Orforglipron is a once-daily GLP-1 pill from Eli Lilly, sold as Foundayo. The FDA approved it on April 1, 2026 for chronic weight management in adults with obesity or overweight plus a weight-related condition.[2][1] In its main trial, people on the highest dose lost an average of 11.2% of their body weight over 72 weeks, versus 2.1% on placebo.[8] Unlike oral semaglutide, it can be taken with or without food.[1]
This profile covers how orforglipron works, the trial results, price, dosing, side effects, and how it compares with Zepbound, Wegovy and other GLP-1 drugs.
What is orforglipron?
Orforglipron is a small-molecule drug that activates the GLP-1 receptor, the same target as semaglutide and liraglutide. It is not a peptide: it is a non-peptide chemical, which is why it survives digestion as a pill.[8][1] It was discovered by Japan’s Chugai Pharmaceutical and licensed to Lilly in 2018.[4]
It was the first new drug approved under the FDA’s National Priority Voucher program, 50 days after filing, which FDA called the fastest approval of a new molecular entity since 2002.[3]
How orforglipron works
Orforglipron binds the human GLP-1 receptor tightly and triggers a full response even at low receptor occupancy.[16] Like other GLP-1 drugs, it reduces appetite and slows stomach emptying. It does not work on rat or mouse GLP-1 receptors, so animal studies required specially engineered animals.[16]
Its half-life of about 29 to 49 hours allows once-daily dosing. Food lowers absorption by about 20%, which FDA judged not clinically relevant.[1][17]
Orforglipron results: what the trials show
Weight loss
| Trial | Who | Top-dose result | Placebo |
|---|---|---|---|
| ATTAIN-1 (72 weeks) | 3,127 adults with obesity | −11.2% body weight[8] | −2.1% |
| ATTAIN-2 (72 weeks) | 1,613 adults with obesity and type 2 diabetes | −9.6%[9] | −2.5% |
| Phase 2 (36 weeks) | 272 adults with obesity | −14.7%[5] | −2.3% |
In ATTAIN-1, 54.6% of people on the top dose lost at least 10% of their weight, and 18.4% lost at least 20%.[8]
Keeping weight off after injections
In ATTAIN-MAINTAIN, people who had lost weight on Zepbound or Wegovy switched to orforglipron or placebo. Those switched from tirzepatide kept 74.7% of their lost weight on orforglipron versus 49.2% on placebo; those switched from semaglutide kept 79.3% versus 37.6%. The trial did not include a group that stayed on the injection.[14]
Type 2 diabetes
- Phase 2 (26 weeks): in 383 adults with type 2 diabetes, HbA1c fell by up to 2.10 points versus 0.43 on placebo and 1.10 on dulaglutide, and weight fell by up to 10.1 kg.[6]
- Early diabetes (ACHIEVE-1): HbA1c fell 1.24 to 1.48 points versus 0.41 on placebo.[7]
- Versus oral semaglutide (ACHIEVE-3): orforglipron lowered HbA1c more than Rybelsus at both doses compared, but caused more stomach side effects.[10]
- Versus dapagliflozin and with insulin: it outperformed dapagliflozin and added benefit to insulin glargine.[11][12]
- Heart safety (ACHIEVE-4): major cardiovascular events occurred in 4.2% versus 5.0% on insulin glargine, meeting the goal of showing no added risk.[13]
Lilly submitted orforglipron for type 2 diabetes in the US in 2026; it is not yet FDA-approved for that use.[28]
Orforglipron vs Zepbound, Wegovy and oral semaglutide
| Orforglipron (Foundayo) | Tirzepatide (Zepbound) | Semaglutide (Wegovy) | |
|---|---|---|---|
| Form | Daily pill, with or without food[1] | Weekly injection | Weekly injection |
| Main obesity trial result | −11.2% at 72 weeks[8] | −20.9% at 72 weeks | −14.9% at 68 weeks |
| Head-to-head data | Beat oral semaglutide on blood sugar[10] | None vs orforglipron | None vs orforglipron |
Comparing separate trials is unreliable, but injectables have produced larger weight loss. An endocrinologist interviewed by NBC called 12% weight loss weak compared with the injectables, while noting the convenience of a pill.[25] See also the investigational retatrutide.
Orforglipron side effects
From the FDA label (pooled weight-loss trials):[1]
| Side effect | Placebo | 5.5 mg | 9 mg | 17.2 mg |
|---|---|---|---|---|
| Nausea | 10% | 26% | 34% | 35% |
| Constipation | 9% | 20% | 27% | 24% |
| Diarrhea | 11% | 21% | 23% | 25% |
| Vomiting | 4% | 13% | 21% | 24% |
| Indigestion | 4% | 12% | 16% | 13% |
| Hair loss | 2% | 4% | 4% | 5% |
- Stopping treatment: 8% stopped because of side effects, versus 3% on placebo, mostly for stomach problems.[1]
- Heart rate: rose 4 to 5 beats per minute; fast heart rate occurred in 3% versus 0.9%.[1]
- Hair loss was more common in women (7%) than men (0.9%).[1]
- Boxed warning: like other GLP-1 drugs, it carries a thyroid C-cell tumor warning, even though orforglipron did not cause tumors in rodents (it is inactive in them). It should not be used by people with a personal or family history of medullary thyroid cancer or MEN 2.[1]
- Other warnings: pancreatitis, severe stomach reactions, kidney injury from dehydration, gallbladder disease and low blood sugar with insulin or sulfonylureas.[1]
- Liver: a pooled analysis found serious liver test elevations equally rare on orforglipron and placebo (0.1% each), but FDA required five years of enhanced liver monitoring after approval.[15][2]
- Birth control pills: use a backup method for 30 days after starting and after each dose increase.[1]
Orforglipron dosage
The label starts at 0.8 mg once daily and increases at least every 30 days:[1]
| Step | Dose |
|---|---|
| Start | 0.8 mg daily |
| After 30 days | 2.5 mg daily |
| After 30 more days | 5.5 mg daily |
| Optional increases | 9 mg, 14.5 mg, then up to 17.2 mg maximum |
Tablets can be taken with or without food and should be swallowed whole. Trial papers report capsule doses (6, 12 and 36 mg) that match the marketed 5.5, 9 and 17.2 mg tablets.[18] If seven or more doses are missed in a row, treatment restarts at a lower dose.[1]
Orforglipron price
At launch, Lilly offered self-pay pricing starting at $149 a month for the lowest dose, with NBC reporting higher doses at up to $349 a month. Commercial savings cards can reduce costs further.[25] Prices change, so confirm current pricing with Lilly or your pharmacy.
Orforglipron around the world
- Japan: the drug’s country of discovery. Japanese trials found strong blood sugar reductions and a longer half-life (52 to 76 hours) in Japanese patients.[19][20] In a 72-week Japanese obesity trial, the top dose did no better than the middle dose.[21]
- United Kingdom: the MHRA approved it in August 2026 for weight management and type 2 diabetes; it is not yet available on the NHS.[22]
- Russia: a 2025 Russian review described it as a promising next-generation incretin therapy.[23]
What users report
Is orforglipron available?
Foundayo is a prescription drug in the US, available since April 2026.[2] MedlinePlus has patient instructions for taking it.[24]
