Switching from Wegovy injections to tablets: what the product information says and who decides

The Wegovy summary of product characteristics (SmPC) in CIMA, the database of the Spanish Agency of Medicines and Medical Devices (AEMPS), describes a switch in only one case. If you use the 2.4 mg pen once a week, you can move to the 25 mg tablet once a day, starting one week after your last injection. Going the other way, from the 25 mg tablet to the 2.4 mg pen, you start the day after your last tablet. The SmPC gives no guidance for switching from other doses, from Ozempic or from Mounjaro, so your doctor decides.

Wegovy tablets have been authorised and available on prescription in Spain since this year, so many people already on the pen are asking whether they can switch. This is not a treatment plan for anyone. It is the framework within which a doctor assesses each case.

What does the SmPC say about switching from injections to tablets?

Section 4.2 of the SmPC for Wegovy tablets states that patients on subcutaneous semaglutide 2.4 mg once weekly can switch to oral semaglutide 25 mg once daily. They can start the tablets one week after their last injection. In other words, the switch goes straight from the pen's maintenance dose to the tablet's maintenance dose, skipping the starting doses of 1.5, 4 and 9 mg.

The reverse switch is in the SmPC for Wegovy injection. If you take 25 mg by mouth each day, you can move to 2.4 mg by injection each week, starting the day after your last oral dose. Both SmPCs open this section with the same warning: the effect of switching between subcutaneous and oral semaglutide cannot easily be predicted, because absorption varies more with the oral form.

What if my pen dose is lower than 2.4 mg?

The SmPC doesn't cover this. It only describes switching from 2.4 mg weekly and says nothing about people who have stayed on 1 or 1.7 mg. The injection's own SmPC allows for this when someone has significant digestive symptoms and the dose increase is delayed or they go back to the previous dose. There is no official tablet equivalent for these doses, so how to make the change is a clinical decision, not a calculation.

There is no tablet equivalent for the highest dose either. The 7.2 mg pen was authorised in CIMA in July 2026. It is only for adults who had a BMI of 30 or more when they started treatment and have been on 2.4 mg for at least four weeks. The tablet does not go above 25 mg, its maximum dose.

Can I switch from Ozempic or Mounjaro to Wegovy tablets?

There is no official guidance. The Wegovy tablets SmPC says nothing about switching from other doses of semaglutide, from other GLP-1 agonists or from tirzepatide, the active substance in Mounjaro. What it does say is that semaglutide should not be combined with other GLP-1 receptor agonists. It also says it has not been studied in people taking other weight-management products, so it is not recommended for them. You should never add the tablet on top of what you already inject.

Ozempic is a slightly different case. It is injectable semaglutide, but it is indicated for type 2 diabetes. The only table for converting from injectable semaglutide is in the SmPC for Rybelsus, another semaglutide tablet that is also for diabetes, and some of its doses are not sold in Spain. You can't use it to switch to Wegovy tablets. Switching from Mounjaro also means changing molecule, and CIMA lists no oral tirzepatide. We compare the two treatments in Wegovy or Mounjaro: tablet, weekly pen and monthly cost.

Does the tablet work as well as the pen?

The SmPC states that efficacy and safety were similar in the OASIS 4 trial, with the 25 mg tablet, and the STEP 1 trial, with the 2.4 mg pen. In OASIS 4, which included people without diabetes, weight fell by an average of 13.6% at 64 weeks, compared with 2.2% on placebo. In STEP 1 it fell by 14.9% at 68 weeks, compared with 2.4%. These were separate trials with different populations and durations, so you can't compare the figures directly.

The main difference is absorption. Only about 1-2% of the semaglutide in each tablet reaches the bloodstream, and exposure varies a lot from person to person and from day to day. The SmPC puts total variability at 166% after a single dose and 68% at steady state. It also acknowledges that some patients did not reach the same exposure on the 25 mg tablet as on the 2.4 mg pen. For this reason, it advises considering a switch to injections for people with type 2 diabetes who don't respond well to the tablet.

There is also one result that only applies to the pen. The 20% reduction in serious cardiovascular events seen in the SELECT trial was with subcutaneous semaglutide 2.4 mg. There has been no cardiovascular outcomes trial with the 25 mg tablet.

What do you gain and lose day to day by switching to tablets?

People usually consider switching for practical reasons, and the SmPCs help put these in context:

• No needle: you swallow the tablet instead of injecting once a week into your abdomen, thigh or upper arm.
• No fridge: you keep the tablets in their original packaging with no special temperature requirements, and they have a 3-year shelf life. The pen must be kept in the fridge at 2-8 °C until first use, and after that it lasts 6 weeks below 30 °C.
• Easier travel: a box of 30 tablets doesn't need to be kept cold.

The trade-off is that the tablet needs more discipline. You take it every day on an empty stomach, ideally after fasting for at least 8 hours. You swallow it whole with a sip of up to 120 ml of water, then wait at least 30 minutes before eating, drinking or taking other oral medicines. The pen is used once a week, at any time of day, with or without food. Missed doses are also handled differently. With the pen, you take a missed dose if 5 days or fewer have passed. With the tablet, you skip the missed dose and carry on the next day.

The tablet also interacts more with your other morning tablets. In a pharmacokinetic trial, taking it with five other tablets cut exposure by 34%. For people taking levothyroxine, the SmPC advises considering monitoring of thyroid levels.

What do the UK and US product labels say?

Essentially the same. The UK SmPC for Wegovy 25 mg tablets matches the European one: switch from 2.4 mg by injection to 25 mg by mouth one week after the last injection, with the same warning about variability. The US prescribing information was revised in June 2026. It describes switching in both directions with the same timings and adds that, if the 25 mg tablet is not tolerated, switching to the 1.7 mg pen may be considered.

Neither gives guidance on switching from tirzepatide or another GLP-1 agonist. The US label also advises against using Wegovy with other semaglutide products or any other GLP-1 agonist.

How much do the pen and the tablet cost?

Neither form is funded by the Spanish National Health System. BIFIMED, the Ministry of Health's database, lists both Wegovy tablets and Wegovy injection as "No financiado por resolución" (not funded, by official resolution). This means you pay the full price at the pharmacy with a prescription. According to Vademecum, the 2.4 mg pen costs €223.64 and holds 4 doses, which covers 4 weeks. For a box of 30 tablets of 25 mg, which lasts 30 days at one a day, the price reported in the press is €236.20. No official price has been published.

You can find the details for each dose in the price of Wegovy pens and why they aren't funded and in the price of Wegovy tablets and getting a prescription. The price of the starting-dose tablets has not been published.

Who decides on the switch, and what should you take to your appointment?

The doctor in charge of your treatment decides, because the SmPC leaves the question open: the effect of switching cannot easily be predicted. The tablet's patient leaflet also tells you not to stop treatment without talking to your doctor. It asks you to tell your doctor if you have type 2 diabetes, as they may need to adjust your other medication to prevent low blood sugar.

How the dose is increased for each form is covered in Wegovy doses, and the daily routine for the tablet in how to take Wegovy tablets.

Key takeaways

The SmPC describes switching from the pen to the tablet in only one case: from 2.4 mg to 25 mg, one week apart. Even then, it warns that the response cannot easily be predicted. Any other switch, from a different dose or a different treatment, needs a doctor's assessment.

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