Foundayo (orforglipron) and the Wegovy pill (oral semaglutide) are the two GLP-1 pills the FDA has approved for weight loss, both taken once a day. The Wegovy pill is taken in the morning on an empty stomach with up to 4 ounces of water, followed by a 30-minute wait, while Foundayo can be taken with or without food. In each label's main trial, people on the top dose lost 13.6% of their body weight on average with the Wegovy pill (64 weeks) and 11.1% with Foundayo (72 weeks). There's no official dose conversion between them.
Medical disclaimer: This is general information for US readers, not medical advice or an ad. Both pills are prescription medications, and which one suits you, if either, is a decision for your prescriber.
A year ago, a GLP-1 for weight loss meant a shot. Now there are two pills. The FDA approved the Wegovy pill in December 2025 and Foundayo in April 2026, and they get mixed up all the time. Different medicines, different makers, and a very different morning.
This page lines them up using the two FDA labels and the trials behind them. It won't pick one for you. It will give you the questions worth bringing to your prescriber.
The two pills at a glance
| Foundayo | Wegovy pill | |
|---|---|---|
| Medicine | Orforglipron, made by Eli Lilly | Semaglutide, made by Novo Nordisk |
| FDA approval | April 1, 2026 | December 22, 2025 |
| How you take it | One pill a day, with or without food | One pill a day, in the morning, on an empty stomach |
| Water and waiting | No rules on the label | Up to 4 oz of water, then wait 30 minutes |
| Dose steps | 0.8, 2.5 and 5.5 mg, then up one level at a time to 9, 14.5 and 17.2 mg | 1.5, 4 and 9 mg, then 25 mg |
| Shortest time to the top dose | 5 months | 3 months |
| Main trial (label) | 11.1% at 72 weeks (17.2 mg) | 13.6% at 64 weeks (25 mg) |
| Approved for | Weight loss and keeping it off | Weight loss and keeping it off, and lowering heart risk in people with heart disease |
Trial figures are average weight lost on the top dose in each label's main trial, counting everyone who started. The shortest time to the top dose assumes every step happens at the earliest point the label allows.
How each one is taken
This is the difference you'll notice every day. The Wegovy pill is semaglutide, a peptide that your stomach readily breaks down, so the label is strict about food, drink and timing (Wegovy label, section 2.1). Foundayo is a small molecule, and its label just says to take it once a day, with or without food (Foundayo label, section 2.1). Lilly describes it as a pill you can take any time of day, without food or water restrictions (Eli Lilly).
From the FDA label
A morning with the Wegovy pill, and what Foundayo needs instead
- In the morning
On an empty stomach, before you eat or drink anything.
- One pill, a little water
Swallow it with up to 4 ounces of water. No other drink.
- Wait at least 30 minutes
No food, coffee, other drinks or other pills yet.
- Then carry on
Breakfast, coffee and your other medications.
Foundayo
One pill a day, with or without food, swallowed whole. Don't break, crush or chew it.
Missed doses work differently too. With the Wegovy pill, skip the missed pill and take the next one the following day. With Foundayo, take it as soon as you can, and don't double up. If you miss 7 or more days of Foundayo in a row, talk to your prescriber before restarting, because the label says to restart at a lower dose.
The dose steps
Both start low and step up so your stomach can adjust. They're two separate ladders, so read them on their own: a step on one isn't the same as the step with the same number on the other.
Foundayo
It starts at 0.8 mg once a day. After at least 30 days it goes to 2.5 mg, then after at least 30 more days to 5.5 mg. From there your prescriber can raise it one level at a time, to 9 mg, then 14.5 mg, then 17.2 mg, each at least 30 days apart, based on how it's working and how you're feeling. 17.2 mg is the maximum (Foundayo label, section 2.1).
The Wegovy pill
It's 1.5 mg a day for days 1 to 30, 4 mg for days 31 to 60 and 9 mg for days 61 to 90, then the 25 mg maintenance dose from day 91. If a step is rough, the label lets your prescriber delay the next one (Wegovy label, section 2.1).
The numbers can't be compared across the two: a 9 mg Foundayo pill and a 9 mg Wegovy pill are different medicines, absorbed differently. For every US dose ladder on one page, see our GLP-1 dosage chart.
