Spain’s first weight-loss pill has reached pharmacies, and it works out a little dearer than the jab it’s meant to rival. Novo Nordisk says the tablet holds eight times more active ingredient than the injection, yet an estimated one to two per cent of it reaches the bloodstream.

The pill costs €236 a month, with no help from the state

Anyone in Spain who’s put off by the needle can now ask a doctor about weight-loss treatment in tablet form, as a daily version of Wegovy has gone on sale in pharmacies this week. It’s the first tablet from the same family of medicines as Ozempic for weight control to reach Spanish pharmacies, and Novo Nordisk presented it on Tuesday November 3.

Pharmacies are charging €236 for 30 days, which works out at roughly €2,834 a year, and patients pick up the entire bill. Spain’s public health system doesn’t fund any obesity drug, and the first month, while the dose is still building up, is cheaper at €179.89.

Here’s the curious part, though. Wegovy injections now cost between €179.89 and €223.64 a month after price cuts in March, which means the pill’s €236 sits a little above even the strongest jab. Prices can vary slightly between pharmacies, so it’s worth checking before you go. 

The tablet holds eight times more medicine than the jab 

Paula Barriga, who runs Novo Nordisk in Spain, said each tablet contains eight times more active ingredient than the injection. Both contain semaglutide, the medicine that quietens appetite and makes you feel full for longer. 

Very little of it makes it into the body, though. To help it across, the tablet is combined with an absorption booster called salcaprozate sodium (SNAC), and even then an estimated one to two per cent reaches the bloodstream. 

It’s prescription only, and not for everyone

Pharmacies can only hand it over with a doctor’s prescription, and as the state doesn’t fund it, that has to be a private one. It’s approved for adults with obesity, meaning a body mass index (BMI) of 30 or above, as well as overweight adults with a BMI between 27 and 30 who’ve at least one weight-related condition. Those include prediabetes, type 2 diabetes, high blood pressure, high cholesterol, sleep apnoea or heart disease. 

It’s meant to be used with a low-calorie diet and more exercise, and not for cosmetic weight loss. Ozempic and Rybelsus, the diabetes tablet, are licensed for type 2 diabetes, whereas Wegovy is the version approved for weight.

You take it when you wake up, then wait half an hour 

The tablet is taken once a day on an empty stomach, after at least eight hours without food, so most people will take it first thing. You then have to wait 30 minutes before eating, drinking or taking any other medicine. It also doesn’t need to be kept in the fridge, unlike the injection. 

Treatment starts small. The dose is 1.5 mg a day for four weeks, then 4 mg and 9 mg for at least four weeks each, before reaching the 25 mg maintenance dose, so there are at least 12 weeks of build-up. It’s worth asking a pharmacy what the prices are for the in-between steps and not just the starting dose.

Side effects are mostly digestive, including nausea, diarrhoea, constipation, tummy pain and vomiting, and they tend to appear at the start.

Trials showed average weight loss of 17 per cent

In a 64-week trial of 307 adults, people on the tablet lost 16.6 per cent of their body weight on average, compared with 2.8 per cent on a placebo pill. Some 34.4 per cent lost at least a fifth of their weight, although results will vary from person to person.

Family doctor Ana Cebrián said she expects the tablet to reach patients who turn down injections, with around one in three not wanting them.

Novo Nordisk says it’s still in talks with the Health Ministry over funding. However, the pricing commission turned down funding for the injection in July, September and October 2025. So until that changes, anyone interested should book a private appointment, check whether their BMI and health conditions qualify, and ask for the full cost of each dose step before they start.