When Rybelsus Isn't Available, These Alternatives Can Help

You've been prescribed Rybelsus for type 2 diabetes, but you can't fill your prescription. Maybe your pharmacy is out of stock. Maybe your insurance won't cover it. Maybe the cost is simply too high without coverage.

Whatever the reason, the important thing is this: you still have options. Several other medications work similarly to Rybelsus and may be available when it isn't.

In this guide, we'll explain what Rybelsus is and how it works, then walk you through four real alternatives your doctor might consider — including their pros, cons, and how they compare.

If your main issue is finding Rybelsus in stock, check out our guide on how to find Rybelsus near you before switching medications.

What Is Rybelsus and How Does It Work?

Rybelsus is the brand name for oral Semaglutide, made by Novo Nordisk. It's a GLP-1 receptor agonist — a class of medications that mimic a natural hormone called glucagon-like peptide-1 (GLP-1).

Here's what GLP-1 does in your body:

• Stimulates insulin release when your blood sugar is high
• Reduces glucagon (a hormone that raises blood sugar)
• Slows down digestion, which helps prevent blood sugar spikes after meals
• Reduces appetite, which can lead to weight loss

Rybelsus is unique because it's the only oral GLP-1 medication available. Most other GLP-1 drugs require injections. That's a significant advantage for patients who are uncomfortable with needles.

For a more detailed explanation, read our article on how Rybelsus works.

Rybelsus is FDA-approved for type 2 diabetes and comes in 3 mg, 7 mg, and 14 mg tablets. For more about uses and dosing, see What is Rybelsus?

Alternative #1: Ozempic (Semaglutide Injection)

Ozempic is the closest alternative to Rybelsus because it contains the exact same active ingredient — Semaglutide. The difference is how you take it: Ozempic is a once-weekly subcutaneous injection using a prefilled pen, while Rybelsus is a daily pill.

Key facts about Ozempic:

• Dosing: 0.25 mg, 0.5 mg, 1 mg, or 2 mg injected once per week
• FDA-approved for: Type 2 diabetes
• Manufacturer: Novo Nordisk
• Cash price: Approximately $900–$1,100 per month

Pros:

• Same active ingredient, so your body responds similarly
• Once-weekly dosing (vs. daily with Rybelsus)
• Strong clinical data for blood sugar control and weight loss
• No food timing restrictions

Cons:

• Requires a weekly injection (may be uncomfortable for some patients)
• Also experiences supply shortages
• Similar price point to Rybelsus without insurance

Alternative #2: Mounjaro (Tirzepatide)

Mounjaro (Tirzepatide) by Eli Lilly is a newer medication that has quickly become one of the most talked-about options for type 2 diabetes. It works on two hormone pathways — GLP-1 and GIP — which is why it's called a "dual incretin" agonist.

Key facts about Mounjaro:

• Dosing: 2.5 mg to 15 mg injected once per week
• FDA-approved for: Type 2 diabetes (also approved as Zepbound for weight management)
• Manufacturer: Eli Lilly
• Cash price: Approximately $1,000–$1,200 per month

Pros:

• May provide stronger blood sugar reduction and weight loss than single-target GLP-1 drugs
• Once-weekly injection
• Rapidly growing clinical evidence

Cons:

• Requires injection
• Newer medication with less long-term safety data
• Can also be difficult to find due to high demand
• May not be covered by all insurance plans yet

Alternative #3: Trulicity (Dulaglutide)

Trulicity (Dulaglutide) is a well-established GLP-1 receptor agonist that has been on the market since 2014. It's another once-weekly injectable option made by Eli Lilly.

Key facts about Trulicity:

• Dosing: 0.75 mg, 1.5 mg, 3 mg, or 4.5 mg injected once per week
• FDA-approved for: Type 2 diabetes; also shown to reduce cardiovascular events in adults with type 2 diabetes and heart disease
• Manufacturer: Eli Lilly
• Cash price: Approximately $900–$1,000 per month

Pros:

• Long track record of safety and effectiveness
• Proven cardiovascular benefits
• Generally easier to find than Semaglutide products
• Hidden needle design makes injections less intimidating

Cons:

• Requires weekly injection
• May produce less weight loss than Semaglutide or Tirzepatide
• GI side effects (nausea, diarrhea) are common, especially when starting

Alternative #4: Jardiance (Empagliflozin)

Jardiance (Empagliflozin) is a different class of diabetes medication — it's an SGLT2 inhibitor rather than a GLP-1 agonist. We're including it here because it's an oral option that many doctors consider when Rybelsus isn't available.

Key facts about Jardiance:

• Dosing: 10 mg or 25 mg taken once daily
• FDA-approved for: Type 2 diabetes, heart failure, and chronic kidney disease
• Manufacturer: Boehringer Ingelheim / Eli Lilly
• Cash price: Approximately $550–$700 per month

Pros:

• Oral tablet — no injections
• No specific food timing requirements
• Proven heart and kidney benefits
• Generally easier to find and may cost less

Cons:

• Different mechanism of action — works by removing glucose through urine
• Increased risk of urinary tract infections and yeast infections
• Less weight loss compared to GLP-1 medications
• Not suitable for patients with severe kidney impairment

How to Decide Which Alternative Is Right for You

The best alternative depends on your individual situation. Here are some questions to discuss with your doctor:

• Are you comfortable with injections? If not, Jardiance is the only oral alternative listed here.
• Is weight loss a priority? Mounjaro and Ozempic tend to produce the most weight loss.
• Do you have heart disease or kidney disease? Trulicity and Jardiance have proven benefits for these conditions.
• What does your insurance cover? Coverage varies significantly between medications. Check with your plan before switching.
• Is the alternative actually available? Some GLP-1 medications face similar shortages. Use Medfinder to check availability.

Never switch medications on your own. Always work with your doctor to find the right alternative and manage the transition safely.

Final Thoughts

Not being able to get your Rybelsus prescription filled is stressful, but it doesn't mean you're out of options. Ozempic, Mounjaro, Trulicity, and Jardiance are all effective medications that can help you manage type 2 diabetes when Rybelsus isn't available.

Talk to your doctor, check what your insurance covers, and use Medfinder to find availability near you. Your diabetes management doesn't have to stop just because one medication is hard to find.

For the latest on Rybelsus availability, read our Rybelsus shortage update for 2026.