Oral GLP-1s compared
Foundayo vs Wegovy: two pills, two routines
Foundayo vs Wegovy is now a pill-against-pill question. Foundayo (orforglipron, from Eli Lilly) and the Wegovy pill (oral semaglutide, from Novo Nordisk) are both once-daily tablets for weight management, but they are different medicines with very different instructions. Here is what each label says, what the trials found and why their numbers cannot simply be lined up.
On this page
- Foundayo vs Wegovy pill at a glance
- How to take each pill: what the labels say
- Orforglipron vs oral semaglutide: why the rules differ
- The GLP-1 pills so far, in order
- Foundayo vs Wegovy pill: weight loss in the trials
- Foundayo vs Wegovy pill side effects
- Foundayo and Wegovy pill strengths
- Foundayo vs Rybelsus and Ozempic tablets
- Foundayo and the Wegovy pill in the UK
- Foundayo vs Wegovy pill cost and coverage
- Switching between Foundayo and the Wegovy pill
- Questions to bring to your prescriber
- Questions people ask
- Sources
In short
- Foundayo (orforglipron) and the Wegovy pill (oral semaglutide 25 mg) are both once-daily tablets approved in the US to reduce excess body weight and keep it off long term, but they are different molecules from different companies, and no trial has compared them head to head.1,2
- Foundayo's label says to take it once a day, with or without food, and names no time of day; the Wegovy pill's says to take it in the morning on an empty stomach with up to 4 ounces of plain water, then wait at least 30 minutes before eating or drinking.1,2
- In separate trials in adults without diabetes, average weight change was −11.1% on Foundayo's highest dose over 72 weeks (ATTAIN-1, placebo −2.1%) and −13.6% on the 25 mg Wegovy pill over 64 weeks (OASIS 4, placebo −2.4%), both counting everyone randomized.1,2
- Stomach side effects are the most common with both, and in the UK both are authorized but neither is currently available on the NHS.1,2,9,10
- Which suits you is a decision for you and your prescriber, and Handle records either one.
Foundayo vs Wegovy pill at a glance
Label facts, side by side. "Wegovy" is also Novo Nordisk's weekly injection; this page compares the pill. For the injection, see Wegovy pill vs injection and Zepbound vs Wegovy.
| Foundayo | Wegovy pill | |
|---|---|---|
| Made by | Eli Lilly and Company1 | Novo Nordisk2 |
| Active ingredient | Orforglipron, a small-molecule GLP-1 receptor agonist1,3 | Semaglutide, a GLP-1 receptor agonist, with an absorption enhancer (SNAC)2 |
| US approval | April 1, 20267 | December 22, 20256 |
| Approved in the US for | Weight reduction and long-term maintenance in adults with obesity, or overweight plus a weight-related condition1 | The same, plus lowering cardiovascular risk in adults with established cardiovascular disease and obesity or overweight2 |
| How it's taken | Once a day, any time, with or without food1,10 | Once a day in the morning, on an empty stomach (details below)2 |
| Strengths | 0.8, 2.5, 5.5, 9, 14.5 and 17.2 mg1 | 1.5, 4, 9 and 25 mg2 |
| Half-life | About 29 to 49 hours1 | About 1 week2 |
| Storage | Room temperature, 20–25 °C (68–77 °F)1 | Room temperature, 20–25 °C (68–77 °F), in the original bottle to protect from moisture2 |
| Main weight trial, no diabetes (everyone randomized) | ATTAIN-1, 72 weeks: −11.1% on 17.2 mg; placebo −2.1%1 | OASIS 4, 64 weeks: −13.6% on 25 mg; placebo −2.4%2 |
| Weight trial in type 2 diabetes | ATTAIN-2: −9.6% on 17.2 mg; placebo −2.5%1 | Not studied for weight reduction in type 2 diabetes2 |
| Nausea in trials | 26–35%; placebo 10% (label)1 | 46.6%; placebo 18.6% (trial registry)5 |
| Boxed warning | Risk of thyroid C-cell tumors1 | Risk of thyroid C-cell tumors2 |
| UK | Authorized August 10, 2026, for weight management and type 2 diabetes; not currently on the NHS10 | Approved June 11, 2026; not currently on the NHS9 |
How to take each pill: what the labels say
Taking a pill as its label describes is part of how it works, and this is where the two differ most. This is label text, not advice about your own routine.