What the trials found
Neither pill has been tested against the other for weight loss. Each label reports its own main trial against a placebo. According to the Wegovy label, people on the 25 mg pill lost 13.6% of their body weight on average over 64 weeks, against 2.4% on placebo (Wegovy label, section 14). According to the Foundayo label, people on 17.2 mg lost 11.1% over 72 weeks, against 2.1% on placebo (Foundayo label, section 14). Both count everyone who started, including people who stopped.
From the FDA labels
Average weight lost in each pill's main trial
Top dose against placebo, counting everyone who started. Two separate trials.
- The pill
- Placebo in the same trial
| Trial group | Average weight lost |
|---|---|
| Wegovy pill 25 mg, 64 weeks | 13.6% |
| Placebo, Wegovy trial | 2.4% |
| Foundayo 17.2 mg, 72 weeks | 11.1% |
| Placebo, Foundayo trial | 2.1% |
Here's how many people reached each milestone, from the same two label tables:
| Lost at least | Foundayo 17.2 mg (placebo) | Wegovy pill 25 mg (placebo) |
|---|---|---|
| 5% of body weight | 71.5% (26.8%) | 76.3% (31.3%) |
| 10% | 54.5% (13%) | 59.8% (14.4%) |
| 15% | 35.9% (6%) | 47% (5.5%) |
| 20% | 18.4% (2.9%) | 27.9% (3.1%) |
The one head-to-head trial, in type 2 diabetes
ACHIEVE-3, an open-label trial, compared the two medicines directly in 1,698 adults with type 2 diabetes over 52 weeks, but it used orforglipron (Foundayo's medicine, as the trial capsules) against oral semaglutide at the lower doses used for diabetes (Rybelsus 7 mg and 14 mg), not the 25 mg Wegovy pill. Foundayo isn't FDA approved for type 2 diabetes. Orforglipron lowered A1C more at both of its doses (ACHIEVE-3, The Lancet 2026). At the highest doses, counting everyone who started, Lilly reported 8.2% weight loss with orforglipron against 5.3% with oral semaglutide (Eli Lilly). More people stopped orforglipron because of side effects: 9% and 10%, against 4% and 5%.
Side effects and warnings
Both are GLP-1 medications, so the common side effects are in the stomach and gut, and they're most likely while the dose is going up. The Foundayo label gives a table by dose. The Wegovy label says the tablets' common side effects were similar in type and frequency to the injection's, and gives a few figures of its own:
| Foundayo 17.2 mg (placebo) | Wegovy pill 25 mg (placebo) | |
|---|---|---|
| Nausea | 35% (10%) | No separate figure on the label |
| Vomiting | 24% (4%) | No separate figure on the label |
| Diarrhea | 25% (11%) | No separate figure on the label |
| Constipation | 24% (9%) | No separate figure on the label |
| Any stomach or gut side effect | 69% (37%) | 74% (42%), from the OASIS 4 paper |
| Stopped because of side effects | 10% (3%) | 6.9% (5.9%) |
| Also on the label | Faster heart rate in 3% (0.9%), hair loss | Odd skin sensations (dysesthesia) in 5% (0%) |
Foundayo: label Table 1 and section 6.1, pooled weight-management trials. Wegovy pill: label section 6.1 and the OASIS 4 paper (NEJM 2025) for any stomach or gut side effect. Different trials, so compare with care.
Before you take either pill
- Don't take any of them if you or anyone in your family has had medullary thyroid cancer, or if you have multiple endocrine neoplasia syndrome type 2 (MEN 2).
- Tell your healthcare provider about a lump or swelling in your neck, hoarseness, trouble swallowing or shortness of breath.
- If you also take insulin or a sulfonylurea, ask whether those doses need lowering, because low blood sugar is more likely.
- Tell your prescriber if you're pregnant or planning to be. Each label says to stop when a pregnancy is confirmed, and Wegovy's says to stop at least 2 months before a planned pregnancy.
- If you could get pregnant, the Foundayo label advises effective contraception during treatment.
- Breastfeeding isn't recommended with the Wegovy pill or Foundayo.
From the Foundayo prescribing information (revised 07/2026) and the Wegovy prescribing information (revised 06/2026): boxed warnings, sections 4, 5 and 8.
