In addition to the fact that Rybelsus is practically the same as Ozempic in pill form, the majority of doctors and researchers expect that to be positive. That is why, if patients have heart disease, their doctor recommends Ozempic instead of Rybelsus. In fact, Ozempic is approved to decrease the risk of negative heart events in people with type 2 diabetes and heart problems. However, Rybelsus isn't approved for this use.