Foundayo
Any time of day
Wegovy pill
Morning, on an empty stomach
UK wording for the Wegovy tablet adds fasting for at least 8 hours beforehand, with a sip of water; the US label does not state an 8-hour fast.9,2
Orforglipron vs oral semaglutide: why the rules differ
Both are GLP-1 receptor agonists: they act on the receptor for GLP-1, a gut hormone involved in appetite and how much we eat.1,2 The difference is the kind of molecule each is.
Oral semaglutide is the same peptide as the Wegovy and Ozempic injections, made with an absorption enhancer, SNAC, so that a small fraction (about 1% to 2%) is absorbed in the stomach. The label reports more was absorbed with less water and a longer wait before eating, hence the precise routine.2 Orforglipron is a small molecule rather than a peptide,3 needs no absorption enhancer, and has no clinically relevant food effect according to Foundayo's label.1
They also leave the body at different speeds: orforglipron's half-life is about 29 to 49 hours, while semaglutide's is about a week, and the Wegovy label says it stays in the circulation for about 5 to 7 weeks after the last 25 mg tablet.1,2
The GLP-1 pills so far, in order
Four brand names have been used for GLP-1 tablets in the US, and some of their strengths overlap. Here is how they arrived.
- 2019Rybelsus
Oral semaglutide in 3, 7 and 14 mg tablets, approved for type 2 diabetes.12
- Dec 2025
- Jan 2026
- Apr 2026
Foundayo vs Wegovy pill: weight loss in the trials
Each company reports its main trial two ways. The treatment-regimen (or treatment-policy) figure counts everyone randomized, whether or not they kept taking the pill; the efficacy (or trial-product) figure estimates the result had everyone stayed on it, which is bigger. Compare like with like.
| Foundayo (ATTAIN-1) | Wegovy pill (OASIS 4) | |
|---|---|---|
| Who took part | 3,127 adults with obesity, without diabetes3 | 307 adults with obesity, or overweight plus a weight-related condition, without diabetes4 |
| Length | 72 weeks | 64 weeks of treatment |
| Dose | 17.2 mg, the label's highest; the trial used an investigational formulation1 | 25 mg2 |
| Average weight change, treatment-regimen | −11.1%; placebo −2.1%1,7 | −13.6%; placebo −2.4%2,6 |
| Average weight change, efficacy estimate | −12.4%; placebo −0.9%7 | −16.6%; placebo −2.7%6 |
| Lost at least 5% of body weight | 71.5%; placebo 26.8%1 | 76.3%; placebo 31.3%2 |
| Stopped the study medicine early | 22–24% across the doses; placebo 30%1 | 18%; placebo 25.5%2 |
Treatment-regimen figures are from each US label; efficacy figures are from each company's approval announcement. The journal papers give slightly different numbers for the same trials (ATTAIN-1: −11.2% vs −2.1%; OASIS 4: −13.6% vs −2.2%) because the analyses differ a little.3,4 Averages from trials are not a prediction for any one person.
Why this is not a head-to-head result
ATTAIN-1 and OASIS 4 were separate trials, run by different companies for different lengths of time, with different numbers of people and different placebo results. Even with the estimands matched, the gap between the two sets of figures is not a measured difference between the pills.1,2
No trial has compared Foundayo with the Wegovy pill in people with obesity. The closest is ACHIEVE-3, an open-label, 52-week trial in 1,698 adults with type 2 diabetes on metformin, comparing orforglipron 12 and 36 mg (trial doses, not Foundayo tablet strengths) with oral semaglutide 7 and 14 mg, the diabetes strengths sold as Rybelsus rather than the 25 mg Wegovy pill.8
Lilly reported that orforglipron reduced HbA1c by 1.7% and 1.9%, against 1.2% and 1.5%, and body weight by 6.1% and 8.2%, against 3.9% and 5.3% (treatment-regimen figures), while more people stopped it because of adverse events: 8.7% and 9.7%, against 4.5% and 4.9%.8 These results come from the company's own announcement of its trial. For Foundayo against a weekly injection, see Foundayo vs Zepbound.
