Medically reviewed by Lindsay Cook, PharmD
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- GLP-1 medications are now available as both pills and injections, offering more options for weight loss treatment.
- The two forms work similarly and have comparable results, but differ in dosing, absorption, and regimens.
- Experts say the best choice comes down to personal preference and how well you tolerate each option.
After years of only being available as shots, certain GLP-1 medications are now being offered as pills. In January, drugmaker Novo Nordisk released an oral version of Wegovy, its semaglutide medication for weight loss, taken once daily and available by prescription. Here's how the GLP-1 pills and shots—specifically those that use the active ingredient semaglutide—compare.
How Do They Work?
The semaglutide pills and shots both activate glucagon-like peptide-1 (GLP-1) receptors, which help regulate blood sugar and appetite. The medications slow digestion, making you feel full for longer, and tell your brain that you're satisfied, reducing hunger.
The main difference is how your body absorbs them: While the shots inject medication directly into your bloodstream, the pills have to go through your digestive system, explained Su-Nui Escobar, DCN, RDN, founder of Nutrition for Weight Loss Meds.
“When semaglutide is taken as a pill, it has to pass through the digestive system before it can be absorbed,” Escobar told Health. That's why the pills come in higher doses—25 milligrams (mg) versus 2.4 mg for the shots—and are taken every day, as opposed to the weekly shot.
The tablets also come with a specific regimen to ensure they're absorbed properly and reduce the chance of side effects. You have to take it in the morning on an empty stomach and wait at least 30 minutes before eating or drinking. Meanwhile, the GLP-1 injections can be taken at any time of day and don't require an empty stomach.
Which is More Effective?
With the same active ingredient, the semaglutide pills and injections appear to have similar results for weight loss, with the shots potentially having a slight edge.
In a 2025 trial, patients who took the tablets lost an average of 13.6% of their body weight over 64 weeks. Participants in a 2021 study of injections lost an average of 14.9% of their body weight after 68 weeks.
Which Is Less Expensive?
With insurance, the copay for oral and injectable semaglutide is the same—as little as $25 a month.
Without coverage, the pills are slightly less expensive. For new users, the Wegovy tablets cost $149 per month, compared to $199 for the injections. As the dose increases, the price of the pills jumps to $299 a month for the 25-mg maintenance dose, and the cost of the shots rises to $349 for the standard 2.4-mg dose.
Which Is Safer?
Both medications slow digestion, which can cause gastrointestinal (GI) side effects, including nausea, diarrhea, and vomiting. Patients may also experience headache, fatigue, dizziness, and heartburn.
Sonia Gibson, MD, an endocrinologist with Allara Health, noted that the semaglutide tablets may cause more stomach issues because they have to be digested. Since the injections bypass the digestive tract, they may be easier to tolerate.
More serious risks, such as pancreatitis or gallbladder disease, are rare and similar in both forms, Gibson told Health. People with a history of certain types of thyroid cancer should not take either medication, Escobar added.
Who Might Benefit The Most?
With similar effectiveness, costs, and safety risks, deciding between the semaglutide pills and shots will likely come down to your personal preferences.
If giving yourself weekly shots sounds intimidating, the daily pill may be an easier option for you. Gibson also noted that the pills may be better for people seeking more moderate weight loss.
The tablets may also be a better fit for frequent travelers, Gibson said, since the pills are easier to transport and don't need to be refrigerated like the shots. Plus, if you're paying out of pocket, you would save about $50 a month on the pills.
On the other hand, a once-weekly injection may be easier for some people than following a strict pill regimen every day, Escobar said. The shots may also be better for people seeking greater weight loss, Gibson added, because of their slower, more predictable absorption.
"Ultimately, the best option depends on patient preference, medical history, insurance coverage, and treatment goals," Gibson said.
