Which GLP-1 Pills Are FDA-Approved for Weight Loss?
Two are: the Wegovy pill and Foundayo. Both are prescription drugs for adults with obesity, or overweight plus at least one weight-related health problem.
The Wegovy pill is oral semaglutide, the same active ingredient as Wegovy shots. The FDA approved it on December 22, 2025, and it launched in early January 2026. Its label also covers lowering the risk of heart attack and stroke in adults with heart disease and obesity or overweight.
Foundayo is orforglipron from Eli Lilly, approved April 1, 2026. It isn’t a peptide like semaglutide. It’s a small molecule, which is why it doesn’t need an empty stomach. Lilly began shipping it through LillyDirect on April 6 and to retail pharmacies and telehealth companies on April 9.
Rybelsus and the newer Ozempic tablets are semaglutide pills too, but their labels cover type 2 diabetes only. And no GLP-1 drug is sold over the counter. Supplements marketed as “GLP-1 boosters” are not these medicines.
Wegovy Pill vs Foundayo: How Do the GLP-1 Pills Compare?
The Wegovy pill lost a little more weight in its trial, and Foundayo is easier to take. The trials were run separately, in different groups of people and over different lengths of time, so they aren’t a head-to-head test.
| Wegovy pill | Foundayo | |
|---|---|---|
| Maker | Novo Nordisk | Eli Lilly |
| Active ingredient | Semaglutide (oral) | Orforglipron |
| FDA approval | December 22, 2025 | April 1, 2026 |
| Approved uses | Weight management; heart-risk reduction in adults with heart disease | Weight management |
| Strengths | 1.5, 4, 9, 25 mg | 0.8, 2.5, 5.5, 9, 14.5, 17.2 mg |
| How to take | Once daily on an empty stomach, up to 4 oz of water, 30 minutes before food | Once daily, any time, with or without food |
| Main trial result | 13.6% average loss at 64 weeks (OASIS 4, 25 mg) | 11.1% average loss at 72 weeks (ATTAIN-1, 17.2 mg) |
| Cash price per month | $149 to $299 | $149 to $299 ($349 at the top doses without an on-time refill) |
| Medicare GLP-1 Bridge | Covered, $50 per fill | Covered, $50 per fill |
Sources: DailyMed labels for Wegovy and Foundayo, Novo Nordisk, Eli Lilly, NovoCare, TrumpRx.gov and Medicare.gov.
How Do You Take GLP-1 Pills?
The Wegovy pill needs a strict morning routine, and Foundayo doesn’t. That difference decides a lot for people with busy mornings.
Per the Wegovy label, you take one tablet each morning on an empty stomach with up to 4 ounces of plain water. You swallow it whole and wait at least 30 minutes before eating, drinking anything else or taking other pills. If you miss a dose, you skip it and take the next one the following day.
Per the Foundayo label, you take one tablet a day at any time, with or without food. If you miss seven or more doses in a row, the label says to restart at a lower dose. Foundayo can also make birth control pills less reliable: the label advises a non-oral method or a backup method for 30 days after you start and after each dose increase.
What Are the Dose Steps?
Both labels start low and step up about monthly to limit stomach side effects. Your prescriber decides your doses.
- Wegovy pill: 1.5 mg for days 1 to 30, 4 mg for days 31 to 60, 9 mg for days 61 to 90, then 25 mg from day 91.
- Foundayo: 0.8 mg for at least 30 days, then 2.5 mg, then 5.5 mg. From there, the dose can rise to 9, 14.5 or 17.2 mg, each after at least 30 days, based on how you respond and tolerate it.
How Much Weight Do People Lose on GLP-1 Pills?
In their main trials, the top doses of the GLP-1 pills produced average losses of 11% to 14%. That’s close to the Wegovy shot and below Zepbound.
In OASIS 4, 307 adults without diabetes took the Wegovy pill (25 mg) or a placebo for 64 weeks. The pill group lost 13.6% of body weight on average, compared with 2.4% on placebo. Nearly half (47%) lost at least 15%.
In ATTAIN-1, 3,127 adults without type 2 diabetes took Foundayo or a placebo for 72 weeks. The 17.2 mg dose averaged 11.1%, compared with 2.1% on placebo, and lower doses lost less: 7.4% at 5.5 mg and 8.3% at 9 mg. At 17.2 mg, 35.9% lost at least 15%. In a separate trial in adults with type 2 diabetes, the top dose averaged 9.6%.
| Drug and dose | Form | Trial length | Average weight loss | Placebo |
|---|---|---|---|---|
| Wegovy pill 25 mg | Daily pill | 64 weeks | 13.6% | 2.4% |
| Foundayo 17.2 mg | Daily pill | 72 weeks | 11.1% | 2.1% |
| Wegovy 2.4 mg | Weekly shot | 68 weeks | 14.9% | 2.4% |
| Wegovy HD 7.2 mg | Weekly shot | 72 weeks | 18.8% | 3.9% |
| Zepbound 15 mg | Weekly shot | 72 weeks | 20.9% | 3.1% |
These are results from separate trials, not head-to-head comparisons. People in each trial also followed a reduced-calorie diet and more physical activity.