From the FDA labels
When to stop, call or get help
Severe stomach pain that won't go away
With or without vomiting, and it can spread to your back. Stop the pill and call your healthcare provider right away. It can be a sign of pancreatitis.
Signs of a serious allergic reaction
Swelling of your face, lips, tongue or throat, trouble breathing or swallowing, severe rash, or feeling faint. Stop the pill and get medical help right away. Call 911 if you need to.
Nausea, vomiting or diarrhea that won't go away
Tell your healthcare provider right away. Losing fluids can lead to kidney problems.
Signs of gallbladder problems
Pain in your upper stomach, fever, yellowing of your skin or eyes, or clay-colored stools. Tell your healthcare provider.
Your heart racing or pounding at rest (Wegovy pill)
If it lasts for several minutes, tell your healthcare provider.
Report side effects
Tell your prescriber, and report side effects to the FDA through MedWatch, online or on 1-800-FDA-1088.
Who each is approved for
Both are approved, alongside a reduced-calorie diet and more physical activity, to help adults with obesity, or with overweight and at least one weight-related health condition, lose weight and keep it off. The Wegovy approval also covers lowering the risk of heart attack, stroke and heart-related death in adults with established heart disease and obesity or overweight, based on the injection's heart trial (Wegovy label, section 1). Neither is approved for children.
If you have type 2 diabetes, one detail matters: the Wegovy label says the tablets haven't been studied for weight loss in adults with type 2 diabetes. Foundayo was, in a separate trial where people on 17.2 mg lost 9.6% against 2.5% on placebo (Foundayo label, section 14).
We don't list prices on this page. For self-pay prices, savings cards and Medicare, see our US GLP-1 prices guide.
No conversion between them
There is no official dose conversion between Foundayo and the Wegovy pill.
Neither label gives a dose for switching from one pill to the other, or from a Zepbound or Wegovy injection to Foundayo. The milligrams aren't comparable, so a matching number doesn't mean a matching dose. If you're thinking about changing medications, the starting dose is your prescriber's decision, based on the new medication's label. Don't work it out yourself, and don't take both.
Questions to take to your prescriber
Neither pill is the best one for everyone. These are the things that tend to decide it, and they're worth thinking through before your appointment:
From the FDA labels
What to think about before you choose
Your mornings
Can you take a pill on an empty stomach and wait 30 minutes before coffee, food or other pills, every day? If not, that points away from the Wegovy pill.
Your other medications
Some medications change Foundayo levels, including ritonavir and certain antibiotics and antifungals, and its label caps simvastatin at 20 mg a day. The Wegovy pill raised levothyroxine levels in a study.
Birth control pills
With Foundayo, use a non-oral method or add condoms for 30 days after starting and after each dose increase. The Wegovy label found no significant effect on a common birth control pill.
Your health history
Type 2 diabetes, heart disease, a history of pancreatitis or gallbladder problems, or plans for pregnancy all belong in the conversation.
For the full detail on each, we have a Foundayo guide and a Wegovy pill guide.
FAQs
What is the difference between Foundayo and the Wegovy pill?
Which works better, Foundayo or the Wegovy pill?
Can I switch from the Wegovy pill to Foundayo?
Can you take Foundayo with food?
Can you take the Wegovy pill with coffee?
Which pill has fewer side effects?
Do Foundayo or the Wegovy pill affect birth control pills?
General information from the FDA labels and published trials, not medical advice. Your prescriber decides which medication and which dose suit you.
View sources (8)
- Foundayo (orforglipron) prescribing information, Eli Lilly, revised 07/2026
- Wegovy (semaglutide) injection and tablets prescribing information, Novo Nordisk, revised 06/2026
- FDA approves Lilly's Foundayo (orforglipron), Eli Lilly press release, April 1, 2026
- FDA approves Novo Nordisk's Wegovy pill, Novo Nordisk press release, December 22, 2025
- Wharton S, et al. Oral semaglutide at a dose of 25 mg in adults with overweight or obesity (OASIS 4). New England Journal of Medicine, 2025
- Rosenstock J, et al. Orforglipron versus oral semaglutide in type 2 diabetes (ACHIEVE-3). The Lancet, 2026
- Lilly's oral GLP-1, orforglipron, superior to oral semaglutide in head-to-head trial, Eli Lilly, September 17, 2025
- MedWatch: report a side effect to the FDA
