The once-a-day diabetes and weight-loss medication, which saw a blockbuster run after its 2022 India launch, is witnessing a levelling off in sales following the entry of injectable GLP-1 drugs earlier this year.
According to PharmaTrac data, Rybelsus sales fell from a peak of 1.46 lakh units or strips in November 2024 to 97,000 units in October 2025, even as overall demand for GLP-1-based therapies continues to soar. One strip contains 10 tablets.
Rybeslus, one of the most successful launches of the Danish drug marker, has clocked nearly ₹400 crore in cumulative sales in the last 12 months, but its growth momentum appears to have slowed as patients and physicians increasingly opt for injectable alternatives for weight loss and obesity.
“Our data shows sales of Rybelsus have fallen after the launch of GLP1 injectable Mounjaro in March,” said Sheetal Sapale, vice-president, commercial, at PharmaTrac. “This could be because in the weight loss segment injectables offer more convenience. So oral semaglutide may not have been able to add many new patients,” she added.
“The reversal of trend from pill to shot is now visible in the weight-loss segment, especially among people whose primary aim is to lose weight,” said Aasim Maldar, consultant-endocrinologist and diabetologist at Mumbai’s PD Hinduja Hospital. “However, as an anti-diabetic drug, Rybelsus continues to be highly effective.”
Doctors attribute the switch to a combination of factors including higher efficacy of injectables that are also available in higher dosage strengths, ease of use, and better compliance with injectables.
“Rybelsus delivers 3-7% weight loss at the currently approved 14 mg dose, the effect plateaus at that level,” said leading diabetologist Rajiv Kovil. “Once injectables such as Mounjaro and Wegovy became available, doctors started prescribing them for better results in weight loss indications, especially since weight-loss outcomes improve with higher doses of GLP-1s,” he said.
A Novo Nordisk spokesperson said: “Sales (of Rybelsus) remain robust as per plans but the channels of sales have shifted. Patients continue to take orals for better and effective treatment of diabetes.”
In sharp contrast, Eli Lilly’s Mounjaro (tirzepatide) has rapidly gained ground, cannibalising demand and cornering the lion’s share of India’s emerging GLP-1 market with ₹450 crore in sales within just seven months.
However, Novo Nordisk’s own injectable Wegovy, launched in June, has seen limited uptake. According to PharmaTrac data monthly sales of Mounjaro is almost ten times that of Wegovy.
Doctors also pointed out to the ease of usage of injectables such as Mounjaro and Wegovy compared to oral semaglutide regimen.
“Even though Rybelsus showed strong early results, it required a strict regimen, taking the pill with exactly 120 ml of water on an empty stomach and waiting 30 minutes before eating,” said Kovil. “For many patients, that wasn’t easy to follow.”
“It was one of the most successful launches Novo Nordisk ever had in India,” said Kovil. But with stronger injectable options now available, some of that momentum seems to have shifted.
Experts, however, believe the trend could swing back once higher-dose versions of Rybelsus (25 mg and 50 mg), which are now under US FDA review, become available.
These new strengths have shown 10-11% weight loss in global trials and are expected to receive approval by early 2026.
Experts are of the view that once higher doses are launched and generic and cheaper semaglutide becomes available after patent expiry, oral therapy could see a second wave of growth.
“Many patients who achieve target weight with injectables may shift back to oral medication for maintenance, especially if cost becomes a concern,” said Kovil.
Injectables such as Mounjaro and Wegovy currently cost ₹14,000-27,000 per month, while Rybelsus is priced lower at ₹10,000-13,000 per month.
As weight-loss therapy typically spans several months, doctors expect cost sensitivity among middle-class consumers to drive renewed interest in orals.
“Indians are preferring shots over pills for now, but the trend could change once higher-dose Rybelsus and affordable generics arrive,” said Kovil.
