Key facts
- Three GLP-1 pills are FDA approved: Foundayo (orforglipron, Lilly) and the Wegovy pill (oral semaglutide 25 mg, Novo Nordisk) for weight, and Rybelsus, now also sold as Ozempic tablets (oral semaglutide), for type 2 diabetes.[1][12][18]
- In their main obesity trials, the Wegovy pill gave 13.6% weight loss at 64 weeks (OASIS 4) and Foundayo 11.2% at 72 weeks (ATTAIN-1). No trial has compared the two directly for weight.[14][8]
- Foundayo is a small molecule taken with or without food. Oral semaglutide is a peptide with an absorption enhancer (SNAC), taken on an empty stomach with up to 4 ounces of water, then 30 minutes before eating.[2][11]
- Self-pay prices published by the makers start at $149 a month for Foundayo, the Wegovy pill and Ozempic tablets.[7][16][21]
- All three are prescription only. None is sold by DBR Labs, and this page is not medical advice.[3][12][18]
GLP-1 Pills at a Glance
As of November 2026 the FDA has approved three GLP-1 pills: Foundayo on 1 April 2026, the Wegovy pill on 22 December 2025 and Rybelsus on 20 September 2019, with Rybelsus also sold in a newer formulation as Ozempic tablets.[1][12][18][20]
| Pill | Maker | Approved for | US approval | Doses (once daily) | How to take | Best weight result (trial) | Self-pay price |
|---|---|---|---|---|---|---|---|
| Foundayo (orforglipron) | Eli Lilly | Weight management in adults[1] | 1 Apr 2026[1] | 0.8, 2.5, 5.5, 9, 14.5, 17.2 mg[2] | With or without food, any time of day[2][4] | -11.2% at 72 wk, top dose (ATTAIN-1)[8] | $149 to $349 a month by dose[7] |
| Wegovy pill (oral semaglutide) | Novo Nordisk | Weight management in adults; cutting heart attack and stroke risk in adults with heart disease and obesity or overweight[11] | 22 Dec 2025[12] | 1.5, 4, 9 mg, then 25 mg maintenance[11] | Empty stomach, morning, up to 4 oz water; wait 30 min[11] | -13.6% at 64 wk, 25 mg (OASIS 4)[14] | $149 to $299 a month by dose[16] |
| Rybelsus (oral semaglutide) | Novo Nordisk | Type 2 diabetes: blood sugar and cardiovascular risk; not weight management[17] | 20 Sep 2019[18] | 3, 7, 14 mg[17] | Empty stomach, morning, up to 4 oz water; wait 30 min[17] | -3.7 kg at 26 wk, 14 mg, type 2 diabetes (PIONEER 1)[17] | Not published on rybelsus.com; as little as $25 with commercial coverage[22] |
| Ozempic tablets (oral semaglutide) | Novo Nordisk | Type 2 diabetes, same uses as Rybelsus[17] | Name approved 4 Feb 2026; on sale from 4 May 2026[20][21] | 1.5, 4, 9 mg[17] | Empty stomach, morning, up to 4 oz water; wait 30 min[17] | Same efficacy as Rybelsus, by bioequivalence[20] | $149 to $299 a month by dose[21] |
What Is a GLP-1 Pill?
