Kidney Stones and Rybelsus (Semaglutide) aka Ozempic and Wegovy

Occasionally a reader experiences a very serious medical problem and attributes it to a medication. Such is the case with the reader below. She wants to know if there is a connection between kidney stones and Rybelsus. This is the oral form of semaglutide. You probably know this drug better as Ozempic or Wegovy.

Is There Any Relationship Between Kidney Stones and Rybelsus?

Q. When I was diagnosed with prediabetes, my doctor prescribed Rybelsus. It’s also supposed to help with weight loss.

I developed five kidney stones and then a month later another cluster of stones. Both times I needed surgery and stents for the stones.

I am prone to kidney stones. In the past I have gotten them every four or five years, not two months apart.

I stopped taking Rybelsus while going through this trauma, but I do want to take something for weight loss and diabetes. Every drug I read about has kidney problems as a side effect. Can you suggest a medication I could try without developing these horrible kidney stones?

A. Rybelsus is an oral (pill) form of semaglutide, a drug that is better recognized by the brand names of its injectable forms, Ozempic and Wegovy. These are what is known as GLP-1 or glucagon-like peptide-1 receptor agonists. You have no doubt heard about weight loss associated with these medications. You can learn more about that at this link.

What fascinates us is the popularity of both Ozempic and Wegovy over Rybelsus. Keep in mind that all three brand name drugs contain the active ingredient semaglutide. Both Ozempic and Wegovy are self-injected drugs. Ozempic has FDA approval for type 2 diabetes. Wegovy has FDA approval for weight loss.

Rybelsus has FDA approval for type 2 diabetes.

For reasons that we do not understand, the injectable forms of semaglutide have been wildly popular but the oral form has not be in shortage and has not garnered nearly as much publicity. We would have thought that Americans would much prefer to swallow a pill than inject themselves, but it appears that we are wrong about that.

What About Kidney Stones and Rybelsus?

There is no mention of kidney stones in the official prescribing information for these drugs. Side effects associated with Rybelsus include:

• Digestive distress (nausea, abdominal pain, diarrhea, vomiting, constipation, heartburn, gastritis and GERD)

Less common but more serious side effects include:

• Thyroid cancer
• Allergic reactions
• Kidney injury
• Gallstones

Lowering the risk of Kidney Stones:

A large trial compared different types of diabetes drugs with respect to the risk of kidney stones (JAMA Internal Medicine, Jan. 29, 2024). This research revealed that some drugs are less likely to trigger kidney stone formation than others.

You might ask your doctor about different diabetes medicines, such as dapagliflozin (Farxiga) or empagliflozin (Jardiance), known as SGLT2 inhibitors.

People with type 2 diabetes are susceptible to kidney stones. SGLT2 inhibitors aren’t perfect for protecting kidneys, but they are less likely to cause stones.

Reader Comments Welcome:

Have you been prescribed semaglutide, either as Ozempic, Wegovy or Rybelsus? How did you respond? Please share your experience in the comment section below. Have you had a problem with kidney stones and Rybelsus. Please let us know. Do you have a theory as to why the injectable forms of semaglutide are so popular but the oral formulation has not received as much attention?