Wegovy vs Foundayo: weekly shot or daily pill vs the newer orforglipron pill. FDA status, food rules, trial results, side effects and self-pay prices checked October 6, 2026.
Fact-checked against FDA labels and official sources; not yet reviewed by a licensed clinician. This page is education, not medical advice. Talk to your doctor before starting, stopping or changing any treatment.
Key takeaways
- Foundayo (orforglipron) was FDA approved on April 1, 2026 as a daily pill for weight reduction in adults with obesity, or overweight with a weight-related condition.[3]
- Wegovy comes as a weekly injection or a daily pill taken on an empty stomach; Foundayo can be taken with or without food.[2]
- In separate placebo-controlled trials, average weight change was -13.6% with the Wegovy pill (64 weeks) and -11.1% with Foundayo's highest dose (72 weeks).[5]
- Only Wegovy is also approved to lower cardiovascular risk, for teens (injection) and for MASH (injection).[1]
- On 2026-10-06, self-pay prices were $149 to $299 a month for the Wegovy pill and $149 to $349 for Foundayo by strength; both are on Medicare's $50 GLP-1 Bridge.[12]
The short answer
Both are FDA-approved GLP-1 medicines for weight reduction in adults with obesity, or overweight with a weight-related condition. Wegovy (semaglutide) is a weekly injection or a daily pill taken on an empty stomach and also has heart-risk, teen and MASH approvals; Foundayo (orforglipron, approved April 1, 2026) is a daily pill taken with or without food, for adults. There is no head-to-head trial in obesity.
Scorecards
| Wegovy (semaglutide): uses, side effects, cost and FDA statusFDA approved for weight managementPrescriptionInjection | Foundayo (orforglipron): status, uses and what is confirmedFDA approved for weight managementPrescriptionPill | |
|---|---|---|
| Medical supervision | Required | — |
No overall score and no winner: what matters depends on you. Hover a value for its definition.
Facts side by side
| Wegovy (semaglutide): uses, side effects, cost and FDA statusFDA approved for weight managementPrescriptionInjection | Foundayo (orforglipron): status, uses and what is confirmedFDA approved for weight managementPrescriptionPill | |
|---|---|---|
| Purpose | Reduce excess body weight and maintain weight reduction long term (with reduced-calorie diet and increased physical activity); Reduce excess body weight and maintain weight reduction long term (injection); Reduce the risk of major adverse cardiovascular events (CV death, nonfatal heart attack, nonfatal stroke); Noncirrhotic MASH with moderate to advanced liver fibrosis (F2 to F3), accelerated approval (injection); Weight reduction and maintenance, and cardiovascular risk reduction (Wegovy tablets) | Reduce excess body weight and maintain weight reduction long term (with reduced-calorie diet and increased physical activity) |
| Class or type | GLP-1 receptor agonist | GLP-1 receptor agonist |
| Regulatory status | FDA approved for weight managementPrescriptionInjection | FDA approved for weight managementPrescriptionPill |
| Prescription required | Yes | Yes |
| How it works | Wegovy (semaglutide): FDA-approved uses, who the label covers, how it is taken in general, trial results, side effects, boxed warning and dated prices. | Foundayo (orforglipron) was FDA approved on April 1, 2026 for chronic weight management: label facts, trials, side effects, boxed warning and dated prices. |
| How it is done or taken | Injection | Pill (tablet) |
| How often | Weekly | Daily |
| Average outcomes in studies |
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| Main risks |
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| Cost (dated) | from 25 USD per month with commercial coverage (max savings $100 a month; government beneficiaries excluded) (checked October 6, 2026) | from 25 USD per 1- to 3-month fill with commercial coverage (card ends 2026-12-31) (checked October 6, 2026) |
| Official resources | dailymed.nlm.nih.gov | dailymed.nlm.nih.gov |
What the trials showed
- ACHIEVE-3 (NCT06045221), type 2 diabetes only 1,698 adults with type 2 diabetes on metformin, 52 weeks, open label: HbA1c -1.91% with orforglipron 36 mg vs -1.47% with oral semaglutide 14 mg (a Rybelsus dose, not the Wegovy pill); GI events 58% vs 45%; discontinuation for adverse events 10% vs 5%. No head-to-head trial in obesity was found.[8]
