To lose weight there will also be a pill to take every day. The European Commission has authorized Wegovy in tablets, the new oral formulation of semaglutide produced by Novo Nordisk, intended for the treatment of obesity and overweight associated with other health problems.
It is the first drug from the Glp-1 receptor agonist family authorized in the European Union in tablets for weight management. A step destined to further expand the market for medicines that have become famous with names such as Ozempic and Wegovy.
Who will be able to take the new pill
The new formulation contains 25 milligrams of semaglutide and must be taken once a day. It is indicated, together with a low-calorie diet and increased physical activity, for adults with a body mass index equal to or greater than 30, therefore with obesity. It can also be prescribed to adults with a BMI between 27 and 30, therefore overweight, as long as at least one condition linked to weight is present: for example hypertension, changes in blood sugar, type 2 diabetes, high cholesterol, obstructive sleep apnea or cardiovascular diseases.
The approval is based primarily on a study of 307 adults who received oral semaglutide 25 milligrams or a placebo for 64 weeks, along with guidance on nutrition and physical activity. Among people who continued to take the medicine correctly, one in three lost at least 20% of their weight. The efficacy therefore appears comparable to that of injectable semaglutide already used against obesity. The main difference is not the molecule, but the way it is taken: one tablet every day instead of one subcutaneous injection per week. It must also be taken on an empty stomach, with a little water, waiting at least 30 minutes before eating, drinking or taking other medicines. For those who fear needles it could represent a more acceptable alternative.
The EMA has provided four dosages, 1.5, 4, 9 and 25 milligrams, in order to gradually increase the quantity taken up to the maintenance dose. Oral semaglutide is not entirely new: it is already available under the name Rybelsus for the treatment of type 2 diabetes.
The real news is the authorization of a higher dose, under the Wegovy brand, specifically intended for weight loss and maintenance. But it is not a pill intended for those who want to quickly lose a few kilos for aesthetic reasons: it is always a prescription drug, designed for people with obesity or with excess weight accompanied by a clinical risk.
The side effects
The safety profile is also similar to that of the injectable version. The most frequent side effects include nausea, vomiting, diarrhea, constipation and abdominal pain. They tend to appear especially during progressive dose increases. The EMA has also classified non-arteritic anterior ischemic optic neuropathy, a pathology that can cause a sudden worsening of vision, as a “very rare” side effect of semaglutide.
Benefits for the heart and circulation
Novo Nordisk also highlights the cardiovascular benefits of semaglutide: it reduced the combined risk of cardiovascular death, heart attack and stroke by 20% in people with overweight or obesity and an already diagnosed cardiovascular disease. However, it is worth underlining that these results refer to studies on injectable semaglutide at a dose of 2.4 milligrams, even if the active ingredient is the same and the authorization takes into account all the knowledge available on semaglutide.
When will it arrive in Italy
Novo Nordisk has announced its intention to launch the pill in other countries during the second half of 2026. At the moment, however, an official date for its arrival in Italian pharmacies has not been communicated. The authorization from the European Commission allows marketing in the countries of the Union, but each state must deal with the price and possible reimbursement chapter separately. In Italy it will be up to the Italian Medicines Agency to classify the new packaging and evaluate a possible negotiation with the company.
Wegovy, Saxenda and Mounjaro, when prescribed for weight management, are currently classified in band C: this means that the cost is entirely borne by the patient. Semaglutide and tirzepatide can instead be reimbursed by the National Health Service under specific conditions when used for type 2 diabetes.
The price of Wegovy pens available in Italy varies approximately, depending on the dosage, from around 200 to over 380 euros for four weeks of therapy. There are no official figures for the new pill yet and it is not certain that a potentially lower production cost automatically translates into a lower price for the citizen.
If spending remains completely private, access to new treatments will be easier for those who can afford a few thousand euros a year. On the other hand, an indiscriminate reimbursement for millions of citizens would, on the other hand, have a huge impact on public finances. The most realistic route may be selective coverage for patients with severe obesity, cardiovascular disease, diabetes, kidney failure, sleep apnea or a particularly high risk of complications.
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