A GLP-1 pill is a once-daily tablet that activates the GLP-1 receptor, the same target as weekly injections such as Wegovy and Ozempic; in the US there are three, in doses from 0.8 mg (Foundayo) to 25 mg (Wegovy pill).[2][11][17]
- The target. GLP-1 receptors sit in brain areas that regulate appetite. The labels say these drugs reduce food intake, and they also slow stomach emptying.[2][11]
- Two kinds of pill. Oral semaglutide is the same peptide as the injections, made swallowable with an absorption enhancer. Orforglipron is a different, small non-peptide molecule designed to be taken by mouth.[11][8]
- Once a day, not once a week. Every approved GLP-1 pill is taken daily. The injections they are compared with are weekly.[2][11][17]
- Same class warnings. All three labels carry the boxed warning on thyroid C-cell tumours and warnings on pancreatitis and gallbladder disease.[2][11][17]
Approved GLP-1 Pills
Two GLP-1 pills are FDA approved for weight loss, Foundayo and the Wegovy pill, and one oral semaglutide product, sold as Rybelsus (3, 7 and 14 mg) and Ozempic tablets (1.5, 4 and 9 mg), is approved for type 2 diabetes only.[1][11][17]
- Foundayo (orforglipron). Approved on 1 April 2026 to reduce excess body weight and keep it off in adults with obesity, or overweight with at least one weight-related condition. Lilly began shipping on 6 April 2026.[1][4] Lilly said it would file for type 2 diabetes by the end of the second quarter of 2026; the 07/2026 label still covers weight management only.[6][2]
- Wegovy pill (oral semaglutide 25 mg). Approved on 22 December 2025, the first GLP-1 pill for weight in the US. The label also covers cutting the risk of heart attack, stroke and cardiovascular death in adults with established heart disease and obesity or overweight.[12][13][11]
- Rybelsus (oral semaglutide 3, 7, 14 mg). Approved on 20 September 2019 for blood sugar control in adults with type 2 diabetes, and since 17 October 2025 also to reduce the risk of major cardiovascular events in high-risk adults with type 2 diabetes.[18][17] In the SOUL trial behind that use, 12.0% on oral semaglutide had a major cardiovascular event over a median of about 4 years, against 13.8% on placebo.[19]
- Ozempic tablets (oral semaglutide 1.5, 4, 9 mg). A reformulated version of Rybelsus, named Ozempic tablets by the FDA in February 2026 and on sale from 4 May 2026. The label says the two are not substitutable milligram for milligram.[20][21][17]
Rybelsus and Ozempic tablets are not approved for weight management, although people lose some weight on them: 3.7 kg on 14 mg against 1.4 kg on placebo over 26 weeks in PIONEER 1.[17] For the full orforglipron profile, see what is orforglipron.
How GLP-1 Pills Differ
Orforglipron is a small molecule with 77% oral bioavailability that can be taken with or without food, while oral semaglutide is a peptide with only 1% to 2% bioavailability that needs an empty stomach, up to 4 ounces of water and a 30-minute wait.[2][11]
| Feature | Foundayo (orforglipron) | Wegovy pill, Rybelsus, Ozempic tablets (oral semaglutide) |
|---|---|---|
| Molecule | Small molecule, non-peptide[8] | Peptide (semaglutide, molecular weight 4,113.58 g/mol)[17] |
| How it gets absorbed | Absorbed directly; absolute bioavailability 77% after 0.8 mg[2] | Co-formulated with SNAC (salcaprozate sodium), an absorption enhancer; absorbed mainly in the stomach[11] |
| Bioavailability | 77%[2] | 1% to 2% (Wegovy pill, Ozempic tablets); 0.4% to 1% (Rybelsus)[11][17] |
| Food and water | With or without food; no water rule[2] | Empty stomach in the morning, up to 4 oz of plain water, then at least 30 minutes before food, drinks or other pills[11][17] |
| Half-life | About 29 to 49 hours[2] | About 1 week[17] |
| Starting dose and steps | 0.8 mg, raised at least every 30 days[2] | Wegovy pill: 1.5 mg, 4 mg, 9 mg, then 25 mg from day 91. Rybelsus: 3 mg, 7 mg, then 14 mg if needed[11][17] |
| Missed dose | Restart escalation if 7 or more doses in a row are missed[2] | Wegovy pill: skip it and take the next dose the next day[11] |
The water and timing rules matter for oral semaglutide because absorption changes with them. In label studies, semaglutide exposure was higher with 50 mL of water than with 240 mL, and higher with a longer wait before eating.[17] For Foundayo, food lowered exposure by 19%, which the label calls not clinically relevant.[2]
GLP-1 Pill Weight Loss Results
The Wegovy pill (25 mg) gave 13.6% weight loss at 64 weeks in OASIS 4 against 2.2% on placebo, and Foundayo (top dose) gave 11.2% at 72 weeks in ATTAIN-1 against 2.1%, in separate trials of adults without diabetes.[14][8]
Separate trials: OASIS 4 at 64 weeks (n = 307) and ATTAIN-1 at 72 weeks (n = 3,127), both regardless of stopping treatment, from the journal abstracts. Not a head-to-head comparison.