Side effects compared
| Wegovy (semaglutide): uses, side effects, cost and FDA statusFDA approved for weight managementPrescriptionInjection | Foundayo (orforglipron): status, uses and what is confirmedFDA approved for weight managementPrescriptionPill | |
|---|---|---|
| From the label |
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Cost and coverage
| Option | Price | Amount | Basis | Checked on |
|---|---|---|---|---|
| Wegovy (semaglutide): uses, side effects, cost and FDA status | List price | 1,349.02 USD | per package (pen, HD pen or pill) | October 6, 2026 |
| Wegovy (semaglutide): uses, side effects, cost and FDA status | Self-pay / cash | 349 USD | per month, pens 0.25 mg to 2.4 mg, NovoCare Pharmacy | October 6, 2026 |
| Wegovy (semaglutide): uses, side effects, cost and FDA status | Self-pay / cash | 399 USD | per month, Wegovy HD 7.2 mg pen, NovoCare Pharmacy | October 6, 2026 |
| Wegovy (semaglutide): uses, side effects, cost and FDA status | Self-pay / cash | 199 USD | per month, first 2 fills of 0.25 mg and 0.5 mg for new patients, through 2026-12-31 | October 6, 2026 |
| Wegovy (semaglutide): uses, side effects, cost and FDA status | With savings program | 25 USD | per month with commercial coverage (max savings $100 a month; government beneficiaries excluded) | October 6, 2026 |
| Foundayo (orforglipron): status, uses and what is confirmed | Self-pay / cash | 149 USD | per month, 0.8 mg (2.5 mg also $149 through 2026-12-31; regular $199) | October 6, 2026 |
| Foundayo (orforglipron): status, uses and what is confirmed | Self-pay / cash | 299 USD | per month, 5.5 mg and 9 mg regular price (5.5 mg $199 through 2026-12-31) | October 6, 2026 |
| Foundayo (orforglipron): status, uses and what is confirmed | Self-pay / cash | 349 USD | per month, 14.5 mg and 17.2 mg regular price ($299 with refills within 45 days) | October 6, 2026 |
| Foundayo (orforglipron): status, uses and what is confirmed | With savings program | 25 USD | per 1- to 3-month fill with commercial coverage (card ends 2026-12-31) | October 6, 2026 |
Prices change often and depend on pharmacy, plan and location. Insurance can change what you pay. Every price shows the date we checked it.
Things people weigh up
- Form: Wegovy offers a weekly pen or a daily pill; Foundayo is a daily pill only.
- Food rules: the Wegovy pill needs an empty stomach and a 30-minute wait; Foundayo can be taken with or without food.
- Other approved uses: only Wegovy is approved for heart-risk reduction, teens (injection) and MASH (injection).
- Trial results come from separate placebo-controlled trials; there is no head-to-head trial in obesity.
- Foundayo's label has specific advice for birth-control pills and for CYP3A4-interacting medicines.
- Self-pay prices overlap ($149 to $349 a month by strength); temporary Foundayo prices end December 31, 2026.
- Track record: orforglipron was approved in April 2026; semaglutide has been marketed since 2017.
These are the differences people commonly consider, not a recommendation. A clinician can help you decide what fits you.
In short: Wegovy (semaglutide, Novo Nordisk) and Foundayo (orforglipron, Eli Lilly) are both FDA-approved GLP-1 medicines for weight reduction in adults with obesity, or overweight with a weight-related condition. Wegovy comes as a weekly injection or a daily pill that must be taken on an empty stomach; Foundayo is only a daily pill and can be taken with or without food. Wegovy also has approvals for heart-risk reduction, for teens (injection) and for a fatty-liver disease (injection); Foundayo is approved for adult weight reduction only. There is no head-to-head trial of the two in people with obesity (status and labels checked on October 6, 2026).
“Injection or pill” is one of the most common questions people bring to their clinician. This page lays out the label facts, the trial numbers and the dated prices so that conversation goes further. It is not advice about which medicine you should use; that needs a medical evaluation by a licensed clinician.
