and absorbed poorly through the gut wall, which is why most are injected. Making semaglutide work as a tablet required a different approach.

Each Wegovy tablet contains an absorption enhancer called SNAC (salcaprozate sodium). When the tablet dissolves in the stomach, SNAC:

• briefly raises the pH (makes it less acidic) in the area around the tablet, protecting semaglutide from being broken down by digestive enzymes
• helps semaglutide pass through the lining of the stomach into the bloodstream

This happens mainly in the stomach, close to where the tablet dissolves. Food, larger amounts of liquid or other tablets can dilute or block this local effect, which is why the dosing rules are so specific. Even when taken correctly, only a small proportion of each dose is absorbed. That is why the tablet dose (25mg daily) is much larger in milligrams than the injected dose (2.4mg weekly).

Once absorbed, semaglutide acts in exactly the same way as the injected form. It has a long half-life of about a week, so daily dosing builds up a steady level in the blood over several weeks. Each 25mg tablet also contains a small amount of sodium (about 23mg), which may be relevant if you follow a strict low-sodium diet.

How semaglutide helps with weight loss

Once in the bloodstream, semaglutide:

• acts on appetite centres in the brain, reducing hunger and increasing feelings of fullness
• slows stomach emptying, so food stays in the stomach longer
• may change food preferences, with some people reporting less interest in high-fat or very sweet foods
• improves blood glucose control by increasing insulin release and lowering glucagon when glucose is high

The net effect is that people tend to eat less without the same level of hunger. Our guide to how Wegovy works explains the biology in more depth.

How to take Wegovy tablets

The dose schedule

According to the UK SmPC, the dose is increased gradually to help your body adjust and reduce gastrointestinal side effects.

Your prescriber may keep you on a dose for longer if side effects are troublesome. You should not take more than one tablet a day.

The daily routine

The SmPC sets out how to take each tablet:

1. Take it on an empty stomach, after fasting for at least eight hours. For most people this means first thing in the morning, before breakfast.
2. Swallow the tablet whole with a sip of water, up to half a glass (120ml). Do not split, crush or chew it.
3. Wait at least 30 minutes before eating, drinking anything else or taking other oral medicines.

Some practical tips:

• Keep your tablets and a small glass by your bed or kettle so you remember to take them before anything else.
• If you usually take other medicines in the morning, plan to take them at least 30 minutes after your semaglutide tablet, or discuss timing with your pharmacist.
• If you drink tea or coffee first thing, wait until the 30 minutes have passed.
• Use the 30 minutes for showering, dressing or a short walk.

Missed doses

If you miss a dose, the SmPC says to skip it and take your next dose the following day. Do not take two tablets to make up. If you miss several days in a row, contact your prescriber before restarting, as your tolerance to side effects may have reduced and a lower dose may be needed.

Switching from injections

People taking semaglutide 2.4mg injections once weekly can switch to 25mg tablets once daily, starting one week after their last injection, according to the SmPC. Switching from lower injection doses, from tirzepatide or from other medicines is a prescriber's decision. Our guide to switching from an injection to a tablet explains the considerations.

What the trials show

OASIS 4: the 25mg dose

OASIS 4 (NEJM, 2025) is the main trial behind the UK licence. It enrolled 307 adults with obesity, or overweight with at least one weight-related condition, without diabetes. Participants took oral semaglutide 25mg or placebo once daily for 64 weeks, alongside lifestyle advice.

Figures from the UK SmPC summary of OASIS 4.

OASIS 1: a higher dose

OASIS 1 (The Lancet, 2023) tested a 50mg dose of an earlier formulation for 68 weeks and found an average weight loss of about 15%, compared with about 2.4% on placebo. The 50mg dose is not licensed in the UK, but the trial helped show that oral semaglutide could achieve weight loss similar to the injection.

How it compares with the injection

There has not been a head-to-head trial in the licensed doses, but the results are broadly similar. In STEP 1 (NEJM, 2021), semaglutide 2.4mg injections led to an average weight loss of 14.9% over 68 weeks. The tablet and injection seem to produce roughly comparable average weight loss when taken correctly. Our Wegovy injections vs oral GLP-1 tablets guide compares them in more detail.

Side effects

The side effects of oral semaglutide are similar to the injection. In the UK SmPC, the most frequent effects during dose escalation in OASIS 4 were:

Most of these effects were mild to moderate and short-lived, and they are most common when the dose is increased. Other common side effects include indigestion, abdominal pain, bloating, burping, wind, tiredness, headache and dizziness.

Managing gastrointestinal side effects

• Eat smaller meals and stop when you feel full.
• Avoid very fatty, rich or spicy foods, especially in the first weeks after a dose increase.
• Drink plenty of fluids through the day (after the 30-minute wait).
• Eat slowly and avoid lying down straight after meals.
• If side effects are severe or persistent, talk to your prescriber, who may slow the dose increases.

Our guides to oral GLP-1 side effects and managing nausea offer more detail.

Less common but important risks

The SmPC lists several warnings shared with other semaglutide products:

• Acute pancreatitis. Rare but serious. Stop taking the tablets and seek urgent help if you develop severe, persistent abdominal pain.
• Gallbladder problems, including gallstones.
• Dehydration and kidney problems, usually linked to severe vomiting or diarrhoea.
• Hypoglycaemia in people who also take insulin or sulfonylureas.
• Diabetic retinopathy may worsen in people with diabetes whose blood glucose falls rapidly.
• Non-arteritic anterior ischaemic optic neuropathy (NAION), a very rare condition causing sudden vision loss in one eye. Anyone with sudden vision loss needs urgent assessment.
• Gastroparesis. Caution is advised in people with severely delayed stomach emptying.