Foundayo vs Wegovy pill side effects
The Wegovy label has no separate side-effect table for the tablets; it says their common side effects were similar to the injection's. So the pill's figures below are the OASIS 4 results posted on ClinicalTrials.gov, counted differently from Foundayo's label table: read the columns side by side, not against each other.
| Side effect | Foundayo (label: two 72-week trials) | Wegovy pill 25 mg (OASIS 4 registry, 71 weeks) |
|---|---|---|
| Nausea | 26–35% (placebo 10%) | 46.6% (placebo 18.6%) |
| Vomiting | 13–24% (placebo 4%) | 30.9% (placebo 5.9%) |
| Constipation | 20–27% (placebo 9%) | 20.1% (placebo 9.8%) |
| Diarrhea | 21–25% (placebo 11%) | 17.6% (placebo 8.8%) |
| Indigestion | 12–16% (placebo 4%) | 18.1% (placebo 8.8%) |
| Stomach pain | 13–14% (placebo 7%) | 7.4% (placebo 3.9%); upper stomach pain 8.8% (placebo 2.0%) |
| Burping | 6–8% (placebo 1%) | 10.3% (placebo 2.0%) |
| Acid reflux (GERD) | 6–7% (placebo 2%) | 7.8% (placebo 4.9%) |
| Headache | 8–9% (placebo 7%) | 11.8% (placebo 8.8%) |
| Fatigue | 6–9% (placebo 4%) | 7.4% (placebo 1.0%) |
| Any stomach or gut side effect | 60–69% (placebo 37%) | 74.0% (placebo 42.2%) |
| Stopped because of side effects | 6–10% (placebo 3%) | 6.9% (placebo 5.9%) |
Sources: Foundayo label, Table 1 and section 61; OASIS 4 registry results, weeks 0 to 715; any stomach or gut event from the OASIS 4 paper4; the Wegovy pill's stopping rate from its label, which gives 6.9% in section 6.1 and 6.8% in section 14.22.
Other differences in the safety sections
Severe stomach side effects: about 3% on Foundayo (1% on placebo) and 2% on Wegovy tablets (0% on placebo). Gallstones: 1% against 0.7% on Foundayo, and 2.5% against 1% on Wegovy tablets. Dysesthesia (unusual skin sensations): 5% on 25 mg Wegovy tablets against none on placebo, and 0.3% to 1% on Foundayo against 0.1%.1,2
Other medicines: Foundayo's label lists interactions through the enzyme CYP3A4 and advises people on an oral contraceptive pill to switch to a non-oral method or add a barrier method for 30 days after starting and after each dose increase. The Wegovy label has no such contraception instruction, but reports that total thyroxine exposure rose by 33% when levothyroxine was taken with oral semaglutide.1,2
The Wegovy label also notes that some people with type 2 diabetes may have lower-than-intended semaglutide levels on the tablets. Both carry the boxed warning about thyroid C-cell tumors; Foundayo's adds that orforglipron is not pharmacologically active in rats or mice and caused no tumors in rodents.1,2 More detail: Foundayo side effects and Wegovy side effects.
In Handle
Choose the symptoms you want to follow
Handle's daily check-in asks about nausea every day and lets you switch on others, such as vomiting or constipation, plus up to six extra symptoms like heartburn, belching or fatigue, or one in your own words.
Some answers, such as severe nausea, come with a clear next step, like contacting your care team. Handle never diagnoses, and it is not a monitoring or emergency service.
- The same short card every day, whatever you answer
- Switch symptoms on or off at any time
- A private daily note that nothing reads
Foundayo and Wegovy pill strengths
Manufacturing facts, not a dose to take. Both labels start low and step up gradually; your prescriber sets the steps and the amount.
- Foundayo. 0.8, 2.5, 5.5, 9, 14.5 and 17.2 mg tablets, in bottles of 30.1
- Wegovy pill. 1.5, 4, 9 and 25 mg tablets, in bottles of 30.2
- Same number, different medicine. A 9 mg Foundayo tablet, a 9 mg Wegovy tablet and a 9 mg Ozempic tablet are three different products. Even Rybelsus and Ozempic tablets, both oral semaglutide, are not substitutable milligram for milligram, according to their label.11
- Missed doses. Each label has its own rule, and the two differ. Ask your prescriber or pharmacist rather than borrowing one pill's rule for the other; Handle records what happened and never tells you to catch up.
