Mital Thakrar is ‘excited’ to give patients another treatment option (Image: Well Pharmacy)
It was the moment thousands of people had been waiting for — the first GLP-1 pill for weight loss was approved last week by the UK’s Medicines and Healthcare products Regulatory Agency (MHRA). The green light means many patients could swap from weekly injections to a daily tablet within months. Pharmacies have also been preparing and some already have tens of thousands of patients who have registered their interest.
Mital Thakrar, head of private services at Well Pharmacy, said he was “excited to be able to offer more options for patients”. However, there are many factors those interested in the Wegovy pill should carefully consider, so Mr Thakrar has shared with the Express some key information patients should be aware of.
What is the Wegovy weight loss pill?
The Wegovy pill contains the same active ingredient that is used in the brand’s weight loss jabs, which have soared in popularity in recent years. Mr Thakrar explained that semaglutide was “initially developed by the Danish multinational pharmaceutical company Novo Nordisk to treat type 2 diabetes“.
He added: “It works exactly the same way as the Wegovy injection, namely mimicking a natural hormone your body produces after you eat, called GLP-1. However, in pill form, it’s arguably far easier and more accessible, especially for those who may not like the idea of having to use an injectable.”
How does a pill replace an injection?
An injected drug can enter the bloodstream directly, while a drug delivered in tablet form must navigate the human digestive system. Mr Thakrar said: “To stop the tablet from being destroyed by the stomach acid, the Wegovy pill uses a special protective coating called SNAC.
“Once swallowed, this coating shields the tablet from your stomach acid, allowing it to safely pass through the stomach wall and into the bloodstream, where it can begin its work. This is why it’s incredibly important to take the tablet whole (rather than crushing or halving it) in order for it to be most effective.”
How does the Wegovy pill help you lose weight?
Like other injected GLP-1 drugs, the pill helps to regulate appetite and hunger in three ways, Mr Tharkrar said. The first is that it stops “food noise” by speaking to the appetite centres in your brain to turn down hunger and reduce intrusive cravings.
Secondly, the drug helps you feel fuller for longer by slowing down digestion so food stays in your stomach a little longer. Finally, the pill helps to prevent sugar crashes. Mr Thakrar said: “It helps your body manage blood sugar levels smoothly — minimising sugar spikes and crashes, which in turn staves off afternoon cravings for high-sugar snacks.”
Some patients prefer a weekly jab while others are keen to go needle-free (Image: Getty)
How much weight can you lose?
The OASIS-4 global clinical trial tested the pill in 307 adults who were overweight or obese. They were randomly assigned to receive either 25 mg oral semaglutide or a placebo once per day, alongside lifestyle intervention, for around 64 weeks.
Mr Thakrar said the results were “striking”. He added: “People taking the daily tablet lost an average of 16.6% of their total body weight when adhering to treatment, compared to around 2.7% in the placebo group.
“Around 87.3% of people on the pill lost at least 5% of their starting weight, and roughly one in three achieved 20% or more weight loss. In comparison, only a small proportion of the placebo group reached these thresholds, with around 3% losing 20% or more of their body weight.”
How do you take the Wegovy pill?
Although the SNAC coating helps to shield the pill from the effects of stomach acid, there are still some restrictions on when it can be taken.
Mr Thakrar explained three golden rules: “Take it on an empty stomach — yes, before your coffee: Take your tablet first thing in the morning, right when you wake up after an eight-hour fast.
“Why? If the tablet gets mixed up with any food mass, it’ll prevent the SNAC coating from touching the stomach wall. Your stomach fires up its enzymes, and the semaglutide will be broken down.
“Watch your water intake: Swallow the tablet whole with a small sip of plain water. Do not drink more than half a glass (120ml). Too much water dilutes the pill’s protective coating, meaning it’ll get broken down.
“The 30-minute rule: After taking the pill, wait at least 30 minutes before having breakfast, drinking your morning coffee or tea, or taking any other daily medications. This gives the pill the best chance to work uninterrupted.”
Are there side effects?
Like the injectable form of Wegovy, the pill can have side effects. Mr Thakrar said: “The OASIS-4 study found that gastrointestinal adverse effects were common, affecting around 74% of participants taking the Wegovy pill, compared to around 42% of those taking a placebo.
“These were generally described as mild to moderate in severity, and most occurred during the dose-escalation period. Importantly, the majority of these side effects reduced over time, and the overall safety profile of oral semaglutide 25 mg was consistent with other GLP-1 medications.”
Common side effects include nausea or a mild upset stomach, diarrhoea or constipation, heartburn and indigestion, and feeling unusually tired.
How much will the Wegovy pill cost?
Mr Thakrar said: “Novo Nordisk is yet to confirm the official UK retail price, however, as the Wegovy pill is already out in the US, we can start to build an idea of what to expect when it does.”
In the US, the list price for a 30-day supply of Wegovy tablets is identical to the injection at around $1,350 per month. However, almost no one pays the list price and uninsured patients pay a discounted rate of around $149 per month, rising to $299 per month if higher doses are required.
Mr Thakrar added: “It’s worth saying that the UK private weight-loss clinics do not mimic US prices directly, however, we’d expect the ratio between the two products to be the same.
“Given that pills are priced at the same cost as the Wegovy pen injectable, we’d expect the Wegovy pill to start at around the same as the lowest strength of Wegovy, which is the 0.25mg. The costs will then scale to between £140-£190 for mid-doses and then £200+ for the maximum weight-maintenance doses.”
Will it be available on the NHS?
The National Institute for Health and Care Excellence (NICE) will decide whether the pill should be recommended for the NHS. Mr Thakrar said: “Private online clinics will be the quickest and most accessible option for most people. If it follows the same route as the injection, it’ll likely be reserved for specialist weight management clinics for patients with severe BMIs.”
The pharmacist added: “We know one size doesn’t fit all, so offering a range of options is important. All patients at Well are clinically reviewed and through consultation our pharmacists can support them with the best option to suit their journey.”
