Wegovy tablets: the first oral GLP-1 medicine licensed for weight loss in the UK

What the OASIS 4 trial actually found — and what it means for weight loss

The OASIS 4 phase-3 trial is the pivotal dataset behind the UK approval. It enrolled 307 adults with obesity or overweight plus at least one weight-related condition, none of whom had type 2 diabetes, and followed them for 64 weeks alongside structured lifestyle guidance. Participants taking oral semaglutide lost an average of around 13.6% of body weight, versus approximately 2.4% in the placebo group. Among those who stayed fully adherent to treatment throughout the trial, the average reached roughly 16.6%, but that figure applies specifically to the adherent subgroup (not to the average participant) so it should always be understood in that context.

The most commonly reported side effects in the trial were gastrointestinal: nausea, vomiting, diarrhoea and constipation appeared in around 74% of participants on oral semaglutide, compared with 42% on placebo. Most were mild to moderate in severity and tended to ease as the body adjusted, particularly after dose increases settled. That pattern mirrors what clinicians see with the injection and is one reason the gradual titration schedule exists, starting low gives the digestive system time to adapt. You can read the MHRA's full announcement of the tablet approval on GOV.UK.

What the data does not tell you is how you personally will respond. Body weight, metabolic health, existing conditions and how closely someone follows dietary guidance all affect outcomes. That is why a prescriber reviews each case individually before any prescription is issued.

How the tablet differs from the Wegovy injection in practice

The semaglutide in Wegovy tablets is chemically identical to the injection, but getting a large protein molecule absorbed through the gut wall requires a helper: SNAC (sodium N-(8-[2-hydroxybenzoyl] amino) caprylate) creates a localised pH change in the stomach that allows the semaglutide to pass into the bloodstream. Without it, the enzyme environment of the gut would break the molecule down before absorption could happen.

Taking the tablet correctly matters more than with most medicines. It goes first thing in the morning, on a completely empty stomach, with a small amount of plain water, roughly up to 120 ml. Food, coffee, other drinks and other oral medicines should all wait at least 30 minutes afterwards. Miss that window and absorption drops significantly, so a quick check that your water glass is measured and your phone alarm is set before bed is genuinely useful here, it takes under a minute and removes the main source of inconsistency.

Storage is simpler than the pen: no fridge needed, just a dry place away from direct heat. For anyone who travels frequently, moves between homes, or simply finds keeping medicines refrigerated impractical, that is a real-world difference. Detailed dosing and storage specifics are laid out in the Wegovy tablets SmPC on the eMC, which is the definitive reference for prescribers and patients alike.

Who the tablets are licensed for, and the NHS picture right now

The MHRA licence covers adults with a BMI of 30 or above, or a BMI of 27 to 29.9 alongside at least one weight-related condition such as high blood pressure, dyslipidaemia or obstructive sleep apnoea. The tablet is taken alongside a reduced-calorie diet and increased physical activity, not instead of them. Lower BMI thresholds may apply for certain ethnic backgrounds under UK clinical guidance, and a prescriber will factor this into their assessment.

The tablet is not licensed for people under 18, and it is not recommended during pregnancy, while breastfeeding, or when trying to conceive. People with a history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 should not use it. Anyone considering it alongside existing medications, including oral contraceptives or other daily tablets, should discuss timing and sequencing with their prescriber before starting.

On NHS availability: NICE has not yet published an appraisal of the oral formulation, so it sits outside NHS commissioning at launch. Access is currently through private prescription. The Wegovy injection has its own NICE appraisal (TA875), which restricts NHS supply to specialist weight management services with strict eligibility criteria. The tablet follows a separate regulatory track and will need its own appraisal before any NHS pathway opens. If you want to explore whether the tablet might suit you, our weight-loss treatment options page outlines how a private consultation works.

Rybelsus and the tablet confusion worth clearing up

Rybelsus is also an oral semaglutide tablet, also made by Novo Nordisk, but it is licensed for type 2 diabetes, not weight management. Its dose strengths (3 mg, 7 mg and 14 mg) are entirely separate from the Wegovy oral tablets used for weight loss, which follow a schedule of 1.5 mg, 4 mg, 9 mg and 25 mg. The two products share an active ingredient and a manufacturer but serve different licensed purposes and use different dose levels. This distinction matters practically: Rybelsus prescribed for diabetes is not a route to weight-loss treatment, and the semaglutide tablets page covers both products side by side if you want the full comparison.

A question our prescribers hear regularly is whether someone already taking the Wegovy injection can switch to the tablet. Clinically, the guidance is that patients established on the 2.4 mg weekly injection may move directly to the 25 mg tablet, but only subject to a clinical assessment, the circumstances matter. If that is your situation, it is worth raising at your next clinical review rather than assuming a direct swap is straightforward.

For a broader look at how Wegovy weight-loss tablets compare with other options, or to read about the 25 mg maintenance dose specifically, those pages go deeper on each angle. If you would like a prescriber to assess whether the tablet is clinically suitable for you, starting a free consultation is the first step.