Foundayo vs Rybelsus and Ozempic tablets
Rybelsus and Ozempic tablets are oral semaglutide for type 2 diabetes, not weight management, with the same empty-stomach routine as the Wegovy pill. In the US they share one label: Rybelsus in 3, 7 and 14 mg, and Ozempic tablets, a newer formulation, in 1.5, 4 and 9 mg; Novo Nordisk says the Rybelsus name continues outside the US.11,12
Foundayo is not approved for type 2 diabetes in the US, although its UK authorization includes it, and ACHIEVE-3 (above) was the first phase 3 trial to compare orforglipron with oral semaglutide directly.1,10,8 For every GLP-1 medicine in one place, see GLP-1 medications compared.
Foundayo and the Wegovy pill in the UK
The MHRA approved the Wegovy tablet on June 11, 2026, as the UK's first GLP-1 tablet for weight loss and weight management, and authorized Foundayo on August 10, 2026, for weight management and type 2 diabetes, the first approval of orforglipron in Europe.9,10
Neither is currently available on the NHS; the MHRA says decisions on NHS use will follow the usual processes, including an evaluation by NICE. UK wording for the Wegovy tablet adds an 8-hour fast before the dose, while Foundayo has no food or water restrictions.9,10
Foundayo vs Wegovy pill cost and coverage
Both are brand-name prescription medicines approved in the US for the same weight-management use, and each company announced self-pay and savings options at launch.6,7 Prices, programs and plan rules change often, so check what applies to you with your plan or pharmacy. In the UK, neither is currently on the NHS.9,10 Handle does not sell or source medicines.
Switching between Foundayo and the Wegovy pill
Moving from one pill to the other is your prescriber's decision, including when to stop one and which strength to start. Neither label describes a switch between these two, and each says using it with another GLP-1 medicine is not recommended.1,2
The routine changes too: from a morning pill on an empty stomach with a 30-minute wait, to one taken at any time with or without food, or the other way round. A clear record makes the first weeks easier to review.
What to record if you switch
- The date and strength of your last tablet of the old medicine
- The date, strength and time of your first tablet of the new one
- How you are taking it, for example on an empty stomach or with breakfast
- Symptoms over the first weeks, especially nausea, vomiting and constipation
- Other medicines you take, including thyroid medicine and the contraceptive pill, which the labels mention
In Handle
A daily pill fits into Today
Foundayo and the Wegovy pill are not on Handle's list of named medicines yet, so you add yours under “Something else” with its name, amount and daily schedule. Then Today's medication card is where you log each tablet. The check-in, weight, food, Journey and the consultation report (a Premium feature) work the same way, and a switch between pills stays on one record.
More in our Foundayo tracker and Wegovy tracker guides.
- Log each tablet with the time you took it
- A daily reminder in the iPhone app, if you want one
- Add a forgotten day, up to 30 days back
Questions to bring to your prescriber
Good ones to ask, whichever pill you are offered.
- Would a pill with empty-stomach rules, or one without, fit my mornings and other medicines better?
- How might the side effects compare for someone with my health history?
- Do any of my medicines, such as thyroid medicine or the contraceptive pill, affect either pill?
- Does having, or being at risk of, type 2 diabetes change which pill makes sense for me?
- I may want to become pregnant in the next year or two. Does that change anything?
- What should I do if I miss a day?
More on getting ready: preparing for a GLP-1 doctor appointment.
Questions people ask
Is Foundayo the same as the Wegovy pill?+
No. Foundayo is orforglipron, a small-molecule GLP-1 receptor agonist from Eli Lilly; the Wegovy pill is oral semaglutide from Novo Nordisk. Both are once-daily tablets approved in the US for weight management, but they differ in how they are taken, their strengths, their trials and their side-effect figures.1,2,3
Which is better, Foundayo or the Wegovy pill?+
No trial has compared them in people with obesity, so no evidence settles it. In separate trials (ATTAIN-1 and OASIS 4), average weight change was −11.1% over 72 weeks on Foundayo's highest dose and −13.6% over 64 weeks on the 25 mg Wegovy pill, against −2.1% and −2.4% on placebo, both counting everyone randomized.1,2 Your health, routine, other medicines and coverage matter too.