| Measure | Wegovy pill 25 mg (OASIS 4, 64 wk) | Foundayo top dose (ATTAIN-1, 72 wk) |
|---|---|---|
| Mean weight change, everyone | -13.6% vs -2.2% placebo[14] | -11.2% vs -2.1% placebo[8] |
| Mean weight change, stayed on treatment | -16.6% vs -2.7%[13] | -12.4% vs -0.9%[4] |
| Lost 10% or more | 59.8% vs 14.4%[11] | 54.6% vs 12.9%[8] |
| Lost 15% or more | 47% vs 5.5%[11] | 36.0% vs 5.9%[8] |
| Lost 20% or more | 27.9% vs 3.1%[11] | 18.4% vs 2.8%[8] |
- Best GLP-1 pill for weight? There is no single answer. The Wegovy pill has the higher figure on paper, but the trials differ in size (307 against 3,127 people), length and population, and no trial has put the Wegovy pill and Foundayo side by side for weight.[14][8]
- The only head-to-head pill trial is ACHIEVE-3, in type 2 diabetes, against the Rybelsus doses of oral semaglutide (7 mg and 14 mg), not the 25 mg Wegovy dose. Orforglipron lowered HbA1c by up to 1.91 points against 1.47, and Lilly reports weight loss of 9.2% against 5.3%.[9][5]
- The trade-off in ACHIEVE-3 was tolerability: more people stopped orforglipron because of adverse events (9% to 10%) than oral semaglutide (4% to 5%).[9]
- A higher oral semaglutide dose of 50 mg gave 15.1% at 68 weeks in OASIS 1, but 50 mg is not an approved dose.[15]
For a closer look at the two weight-loss pills, see Foundayo vs Wegovy pill.
GLP-1 Pill Side Effects
Stomach and gut side effects are the most common on every GLP-1 pill: in their obesity trials, 74.0% had GI events on the Wegovy pill against 42.2% on placebo, and on Foundayo nausea reached 35% against 10%.[14][2]
| Measure | Foundayo (pooled ATTAIN) | Wegovy pill 25 mg (OASIS 4) | Rybelsus 14 mg (placebo-controlled pool) |
|---|---|---|---|
| Nausea | 26% to 35% vs 10%[2] | Not given separately; label says similar to Wegovy injection[11] | 20% vs 6%[17] |
| Any GI event | 60% to 69% vs 37%[2] | 74.0% vs 42.2%[14] | 41% vs 21%[17] |
| Stopped due to side effects | 8% vs 3%[2] | 6.9% vs 5.9%[11] | 8% stopped for GI reactions (14 mg)[17] |
- Nausea, vomiting and diarrhoea are most common while the dose is being raised, according to the Foundayo and Rybelsus labels.[2][17]
- All three labels carry a boxed warning on thyroid C-cell tumours and say not to use the drug with a personal or family history of medullary thyroid carcinoma or MEN 2.[2][11][17]
- Shared warnings include acute pancreatitis, gallbladder disease, kidney injury from dehydration, low blood sugar with insulin or sulfonylureas, and aspiration during anaesthesia.[2][11][17]
- The SNAC enhancer in oral semaglutide reaches breast milk, so the Wegovy pill and Rybelsus labels advise against breastfeeding.[11][17]
How Much Do GLP-1 Pills Cost?
Self-pay prices published by the makers start at $149 a month for Foundayo (0.8 mg), the Wegovy pill (1.5 mg) and Ozempic tablets (1.5 mg), and top out at $349 for Foundayo and $299 for the Wegovy pill and Ozempic tablets.[7][16][21]
| Pill | Starting dose | Middle doses | Top dose | With commercial coverage |
|---|---|---|---|---|
| Foundayo | $149 (0.8 mg) | $199 (2.5 mg), $299 (5.5 mg, 9 mg) | $349 (14.5 mg, 17.2 mg); $299 with a refill within 45 days | As little as $25[7] |
| Wegovy pill | $149 (1.5 mg) | $199 (4 mg), $299 (9 mg) | $299 (25 mg) | As little as $25[16] |
| Ozempic tablets | $149 (1.5 mg) | $199 (4 mg) | $299 (9 mg) | As little as $25[21] |
| Rybelsus | Not published | Not published | Not published | As little as $25[22] |
- Until 31 December 2026 Lilly cuts Foundayo 2.5 mg to $149 and 5.5 mg to $199.[7]
- Eligible Medicare Part D patients can get Foundayo and the Wegovy pill for $50 a month through the Medicare GLP-1 Bridge.[7][16]
- Ozempic tablets self-pay is through NovoCare Pharmacy and select telehealth providers.[21]
For the full Foundayo price breakdown, savings card terms and Medicare rules, see Foundayo price.
