Quick answer: there are two GLP-1 pills FDA-approved for weight loss in 2026: the Wegovy pill (oral semaglutide 25 mg, approved December 2025) and Foundayo (orforglipron, approved April 2026).[4][5] In their main trials, adults without diabetes lost an average of 13.6% and 11.1% of body weight on the top doses.[1][2] A third pill, oral semaglutide for type 2 diabetes, was sold as Rybelsus and is now marketed as Ozempic tablets.[3][12]
This page compares all three and links to our deeper guides. If you are new to the drug class, start with how GLP-1 drugs work or the GLP-1 basics hub.
GLP-1 pills at a glance
| Wegovy pill | Foundayo | Rybelsus | |
|---|---|---|---|
| Drug | Semaglutide (peptide) | Orforglipron (small molecule) | Semaglutide (peptide) |
| Maker | Novo Nordisk | Eli Lilly | Novo Nordisk |
| FDA approval | Dec 22, 2025 | Apr 1, 2026 | Sep 20, 2019 |
| Approved for | Weight loss; heart risk in heart disease | Weight loss | Type 2 diabetes; heart risk in type 2 diabetes |
| Starting dose | 1.5 mg daily | 0.8 mg daily | 3 mg daily |
| Top dose | 25 mg daily | 17.2 mg daily | 14 mg daily |
| Food rules | Empty stomach, ≤4 oz water, wait 30 min | With or without food | Empty stomach, ≤4 oz water, wait 30 min |
Sources: FDA labels[1][2][3] and Drugs@FDA approval records.[4][5][6]
The Wegovy pill (oral semaglutide 25 mg)
The Wegovy pill uses the same molecule as the Wegovy injection, paired with an absorption enhancer called SNAC. It is approved to reduce and maintain body weight in adults, and to lower the risk of heart attack, stroke or heart-related death in adults with heart disease and obesity or overweight.[1]
- Dosing: 1.5 mg, then 4 mg, then 9 mg, each for 30 days, then 25 mg daily from day 91.[1]
- Results: in the 64-week OASIS 4 trial of 307 adults without diabetes, weight fell 13.6% versus 2.4% on placebo, and 47% lost at least 15%.[1]
- Side effects: stomach side effects affected 74.0% versus 42.2% on placebo.[7]
- Limits: not studied for weight loss in people with type 2 diabetes, and adults only.[1]
Full details in our Wegovy pill guide.
Foundayo (orforglipron)
Foundayo is a different kind of drug. Orforglipron is a small-molecule, non-peptide GLP-1 agonist, so it does not need an absorption enhancer or a fasting window.[8][2]
- Dosing: 0.8 mg daily for at least 30 days, then 2.5 mg, then 5.5 mg. It can go up to 9, 14.5 and 17.2 mg, at least 30 days apart, based on response and tolerability.[2]
- Results: in the 72-week ATTAIN-1 trial of 3,127 adults without diabetes, weight fell 7.4%, 8.3% and 11.1% on 5.5, 9 and 17.2 mg, versus 2.1% on placebo. In adults with type 2 diabetes, the top dose gave 9.6% versus 2.5%.[2]
- Side effects: nausea affected 26% to 35% depending on dose, versus 10% on placebo, and 8% stopped because of side effects, versus 3%.[2]
- Interactions: some medicines, such as the antibiotic clarithromycin and the seizure drug carbamazepine, change its blood levels, and people on birth control pills need a backup method for 30 days after starting and after each dose increase.[2]
See our Foundayo dosage guide and orforglipron profile.
Rybelsus (oral semaglutide for diabetes)
Rybelsus was the first GLP-1 pill, approved in 2019. It is approved to improve blood sugar in adults with type 2 diabetes and, since an October 2025 label update, to reduce the risk of major heart events in adults with type 2 diabetes at high risk.[3][6]
- Dosing: 3 mg daily for 30 days (a starter dose that does not control blood sugar), then 7 mg, and 14 mg if more control is needed.[3]
- Heart outcomes: in the SOUL trial of 9,650 people with type 2 diabetes and heart or kidney disease, major heart events occurred in 12.0% on oral semaglutide versus 13.8% on placebo over about four years.[10]
- Newer strengths: the current label also covers semaglutide tablets sold as Ozempic tablets in 1.5, 4 and 9 mg. They are not swapped with Rybelsus mg for mg.[3]
- Brand change: earlier in 2026, Novo Nordisk stopped marketing the pill under the Rybelsus name and began marketing it as the pill form of Ozempic or Wegovy, depending on the dose.[12]
Rybelsus is not approved for weight loss. More in Rybelsus vs Ozempic.
Foundayo vs Rybelsus head to head
The only head-to-head trial between GLP-1 pills is ACHIEVE-3, in 1,698 adults with type 2 diabetes on metformin. Over 52 weeks, orforglipron lowered HbA1c (a three-month blood sugar average) more than oral semaglutide: 1.71 and 1.91 points on the two orforglipron doses, versus 1.23 and 1.47 on semaglutide 7 mg and 14 mg.[9]
It came at a cost. Stomach side effects affected 58% to 59% on orforglipron versus 37% to 45% on semaglutide, and 9% to 10% stopped orforglipron because of side effects, versus 4% to 5%.[9] The trial was funded by Lilly and was open label. For the two weight-loss pills, see Foundayo vs the Wegovy pill.
Side effects all GLP-1 pills share
Pills and injections act on the same receptor, so the side effects look alike:[1][2][3]
- Nausea, diarrhea, vomiting and constipation, mostly while the dose is rising.
- A boxed warning about thyroid C-cell tumors seen in rodents. None of these pills should be used by people with a personal or family history of medullary thyroid cancer or with MEN 2.
- Warnings for pancreatitis, gallbladder disease, kidney injury from dehydration and low blood sugar when combined with insulin or sulfonylureas.
See GLP-1 side effects for the full picture.
Pill or injection?
A pill may suit people who dislike needles or want to avoid refrigerated pens. The trade-offs are a daily dose instead of weekly, strict morning timing for semaglutide pills, and, on current trial data, somewhat less weight loss than the strongest injections. If daily timing is hard, our guide to the best time to take a GLP-1 and the missed GLP-1 dose guide can help.
Compounded GLP-1 products and those sold online as “research” chemicals are not these approved pills. FDA notes that compounded and unapproved GLP-1 products are not reviewed for safety, effectiveness or quality.[11]
People also search for a tirzepatide pill. None exists; see is there a tirzepatide pill?
Questions to ask your clinician
- Do I qualify for a weight-loss pill, and which fits my routine and other medicines?
- If I have type 2 diabetes, is a pill likely to work as well for me as an injection?
- How will we handle side effects during the dose climb?
- What does my insurance cover?
Talk to a licensed clinician before starting or switching any GLP-1 medicine.
