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While the official recommendation for branded versions like Rybelsus is to take it first thing in the morning, the primary physiological requirement is an empty stomach

Major CVOTs such as TECOS were pragmatic usual-care safety studies with glycemic equipoise (small HbA1c differences), high background use of statins/ACE inhibitors/ARBs/antiplatelets, and heterogeneous adherence conditions that dilute any incremental macrovascular effect of a glucose-lowering drug that is otherwise CV-neutral [9]

10.1021/acs.jmedchem.8b00315[Epub ahead of print]

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