GLP-1 Pills in Development
Oral amycretin (zenagamtide) from Novo Nordisk gave 13.1% weight loss at 12 weeks on 100 mg a day in phase 1 and is heading into phase 3, while Pfizer stopped its GLP-1 pill danuglipron on 14 April 2025.[25][23]
| Candidate | Maker | Type | Latest result | Status |
|---|---|---|---|---|
| Amycretin (zenagamtide), oral | Novo Nordisk | Single peptide acting on GLP-1 and amylin receptors | Phase 1: -13.1% at 12 wk on 100 mg vs -1.2% placebo (exploratory)[25][26] | Moving to phase 3 for weight, per Novo in June 2025[25] |
| Amycretin (zenagamtide), oral, type 2 diabetes | Novo Nordisk | As above | Phase 2, 36 wk: HbA1c -0.9 to -1.4 points on 6 to 50 mg[24] | Phase 2 complete[24] |
| Oral semaglutide 25 mg for type 2 diabetes | Novo Nordisk | Peptide with SNAC | Approved for weight as the Wegovy pill[11] | Filed as Ozempic tablets 25 mg; FDA decision expected by end of 2026[20] |
| Orforglipron for type 2 diabetes | Eli Lilly | Small molecule | ACHIEVE-3: HbA1c -1.91 points vs -1.47 for oral semaglutide 14 mg[9] | Lilly planned to file by end of Q2 2026[6] |
| Danuglipron | Pfizer | Small molecule | One participant had possible drug-induced liver injury, which resolved[23] | Discontinued 14 Apr 2025[23] |
Pfizer said liver enzyme rises across more than 1,400 danuglipron participants were in line with approved drugs in the class, but stopped the programme after the single liver case and input from regulators.[23] For the injected and oral amycretin data, see amycretin (zenagamtide).
GLP-1 Pill vs Injection
On the Wegovy label, the 25 mg daily pill gives semaglutide levels predicted to be comparable to the 2.4 mg weekly injection, and in separate trials the pill gave 13.6% weight loss at 64 weeks against 14.9% at 68 weeks for the injection in STEP 1.[11][14][27]
- Wegovy pill vs Wegovy injection. The label lets people switch either way: start the 25 mg pill one week after the last 2.4 mg injection, or start the injection the day after the last 25 mg pill. Levels vary more with the pill.[11]
- Foundayo vs Zepbound. Foundayo gave 11.2% at 72 weeks in ATTAIN-1; tirzepatide 15 mg, the drug in Zepbound, gave 20.9% at 72 weeks in SURMOUNT-1. These are separate trials. See Foundayo vs Zepbound.[8][28]
- Switching from injections to a pill. In ATTAIN-MAINTAIN, people who switched to orforglipron after reaching a plateau on tirzepatide or semaglutide injections kept 74.7% and 79.3% of their weight loss at 52 weeks, against 49.2% and 37.6% on placebo.[10]
- Daily routine. The pills are taken every day; the injections once a week. Oral semaglutide also comes with the empty-stomach rule.[11][2]
- Price. The Wegovy pen is $349 a month self-pay after an introductory offer, against $149 to $299 for the Wegovy pill.[16]
Frequently Asked Questions
What is the GLP-1 pill?
A once-daily tablet that activates the GLP-1 receptor, like the weekly injections. In the US there are three: Foundayo (orforglipron) and the Wegovy pill (oral semaglutide 25 mg) for weight management, and Rybelsus, also sold as Ozempic tablets, for type 2 diabetes.
Is there a GLP-1 pill for weight loss?
Yes, two. The FDA approved the Wegovy pill on 22 December 2025 and Foundayo on 1 April 2026, both for adults with obesity, or overweight with at least one weight-related condition, alongside diet and exercise. Rybelsus and Ozempic tablets are approved for type 2 diabetes, not weight loss.
What is the best GLP-1 pill?
There is no single best. The Wegovy pill gave 13.6% weight loss at 64 weeks in OASIS 4 and Foundayo 11.2% at 72 weeks in ATTAIN-1, but these were separate trials and no head-to-head trial for weight exists. Foundayo can be taken with or without food, while the Wegovy pill needs an empty stomach and a 30-minute wait. The right choice is a decision for a prescriber.
How much does the GLP-1 pill cost?
Makers’ self-pay prices start at $149 a month for Foundayo, the Wegovy pill and Ozempic tablets. Top doses cost $349 a month for Foundayo ($299 with a refill within 45 days) and $299 for the Wegovy pill and Ozempic tablets. With commercial coverage, savings cards bring the cost to as little as $25. Prices checked 8 November 2026.
Is the GLP-1 pill as effective as the injection?
For semaglutide, close. The Wegovy label predicts the 25 mg daily pill gives semaglutide levels comparable to the 2.4 mg weekly injection, and the pill gave 13.6% weight loss at 64 weeks against 14.9% at 68 weeks for the injection in a separate trial. Foundayo’s 11.2% at 72 weeks is lower than tirzepatide’s 20.9% in SURMOUNT-1, again in separate trials.
