GLP-1 tablets are set to change the way patients manage weight and blood sugar. These oral versions of popular injectable medications like Wegovy and Mounjaro could make treatment more convenient for those who prefer a pill over a pen.
In this guide, we explore how GLP-1 tablets work, where they are in development, and what they could mean for the future of weight management.
What are GLP-1 tablets?
GLP-1 tablets are a new form of medication that you take orally to help manage blood sugar levels and support weight loss. They belong to a group of medicines called glucagon-like peptide-1 receptor agonists (GLP-1 RAs), which work by mimicking a natural hormone in your body called GLP-1. This hormone is released after eating and helps control blood sugar, reduce appetite, and slow down digestion so you feel full for longer.
Traditionally, GLP-1 medicines such as Wegovy and Mounjaro have been given as injections under the skin. The introduction of oral tablets offers an alternative for those who find injections difficult or prefer taking a pill instead. These tablets aim to help the body release insulin when blood sugar rises, slow down how quickly your stomach empties to keep hunger at bay, and reduce the release of glucagon — a hormone that can raise blood sugar levels.
For many patients, having the choice of an oral GLP-1 treatment could make managing diabetes and weight more convenient and comfortable.
How Mounjaro & Wegovy oral tablets will work
GLP-1 tablets work by imitating the natural incretin hormones in your body that help regulate blood sugar after meals. Here's what they do:
- Stimulate insulin secretion: They encourage your pancreas to release insulin only when your blood sugar is high, helping to bring it down to a healthier level.
- Slow gastric emptying: By slowing how fast food leaves your stomach, they help you feel full longer and reduce hunger.
- Reduce glucagon secretion: They limit the release of glucagon, which otherwise tells your liver to release stored sugar, preventing blood sugar spikes.
One of the challenges in creating effective oral GLP-1 tablets has been protecting the medicine from being broken down by the digestive system before it can work. Scientists have been developing special technologies to help these medicines survive the stomach and reach the bloodstream.
Where are GLP-1 pills and tablets in the development process?
Key Developments in Oral GLP-1 Tablets:
- Rybelsus (oral semaglutide) was the first GLP-1 tablet approved in the UK and EU in 2020 to help adults with type 2 diabetes control blood sugar alongside diet and exercise. However, it’s not yet approved for weight loss or obesity.
- Oral versions of tirzepatide (the active ingredient in Mounjaro) are currently being developed, but “Mounjaro tablets” are not yet widely available. These new oral medicines aim to target two hormones (GLP-1 and GIP) for improved effects.
- Scientists are working on new technologies such as special coatings and carriers to help these tablets survive digestion and provide improved absorption.
- While Rybelsus is already available for diabetes, it’s unclear when oral versions of Mounjaro or Wegovy will be approved in the UK for diabetes or weight loss. Some predictions suggest approval could happen within 1 to 3 years, depending on clinical trials and regulations.
- All oral GLP-1 tablets must pass strict safety and quality checks by the UK’s MHRA (Medicines and Healthcare products Regulatory Agency).
Which companies & manufacturers are the key players in oral GLP-1 development
Several pharmaceutical companies are at the forefront of oral GLP-1 research:
- Novo Nordisk developed Rybelsus and is a leader in GLP-1 medicines.
- Eli Lilly is working on oral versions of tirzepatide (Mounjaro).
- Pfizer also has research programs exploring oral GLP-1 treatments.
- Emerging biotech firms are innovating new delivery technologies to make oral GLP-1 medicines more effective and accessible.
Collaboration between pharma companies and technology developers is helping to speed up the development of these oral treatments.
How Mounjaro and Wegovy tablets differ to the injectable formulations
While both oral and injectable GLP-1 medicines work through similar biological pathways, there are some differences to consider:
- Ease of use: Tablets may be preferred by patients who dislike needles or have difficulty with injections.
- Dosing and absorption: Oral tablets usually have specific requirements, such as taking them on an empty stomach with water and waiting before eating, to ensure the medicine is absorbed properly.
- Besides diabetes and weight loss, research is exploring other health benefits of GLP-1 medicines, including heart health.
Injectables have been proven effective over years of use, but oral options could improve adherence by offering a less invasive option.
Do the results differ between oral tablets and injectable weight loss medications?
When comparing outcomes:
- For blood glucose reduction: Oral semaglutide (Rybelsus) has shown significant HbA1c reductions compared with comparators in the PIONEER trial programme.
- For weight loss: The weight-loss effect of oral versions appears less dramatic compared to injectables. For example, one review of Rybelsus shows a body weight reduction of ~3.7kg over 26 weeks versus ~4.5kg for injectable semaglutide in the same period.
- Durability: Long-term data for oral forms is still emerging; durability of effect, maintenance of weight loss, and adherence patterns may differ.
Comparative Studies
- Oral semaglutide vs injectable semaglutide: Data suggests injectables may yield greater weight-loss but both have efficacy.
- GLP-1 tablets vs other oral diabetes medications: Oral semaglutide has outperformed some oral glucose-lowering meds in HbA1c reduction.
- Cost-effectiveness: Tablets may reduce logistical costs, but the final pricing, reimbursement and supply need to be established before full cost-effectiveness in the UK context is known.
Safety profile and side effects expected with Mounjaro & Wegovy oral tablets
The safety profile of tablets is expected to align broadly with known GLP-1 class effects.
- Common adverse effects: nausea, vomiting, diarrhoea, constipation — particularly in the early weeks of treatment.
- Risk of hypoglycaemia: Lower than insulin and sulfonylurea drugs when used alone.
- Pancreatic safety: As with any GLP-1, pancreatitis is a rare but serious concern; severe stomach pain requires immediate review.
- Cardiovascular outcomes: Oral semaglutide has demonstrated cardiovascular benefit (reduction in major adverse cardiovascular events) in a recent EU label update.
- Long-term safety: Because tablets are newer, long-term real-world monitoring is essential (especially for complications like retinopathy, renal outcomes, and off-label use).
Will these require different administration guidelines than injectables?
Yes — tablets often have distinctive administration guidelines:
- They often need to be taken on an empty stomach with a full glass of water.
- You may need to wait 30 minutes to an hour before eating or drinking anything else as some foods and other medicines can interfere with tablet absorption.
- Strategies may be suggested to reduce gastrointestinal side effects like nausea e.g. starting on a low dose, titrating dose steadily and staying hydrated is key.
Some patients may prefer a weekly injection rather than a daily tablet; others may prefer tablets. Adherence may depend on individual lifestyle, convenience and side-effect profile.
Summary
GLP-1 tablets represent an exciting new option for managing weight loss. By mimicking a natural hormone that regulates blood sugar and appetite, these oral medicines could offer a simpler alternative to injectable medications like Wegovy and Mounjaro. While Rybelsus is already available, oral versions of other popular GLP-1 drugs are in development and expected to arrive in the UK soon.
Whether it is tablets or injections, these medicines offer promising ways to improve blood sugar control and support healthy weight management.
References
- Oral semaglutide (Rybelsus®) approved for treatment of adults with type 2 diabetes (EU). GlobeNewswire+2GlobeNewswire+2
- Rybelsus accepted for restricted use within NHS Scotland. medicinesresources.nhs.uk+1
- Rybelsus UK weight-loss status: not currently approved for weight loss in UK. Ashcroft Pharmacy+1
- GLP-1 medicines for weight loss and diabetes: GOV.UK. GOV.UK
- Oral GLP-1 tablets: administration protocol (empty stomach, water only). bswtogether.org.uk+1
- Novel oral tirzepatide development. GlobeNewswire+1
- Oral semaglutide cardiovascular outcomes (EU label update).