Can you take the Wegovy pill with coffee?+
The US label says to take the Wegovy pill in the morning on an empty stomach with plain water only, up to 4 ounces, and to wait at least 30 minutes before eating, drinking anything else or taking other oral medicines.2 Foundayo's label has no such rules; it can be taken with or without food.1
What is the difference between Foundayo and Rybelsus?+
Rybelsus is oral semaglutide for type 2 diabetes, in 3, 7 and 14 mg tablets; in the US, the newer 1.5, 4 and 9 mg tablets are called Ozempic tablets.11 Foundayo is orforglipron, approved in the US for weight management, with no empty-stomach rules.1 The ACHIEVE-3 diabetes trial compared the two molecules directly.8
Are Foundayo and the Wegovy pill available in the UK?+
Both are authorized: the Wegovy tablet since June 11, 2026, and Foundayo since August 10, 2026. Neither is currently available on the NHS.9,10 UK guidance for the Wegovy tablet mentions fasting for at least 8 hours beforehand, which the US label does not state.9
Which pill has fewer side effects?+
Their figures cannot be ranked, because they come from different trials counted in different ways. Stomach effects lead both lists: nausea affected 26–35% on Foundayo (10% on placebo) in its label trials and 46.6% on the Wegovy pill (18.6% on placebo) in OASIS 4, and 6–10% (3% on placebo) and 6.9% (5.9% on placebo) stopped because of side effects.1,2,5
Can I switch from the Wegovy pill to Foundayo?+
Your prescriber can move you from one to the other and decides the timing and starting strength. Neither label describes a switch between them, and each says using it with another GLP-1 medicine is not recommended.1,2 Handle keeps both medicines on one record, so the change is clear at your next appointment.
Can I track Foundayo or the Wegovy pill in Handle?+
Yes. Neither is on Handle's list of named medicines yet, so add yours under “Something else” with its name, amount and daily schedule. Logging doses, the daily check-in, weight, food, Journey and the consultation report (a Premium feature) then work the same way. See the Foundayo tracker and Wegovy tracker.
Sources
- Eli Lilly and Company, via DailyMed (U.S. National Library of Medicine). Foundayo (orforglipron) tablets — Prescribing Information, effective July 29, 2026.
- Novo Nordisk, via DailyMed (U.S. National Library of Medicine). Wegovy (semaglutide) injection and Wegovy (semaglutide) tablets — Prescribing Information, effective June 18, 2026.
- The New England Journal of Medicine, via PubMed. Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment (ATTAIN-1), 2025.
- The New England Journal of Medicine, via PubMed. Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity (OASIS 4), 2025.
- ClinicalTrials.gov (U.S. National Library of Medicine). Efficacy and Safety of Oral Semaglutide 25 mg Once Daily in Adults With Overweight or Obesity (OASIS 4, NCT05564117): results.
- Novo Nordisk, via PR Newswire. FDA approves Novo Nordisk's Wegovy pill, the first and only oral GLP-1 for weight loss in adults, December 22, 2025.
- Eli Lilly and Company, via PR Newswire. FDA approves Lilly's Foundayo (orforglipron), the only GLP-1 pill for weight loss that can be taken any time of day without food or water restrictions, April 1, 2026.
- Eli Lilly and Company, via PR Newswire. Lilly's oral GLP-1, orforglipron, delivered superior blood sugar control and weight loss compared to oral semaglutide in head-to-head type 2 diabetes trial published in The Lancet, February 26, 2026.
- Medicines and Healthcare products Regulatory Agency (UK). First GLP-1 tablet for weight loss approved in the UK, June 11, 2026.
- Medicines and Healthcare products Regulatory Agency (UK). UK first in Europe to authorise orforglipron for weight management and type 2 diabetes, August 10, 2026.
- Novo Nordisk, via DailyMed (U.S. National Library of Medicine). Rybelsus (semaglutide) tablets and Ozempic (semaglutide) tablets — Prescribing Information, effective January 30, 2026.
- Novo Nordisk, via PR Newswire. Novo Nordisk's Ozempic pill, the only FDA-approved oral peptide GLP-1 medication for adults with type 2 diabetes, soon to be available in the US, May 1, 2026.
Written by the Handle team from the sources above, last checked on September 23, 2026. How we write: our editorial policy. Spotted something out of date? Tell us at [email protected].
Handle supports recording and conversations with your care team. It does not diagnose, and it never tells you to start, change, skip or stop a dose. This page is general information, not medical advice. Always follow your prescriber and your medicine's instructions for use.