Can you get a GLP-1 pill over the counter?
No. Foundayo, the Wegovy pill, Rybelsus and Ozempic tablets are all prescription-only medicines in the FDA’s records and labels. You need a prescription from a licensed prescriber.
Sources
- FDA. NDA 220934 approval letter, Foundayo (orforglipron) tablets, 1 Apr 2026
- FDA. FOUNDAYO (orforglipron) tablets prescribing information, revised 07/2026 (NDA 220934, supplement 3)
- openFDA Drugs@FDA record, NDA 220934 (Foundayo): products and marketing status
- Eli Lilly press release, 1 Apr 2026: FDA approves Foundayo (orforglipron)
- Eli Lilly press release, 8 Jun 2026: ACHIEVE-2, ACHIEVE-3 and ACHIEVE-5 results (ADA 2026)
- Eli Lilly press release, 16 Apr 2026: ACHIEVE-4 topline results and type 2 diabetes submission plan
- Lilly, Foundayo coverage and savings page (page code CMAT-27550 08/2026, checked 8 Nov 2026)
- Wharton S, et al. Orforglipron, an oral small-molecule GLP-1 receptor agonist for obesity treatment (ATTAIN-1). N Engl J Med 2025;393(18):1796-1806. DOI 10.1056/NEJMoa2511774
- Rosenstock J, et al. Once-daily oral orforglipron compared with oral semaglutide in type 2 diabetes (ACHIEVE-3). The Lancet 2026;407(10534):1147-1160. DOI 10.1016/S0140-6736(26)00202-3
- Aronne LJ, et al. Orforglipron for maintenance of body weight reduction (ATTAIN-MAINTAIN). Nature Medicine 2026;32(7):2679-2687. DOI 10.1038/s41591-026-04386-7
- FDA. WEGOVY (semaglutide) injection and tablets prescribing information, revised 06/2026 (NDA 218316, supplement 7)
- openFDA Drugs@FDA record, NDA 218316 (Wegovy tablets): approval 22 Dec 2025, products and marketing status
- Novo Nordisk press release, 22 Dec 2025: FDA approves Wegovy pill
- Wharton S, et al. Oral semaglutide at a dose of 25 mg in adults with overweight or obesity (OASIS 4). N Engl J Med 2025;393(11):1077-1087. DOI 10.1056/NEJMoa2500969
- Knop FK, et al. Oral semaglutide 50 mg taken once per day in adults with overweight or obesity (OASIS 1). The Lancet 2023;402(10403):705-719. DOI 10.1016/S0140-6736(23)01185-6
- Novo Nordisk, What to pay for Wegovy (checked 8 Nov 2026)
- FDA. RYBELSUS and OZEMPIC (semaglutide) tablets prescribing information, revised 01/2026 (NDA 213051, supplement 30)
- openFDA Drugs@FDA record, NDA 213051 (Rybelsus and Ozempic tablets): approval 20 Sep 2019, products and marketing status
- McGuire DK, et al. Oral semaglutide and cardiovascular outcomes in high-risk type 2 diabetes (SOUL). N Engl J Med 2025;392(20):2001-2012. DOI 10.1056/NEJMoa2501006
- Novo Nordisk press release, 4 Feb 2026: FDA approves Ozempic tablets name for oral semaglutide 1.5, 4 and 9 mg
- Novo Nordisk press release, 1 May 2026: Ozempic pill US availability and self-pay prices
- Novo Nordisk, Rybelsus savings and support page (page code US26RYB00012 May 2026, checked 8 Nov 2026)
- Pfizer press release, 14 Apr 2025: Pfizer provides update on oral GLP-1 receptor agonist danuglipron
- Mora P, et al. Once-daily oral zenagamtide in adults with type 2 diabetes: phase 2 dose-finding trial. The Lancet 2026;408(10555):607-620. DOI 10.1016/S0140-6736(26)01247-X
- Novo Nordisk press release, 20 Jun 2025: amycretin results and move to phase 3
- Gasiorek A, et al. Oral amycretin phase 1. The Lancet 2025;406:135-148. DOI 10.1016/S0140-6736(25)01176-6
- Wilding JPH, et al. Semaglutide STEP 1. N Engl J Med 2021;384:989-1002. DOI 10.1056/NEJMoa2032183
- Jastreboff AM, et al. Tirzepatide SURMOUNT-1. N Engl J Med 2022;387:205-216. DOI 10.1056/NEJMoa2206038
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