Interactions with other medicines

Because semaglutide slows stomach emptying, and the tablet must be taken alone, oral semaglutide can affect other medicines:

• Levothyroxine: in studies, total exposure to thyroxine increased by about a third when taken with oral semaglutide. Your thyroid levels may need monitoring and your dose may need adjusting.
• Warfarin and similar anticoagulants: INR monitoring is advised when starting.
• Other oral medicines: take them at least 30 minutes after your semaglutide tablet.
• Insulin and sulfonylureas: doses may need reducing to avoid hypoglycaemia.

Tell your prescriber and pharmacist about all the medicines and supplements you take. Our guide to GLP-1 medication interactions covers this in more depth.

Pregnancy, fertility and breastfeeding

Oral semaglutide should not be used during pregnancy. The SmPC advises stopping it at least two months before a planned pregnancy, because semaglutide stays in the body for several weeks. It should not be used while breastfeeding. Weight loss can improve fertility, so effective contraception is important. See our pregnancy and fertility guide.

What the first months may look like

Every person's experience is different, but the structure of treatment gives a rough shape to the first few months.

This is a general guide based on how GLP-1 treatment usually progresses, not a prediction. Your prescriber may hold you at a dose for longer if side effects are difficult. Our guide to realistic weight loss expectations explains how progress is usually measured.

Practical situations

Shift work and irregular hours

The SmPC rule is an empty stomach after at least eight hours of fasting, which for most people means on waking. If you work nights, the right time may be after your main sleep, whenever that is. Talk to your prescriber or pharmacist about the right timing for your pattern, and try to keep it consistent.

Morning medicines

If you take several tablets each morning, plan the order: semaglutide first, then wait at least 30 minutes before the others. For medicines that must be taken on an empty stomach themselves, such as levothyroxine, ask your pharmacist how to arrange them, as both cannot be taken at exactly the same time.

Travel

Keep tablets in their original packaging and in your hand luggage, with a copy of your prescription. When crossing time zones, aim for roughly 24 hours between doses and keep to the fasting and 30-minute rules at your destination.

Being unwell

If you have a stomach bug with vomiting or diarrhoea, your risk of dehydration is higher. Keep sipping fluids. If you vomit soon after taking your tablet, do not take an extra tablet without advice from your pharmacist or prescriber. If you cannot keep fluids down or are unwell for more than a day or two, contact your prescriber or NHS 111.

Surgery and procedures

Semaglutide slows stomach emptying, which can increase the risk of inhaling stomach contents under general anaesthesia or deep sedation. Tell your surgical team well in advance that you take oral semaglutide. See our guide to GLP-1 medication before surgery.

Who might Wegovy tablets suit?

A tablet may suit people who:

• prefer not to inject or have needle anxiety
• can reliably take a tablet on waking and wait 30 minutes before eating or drinking
• travel often and prefer not to manage refrigerated pens
• are already doing well on 2.4mg semaglutide injections and want to switch

It may be less suitable for people who:

• find it hard to fast in the morning or have irregular routines, such as night-shift workers
• take several morning medicines that are hard to separate
• prefer a once-weekly treatment
• need the cardiovascular risk-reduction evidence that currently applies to the injection

Foundayo (orforglipron), the other GLP-1 tablet licensed for weight management in the UK, has no food or water restrictions, which may suit some people better. Our Foundayo guide explains the differences, and our oral GLP-1 guide compares all the options.

UK access

NHS

At the time of writing, NICE had not recommended Wegovy tablets for weight management, so they were not routinely available on the NHS. NHS access to semaglutide for weight management remains through Wegovy injections under NICE TA875, within specialist weight management services. Check the NICE website for any later appraisal of the tablets.

Private prescription

Wegovy tablets became available on private prescription from regulated providers in the weeks after authorisation. A regulated prescriber should assess your health, medicines and weight before prescribing, and review you regularly. Our provider comparison sets out how services differ. Costs depend on the dose, the provider and what is included; our prices page explains these factors.

Stopping oral semaglutide

As with the injection, weight tends to return after semaglutide is stopped. In the STEP 1 extension, people regained about two-thirds of the weight they had lost within a year of stopping the injection. There is no reason to expect a different pattern with the tablet. If you are thinking of stopping, talk to your prescriber first. Our Wegovy maintenance guide covers what to expect.

When to speak to a professional

Speak to your GP, pharmacist or prescriber if:

• You are considering Wegovy tablets and want to know whether they are suitable for you.
• You take levothyroxine, warfarin, insulin, a sulfonylurea or several morning medicines.
• You find the empty-stomach routine hard to follow.
• Side effects are affecting your ability to eat or drink.
• You are planning pregnancy, are pregnant or are breastfeeding.
• You have missed several doses and need to restart.

Seek urgent medical help (NHS 111, or 999 in an emergency) if you have:

• Severe, persistent abdominal pain, which may spread to your back, with or without vomiting (possible pancreatitis).
• Pain in the upper right abdomen, fever, or yellowing of the skin or eyes (possible gallbladder problems).
• Persistent vomiting or diarrhoea with signs of dehydration, such as dizziness or passing very little urine.
• Sudden loss of vision or blurred vision in one eye.
• Signs of a severe allergic reaction, such as swelling of the face or throat or difficulty breathing.

For more on tablet treatments, visit our oral GLP-1 hub. Whether oral semaglutide is right for you is a decision for a qualified prescriber who knows your medical history.