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Eloralintide vs Semaglutide (Wegovy): Amylin vs GLP-1

Eloralintide vs semaglutide: Lilly’s amylin agonist reached 20.1% weight loss at 48 weeks in phase 2, against 14.9% at 68 weeks for Wegovy in STEP 1. Mechanism, nausea and dosing compared.

Updated 8 November 2026 6 min read 8 primary sourcesHow we research

Key facts

  • Eloralintide is an amylin receptor agonist. Semaglutide (Wegovy) is a GLP-1 analogue with 94% homology to human GLP-1.[1][2]
  • Best obesity results: eloralintide 20.1% at 48 weeks (phase 2, 9 mg) vs semaglutide 2.4 mg 14.9% at 68 weeks (STEP 1).[3][4]
  • Nausea: 44.1% on semaglutide in STEP 1 vs 11% to 64% across eloralintide doses in phase 2.[5][6]
  • Semaglutide 2.4 mg (Wegovy) has been FDA approved since 2021. Eloralintide is investigational.[2]

Eloralintide vs Semaglutide: Key Differences

Eloralintide activates amylin receptors and semaglutide activates the GLP-1 receptor, two separate appetite pathways, and only semaglutide is approved.[1][2]

FeatureEloralintideSemaglutide 2.4 mg (Wegovy)
DeveloperEli LillyNovo Nordisk
ReceptorAmylin, selective for AMY1R[1]GLP-1[2]
Dosing in trialsOnce weekly, 1 to 9 mg[6]Once weekly, 16-week escalation to 2.4 mg[2]
Best obesity result-20.1% at 48 wk[3]-14.9% at 68 wk (STEP 1)[4]
Nausea11% to 64% by dose (placebo 14%)[6]44.1% (placebo 17.4%)[5]
StatusPhase 3Approved (FDA, June 2021)[2]

Eloralintide vs Semaglutide Weight Loss

Eloralintide 9 mg gave 20.1% mean weight loss at 48 weeks in phase 2, while semaglutide 2.4 mg gave 14.9% at 68 weeks in STEP 1, in separate trials using different estimands.[3][4]

Best reported mean weight loss, separate trials
Semaglutide 2.4 mg (68 wk)14.9%Eloralintide 6 mg (48 wk)17.6%Eloralintide 9 mg (48 wk)20.1%

Eloralintide: phase 2, 48 weeks, efficacy estimand, n = 263. Semaglutide: STEP 1, 68 weeks, treatment-policy estimand, n = 1,961. Not head-to-head.

STEP 1 counts everyone randomised, including people who stopped treatment; the eloralintide figure assumes everyone stayed on treatment. That difference alone can widen the gap.

Side Effects Compared

In STEP 1, 44.1% of people on semaglutide had nausea against 17.4% on placebo; in eloralintide’s phase 2, nausea ranged from 11% at 1 mg to 64% at 6 mg against 14% on placebo.[5][6]

  • Semaglutide in STEP 1 also caused diarrhoea (31.5%), vomiting (24.6%) and constipation (23.4%). 4.5% stopped because of GI effects.[5][4]
  • Eloralintide’s GI effects were similar to placebo at 1 mg and 3 mg and lower with slower dose escalation, according to Lilly.[3]
  • More detail: eloralintide side effects.

Amylin Plus GLP-1: Combinations

Novo Nordisk pairs the amylin analogue cagrilintide with semaglutide as CagriSema (20.4% at 68 weeks), while Lilly pairs eloralintide with tirzepatide as EloraTZP (23.3% at 48 weeks in type 2 diabetes).[7][8]

See eloralintide vs cagrilintide and eloralintide vs tirzepatide.

Frequently Asked Questions

Is eloralintide better than semaglutide?

In separate trials eloralintide 9 mg reached 20.1% at 48 weeks and semaglutide 2.4 mg reached 14.9% at 68 weeks, but the trials used different methods. No head-to-head trial exists, and semaglutide is approved while eloralintide is not.

Is eloralintide a GLP-1 like semaglutide?

No. Eloralintide acts on amylin receptors; semaglutide acts on the GLP-1 receptor. They work through different hormone pathways.

Does eloralintide cause less nausea than Wegovy?

It depends on dose. At 1 mg and 3 mg, eloralintide nausea (11% to 13%) was close to placebo. At 6 mg it was 64%. Semaglutide 2.4 mg caused nausea in 44.1% in STEP 1.

Can eloralintide be taken with semaglutide?

No trial of eloralintide with semaglutide has been reported. Lilly is testing eloralintide with tirzepatide instead. Nothing here is medical advice.

Sources

  1. Briere DA, et al. Discovery and first-in-human study of eloralintide. Molecular Metabolism 2025;102:102271. DOI 10.1016/j.molmet.2025.102271
  2. FDA. WEGOVY (semaglutide) prescribing information, revised 05/2026
  3. Eli Lilly press release, 6 Nov 2025: eloralintide phase 2 results
  4. Wilding JPH, et al. Semaglutide STEP 1. N Engl J Med 2021;384:989-1002. DOI 10.1056/NEJMoa2032183
  5. ClinicalTrials.gov NCT03548935, STEP 1 posted adverse events
  6. Billings LK, et al. Eloralintide phase 2, 48-week trial. The Lancet 2025;406:2631-2643. DOI 10.1016/S0140-6736(25)02155-5
  7. Garvey WT, et al. CagriSema REDEFINE 1. N Engl J Med 2025;393:635-647. DOI 10.1056/NEJMoa2502081
  8. Eli Lilly press release, 30 Sep 2026: EloraTZP (eloralintide + tirzepatide) phase 2b results

For research use only. Not for human or veterinary consumption. This guide summarises published research for information only. It is not medical advice and does not describe any use of products sold on this site.

Related Guides

Comparisons

Eloralintide vs Tirzepatide, and the EloraTZP Combination

Eloralintide vs tirzepatide (Zepbound, Mounjaro): amylin vs GIP/GLP-1, 20.1% at 48 weeks vs 20.9% at 72 weeks, and EloraTZP, the combination that reached 23.3% in type 2 diabetes.

Comparisons

Eloralintide vs Cagrilintide: Two Amylin Analogues Compared

Eloralintide vs cagrilintide: Lilly’s selective amylin agonist vs Novo Nordisk’s non-selective one. Receptor selectivity, half-life, 20.1% vs 10.8% weight loss, CagriSema and amycretin.

Basics

What Is Amylin? The Hormone Behind Eloralintide and Cagrilintide

Amylin is a 37-amino-acid hormone released with insulin that slows stomach emptying, curbs glucagon and signals fullness. How amylin analogues work, from pramlintide to eloralintide.