Oral semaglutide 50mg (Rybelsus HD) — OASIS program results

The figures, for anyone assembling their own picture. For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and subcutaneous bioavailability near 89%. Those four numbers explain most of the questions people ask about timing.

Worth separating that from semaglutide, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.

A narrower follow-up, since the general answer is now clear:

How much of the oral variability is the SNAC absorption window and how much is dose, because the two get conflated constantly?

DataDave said:

For anyone assembling their own picture: Tmax is one to three days, terminal half-life about 165 to 170 hours, steady state at four to five weeks, and…

Coming at DataDave’s question from a different direction. The mechanism that matters here is not stomach emptying, it is central. GLP-1 receptor agonism in the arcuate nucleus stimulates POMC neurons and suppresses AgRP/NPY signalling, which is why the effect is appetite and food salience rather than physical fullness. Delayed gastric emptying largely tachyphylaxes over the first months; the appetite effect does not.

Reporting back.

Update — I went back to the injectable. Not because the tablet did not work, but because the fasting window and my mornings were never going to agree.

roxy_nash said:

The mechanism that matters here is not stomach emptying, it is central.

That is correct as far as it goes, and here is where it stops going. The absorption variability is real, but it partly averages out over weeks — the steady-state trough is less erratic than any single day would suggest. Where it bites is in the first fortnight, when people conclude the tablet does nothing.