What Are the Side Effects of GLP-1 Pills?
Stomach problems are the most common side effects, much like the shots. Most are worst while the dose is going up.
For Foundayo at 17.2 mg, the label lists nausea in 35% of people (10% on placebo), diarrhea in 25%, constipation in 24% and vomiting in 24%. About 10% at that dose stopped because of side effects, compared with 3% on placebo.
The Wegovy label says side effects of the tablets are similar in type and frequency to the shots. A few were more common with the pill than with placebo: gallstones (2.5% vs 1%), severe stomach reactions (2% vs 0%) and skin burning or tingling (5% vs 0%). About 7% stopped because of side effects, compared with about 6% on placebo.
Both labels carry a boxed warning about thyroid C-cell tumors seen in rodents. People with a personal or family history of medullary thyroid cancer or MEN 2 shouldn’t take them.
How Much Do GLP-1 Pills Cost?
GLP-1 pills cost $149 to $299 a month with the makers’ cash programs, as of September 2026. That’s the lowest cash price for any FDA-approved GLP-1.
| Where | Wegovy pill | Foundayo |
|---|---|---|
| NovoCare Pharmacy (Novo Nordisk) | $149 (1.5 mg), $199 (4 mg), $299 (9 and 25 mg) | Not sold |
| LillyDirect (Eli Lilly) | Not sold | $149 (0.8 and 2.5 mg), $199 (5.5 mg), $299 (9 mg); $299 at 14.5 and 17.2 mg with a refill within 45 days, otherwise $349 |
| TrumpRx.gov | Starting at $149, with a coupon used at a retail pharmacy | Routes you to LillyDirect |
| Amazon Pharmacy | Cash price starting at $149 | Check at checkout |
| AgelessRx (telehealth) | $50 monthly membership plus Amazon Pharmacy’s price | Not listed |
| Medicare GLP-1 Bridge | $50 per fill if you qualify | $50 per fill if you qualify |
| Commercial insurance with a savings card | Depends on your plan | As little as $25 a month if your plan covers it, per Lilly |
Foundayo’s 2.5 mg and 5.5 mg prices are temporary cuts through December 31, 2026. Sources: NovoCare, TrumpRx.gov, Eli Lilly, Amazon, AgelessRx (checked September 2026).
At maintenance, a pill costs $299 a month. That’s $50 less than a Wegovy pen ($349) and $150 less than Zepbound at 7.5 mg and up ($449).
Does Insurance or Medicare Cover GLP-1 Pills?
Coverage follows the same rules as the shots. Your plan decides, and many plans don’t pay for weight-loss drugs at all.
If your plan covers weight-management GLP-1s, the pills usually need prior authorization, like the injections. The Wegovy pill’s heart-risk approval can help if you have heart disease. CVS Caremark, a large pharmacy benefit manager, removed its new-drug block on Foundayo on June 1, 2026.
Medicare Part D can’t cover drugs used for weight loss. The Medicare GLP-1 Bridge fills that gap until December 31, 2027: eligible members pay $50 for a 30-day supply of either pill. You must meet BMI rules, and people with type 2 diabetes, moderate-to-severe sleep apnea or MASH go through Part D instead.
Are Compounded Oral Semaglutide Pills the Same as the Wegovy Pill?
No. Compounded semaglutide tablets, drops and lozenges are not FDA-approved, and nobody has shown how well they’re absorbed.
Semaglutide is a peptide that the stomach breaks down easily. The approved tablets contain an absorption enhancer, salcaprozate sodium (SNAC), and even so the label requires the empty-stomach routine. Compounded oral products were never tested in trials like OASIS 4, and the FDA doesn’t review them for safety, effectiveness or quality.
Some telehealth companies sell compounded oral versions. SkinnyRx lists compounded semaglutide and tirzepatide tablets, and Strut Health a semaglutide lozenge. The FDA’s May 2026 notice looked at oral, sublingual and buccal forms of compounded semaglutide as well, and it still proposed keeping semaglutide off the list outsourcing facilities can compound from. See what’s legal now for compounded GLP-1s.
Want the Wegovy pill through telehealth?
Pill or Shot: Which GLP-1 Fits You?
A pill makes sense if needles are the barrier. A weekly shot makes sense if you want the largest average weight loss. Cost is close either way.
A GLP-1 pill may suit you if:
- You don’t want injections or have trouble with needles.
- You travel a lot. The pills don’t need a refrigerator.
- You can’t keep a fasting routine every morning, in which case Foundayo is the easier pill.
A weekly shot may suit you better if:
- You want the largest average loss. Zepbound 15 mg averaged 20.9% in its main trial.
- You’d rather dose once a week than every day.
- Your plan covers an injection but not a pill.
Your prescriber weighs your health history, other medicines and goals. Compare options in our guide to how to choose a GLP-1 provider.