"Oral semaglutide dose" looks like a question with one answer and has three, because three tablet products now carry the molecule at three sets of strengths: RYBELSUS, the OZEMPIC tablet that joined it on one label, and the WEGOVY tablet for weight reduction. None of their milligram figures can be read against an injection, and two of them cannot even be read against each other. This page reports the labels (read 2026-10-03), works out what the milligrams mean once absorption is counted, and states what is known about the sublingual forms sold by compounders. It describes; it does not advise.
The injected doses, the half-life and the vial arithmetic are on the semaglutide dosage page; every GLP-1 product side by side is on the GLP-1 dosage chart.
The three tablet schedules, as labelled
| Product | Indication on label | Days 1–30 | Days 31–60 | Days 61–90 | Maintenance |
|---|---|---|---|---|---|
| RYBELSUS | Type 2 diabetes | 3 mg | 7 mg | 7 mg or 14 mg | 7 mg or 14 mg |
| OZEMPIC tablets | Type 2 diabetes | 1.5 mg | 4 mg | 4 mg or 9 mg | 4 mg or 9 mg |
| WEGOVY tablets | Weight reduction, CV risk | 1.5 mg | 4 mg | 9 mg | 25 mg from day 91 |
All three are once daily. The RYBELSUS and OZEMPIC label describes the starting strength as "not effective for glycemic control" — it exists to let the stomach adjust. The search "semaglutide oral dose for weight loss" has one labelled answer, the WEGOVY tablet's 25 mg; the two diabetes tablets are not labelled for weight.
Why a tablet milligram is not an injected milligram
Semaglutide is a peptide, and the stomach is built to break peptides down. The tablets are co-formulated with SNAC (salcaprozate sodium), which the labels say "facilitates the absorption", and absorption happens mostly in the stomach. Even so, very little arrives. The labels' own figures:
| Form | Absolute bioavailability | Weekly milligrams at maintenance | Absorbed per week (arithmetic) |
|---|---|---|---|
| WEGOVY injection 2.4 mg weekly | 89% | 2.4 mg | ≈2.1 mg |
| WEGOVY tablet 25 mg daily | ≈1% to 2% | 175 mg | ≈1.75 to 3.5 mg |
| OZEMPIC tablet 9 mg daily | ≈1% to 2% | 63 mg | ≈0.63 to 1.26 mg |
| RYBELSUS 14 mg daily | ≈0.4% to 1% | 98 mg | ≈0.39 to 0.98 mg |
The 73-fold difference in swallowed mass largely disappears once bioavailability is applied: the absorbed range for the 25 mg tablet brackets the injection's. The WEGOVY label's measured concentrations agree — about 77 nmol/L on 25 mg tablets against about 75 nmol/L on the 2.4 mg injection in people with overweight or obesity.
The average hides the spread, and the label prints the spread too. Ninety per cent of tablet users had average concentrations between 27 and 186 nmol/L, against 51 to 110 nmol/L on the injection — a sevenfold range against roughly twofold. In type 2 diabetes the tablet average fell to about 44 nmol/L against 68 nmol/L injected, and the label adds that some patients with type 2 diabetes "may experience subtherapeutic semaglutide blood concentrations" on tablets. A low and variable fraction of a large dose is what a tablet milligram is.
Two tablets, one molecule, different milligrams
The oral label states twice that "RYBELSUS and OZEMPIC tablets are not substitutable on a mg-to-mg basis". Its exposure study then explains the numbers: RYBELSUS 3, 7 and 14 mg and OZEMPIC tablets 1.5, 4 and 9 mg showed no clinically significant difference in steady-state exposure. The newer tablet gets there with 50%, 57% and 64% of the milligrams, consistent with its higher stated bioavailability (1% to 2% against 0.4% to 1%).
The label's switching rules follow from that. No switch between the two in the first 30 days; after that, RYBELSUS 7 mg corresponds to OZEMPIC tablets 4 mg and 14 mg to 9 mg, with the other product started the day after the last tablet.
Switching between injections and tablets
| From | To | Labelled timing |
|---|---|---|
| OZEMPIC injection 0.5 mg weekly | RYBELSUS 7 or 14 mg, or OZEMPIC tablets 4 or 9 mg | One week after the last injection |
| WEGOVY injection 2.4 mg weekly | WEGOVY tablets 25 mg | One week after the last injection |
| WEGOVY tablets 25 mg | WEGOVY injection 2.4 mg weekly | The day after the last tablet |
Only those doses have a labelled switch. The WEGOVY label also names 1.7 mg injected as the alternative where the 25 mg tablet is not tolerated. The one-week gap matches the injection's pharmacology — a half-life of about a week, set out on the semaglutide half-life page — and the tablet's steady state takes 4 to 5 weeks to reach, by the oral label. Moving between semaglutide and tirzepatide is a different question with no labelled answer, covered on switching from semaglutide to tirzepatide.
The water and fasting conditions, and why they exist
All three labels set the same conditions: once daily on an empty stomach in the morning, with up to 4 ounces (about 120 mL) of plain water, swallowed whole, then at least 30 minutes before food, drink or other oral medicines; a missed tablet is skipped. These are not etiquette. In the labels' absorption studies, single doses taken with 50 mL of water gave higher exposure than with 240 mL, and in a 10-day study exposure rose as the post-dose fast lengthened from 15 to 120 minutes. The rules are the conditions under which the 1% to 2% was measured.
Sublingual and compounded oral forms
No sublingual semaglutide has an FDA label. Compounders sell them: a survey of compounding websites between February and March 2025 found 33 semaglutide or tirzepatide products differing from approved forms, and of the 17 with a single active ingredient, 82% were sublingual and 18% orally disintegrating tablets (Belcourt et al., Annals of Pharmacotherapy 2026, PMID 41689811). The authors found "a rationale" for such forms but that "whether these formulations offer advantages over innovator oral tablets has not been determined".
The only published pharmacokinetic study is in rats. Semaglutide under the tongue at 1 mg/kg gave relative bioavailability of 0.34% (made from crushed commercial tablets) and 0.29% (from peptide powder), against 0.06% for swallowed tablets at the same dose and 0.16% at 20 mg/kg (Liu et al., European Journal of Pharmaceutical Sciences 2026, PMID 41386332). The authors are employed by the Professional Compounding Centers of America and describe the work as a proof of concept supporting "research in humans". A rat result in a compounder's vehicle is not a human dose, and no human figure exists to convert from. The tirzepatide drops sold beside them have even less behind them, as the record on oral and sublingual tirzepatide shows.
What is not established
No label converts a tablet milligram into an injected one beyond the specific switching pairs above, and no label covers a sublingual, compounded or research-vial semaglutide taken by mouth. A lyophilised research vial is made for injection; swallowing its contents would have no SNAC and no measured bioavailability. The compound and its evidence are in Medibact's Semaglutide guide; the same oral question for a peptide with no approved tablet at all is set out on oral BPC-157 versus injection. Nothing on this page is an instruction; product and dose belong with the prescriber.
Sources and dates
Opened 2026-10-03: the RYBELSUS and OZEMPIC tablets label via openFDA (NDA 213051, Novo Nordisk, effective 2026-01-30; recent major changes dated 10/2025 and 12/2025) — sections 1, 2.1–2.4, 3 and 12.3; the WEGOVY injection and tablets label via DailyMed (set id ee06186f-2aa3-4990-a760-757579d8f77b, effective 2026-06-18) — sections 2.1–2.5, 5 and 12.3; PubMed records 41689811 and 41386332 (abstracts read). Absorbed amounts and ratios are arithmetic by this site from the label figures. Corrections go to the contact page.