Wegovy vs Foundayo at a glance
- April 1, 2026Foundayo's FDA approval, a new molecular entityDrugs@FDA NDA 220934
- -13.6% vs -11.1%average weight change with the Wegovy pill (64 weeks) and Foundayo's highest dose (72 weeks) in their own placebo trialsDailyMed labels
- Food rulesWegovy pill: empty stomach, then wait 30 minutes; Foundayo: with or without foodFDA labels
Checked on October 6, 2026
The basics side by side
| Wegovy (pen and pill) | Foundayo | |
|---|---|---|
| Active ingredient | Semaglutide, a peptide GLP-1 receptor agonist | Orforglipron, a small-molecule (non-peptide) GLP-1 receptor agonist |
| Maker | Novo Nordisk | Eli Lilly |
| Forms | Weekly single-dose pen (up to 2.4 mg; Wegovy HD 7.2 mg); daily tablet (1.5, 4, 9, 25 mg) | Daily tablet (0.8, 2.5, 5.5, 9, 14.5, 17.2 mg) |
| FDA approval | Injection June 4, 2021; tablets December 22, 2025 | April 1, 2026 |
| Approved uses | Weight reduction and maintenance (adults; teens 12+ with obesity for the injection); lower risk of major cardiovascular events in adults with heart disease and obesity or overweight; MASH with moderate to advanced fibrosis (injection) | Weight reduction in adults with obesity, or overweight with at least one weight-related condition |
| How the pill is taken | Once daily in the morning on an empty stomach with up to 4 ounces of water; wait at least 30 minutes before food, drinks or other oral medicines | Once daily, with or without food; swallow whole |
| Dose steps (pill) | Increases about every 30 days | Starts at 0.8 mg; increases at least 30 days apart |
| Boxed warning | Thyroid C-cell tumors in rodents | Thyroid C-cell tumor warning for the class; the label notes orforglipron is not active in rodents and did not cause tumors in rodent studies, and that human relevance is not determined |
Who the labels describe
Both labels describe adults with obesity, or adults with overweight who also have at least one weight-related condition, and both are meant to be used together with a reduced-calorie diet and more physical activity. In the main trials that meant, for example, a BMI of 30 or more, or 27 or more with a weight-related complication, in people without diabetes (OASIS 4). Neither label is a judgment about any one person: whether a medicine fits you depends on your full history, which only a clinician who evaluates you can weigh. You can check your own numbers with the BMI calculator before the appointment.
The Wegovy label also includes instructions for switching between the injection and the tablets, and the two forms are never used at the same time. Moving between Wegovy and Foundayo, in either direction, is a prescriber decision, and each medicine is started according to its own label.
How they differ in how they work
Both medicines activate the GLP-1 receptor, which lowers appetite and slows stomach emptying; our GLP-1 guide explains the class. The difference is the molecule. Semaglutide is a peptide, a small protein, which the stomach would normally break down. The Wegovy pill gets around this with an absorption enhancer and strict rules: an empty stomach, a small sip of water and a 30-minute wait. Orforglipron is a small, non-peptide molecule designed to be absorbed like a typical pill, which is why its label allows it with or without food. For the bigger picture on tablets, see oral GLP-1 medications.
What the trials showed
No head-to-head trial in obesity. As of October 6, 2026, we found no randomized trial comparing Wegovy and Foundayo directly in people with obesity. Each was tested against placebo:
- Wegovy pill (OASIS 4): 307 adults without diabetes, 64 weeks. Average weight change was -13.6% with the 25 mg tablet versus -2.2% with placebo (the label reports -2.4% for placebo). Digestive side effects were reported by 74.0% versus 42.2%.
- Wegovy injection (STEP 1): 1,961 adults without diabetes, 68 weeks: -14.9% with 2.4 mg versus -2.4% with placebo.
- Foundayo (ATTAIN-1, Trial 1 on the label): 3,127 adults without diabetes, 72 weeks: -11.1% at the highest dose versus -2.1% with placebo on the label (the published paper reports -11.2%). With the highest dose, 54.6% lost 10% or more and 18.4% lost 20% or more. In adults with type 2 diabetes (Trial 2), the highest dose led to -9.6% versus -2.5%.
| Item | Medicine | Placebo |
|---|---|---|
| Wegovy injection 2.4 mg (STEP 1, 68 weeks) | 14.9% | 2.4% |
| Wegovy pill 25 mg (OASIS 4, 64 weeks) | 13.6% | 2.2% |
| Foundayo 17.2 mg (ATTAIN-1, 72 weeks) | 11.1% | 2.1% |
Separate trials with different lengths, sizes and populations; not a head-to-head comparison.
Source: Wilding JPH et al., NEJM 2021; Wharton S et al., NEJM 2025 (OASIS 4); Foundayo prescribing information (Trial 1) (checked on October 6, 2026)
A head-to-head trial in diabetes. ACHIEVE-3 compared orforglipron with oral semaglutide in 1,698 adults with type 2 diabetes not controlled on metformin, over 52 weeks. Note that the oral semaglutide doses were the diabetes doses (7 and 14 mg, sold as Rybelsus), not the 25 mg Wegovy pill. Orforglipron lowered HbA1c more (-1.91% at 36 mg versus -1.47% at 14 mg). It also caused more digestive side effects (58-59% versus 37-45%), more stopping because of side effects (9-10% versus 4-5%) and a larger rise in pulse (3.7-4.7 versus 1.0-1.5 beats per minute). The trial was open label and funded by Eli Lilly.
| Item | Orforglipron 36 mg | Oral semaglutide 14 mg |
|---|---|---|
| Digestive side effects | 58% | 45% |
| Stopped because of side effects | 10% | 5% |
Diabetes doses of oral semaglutide (Rybelsus), not the Wegovy pill. Open label; funded by Eli Lilly. Rounded from 245/423 and 193/425; 41/423 and 21/425.
Source: Rosenstock J et al., Lancet 2026 (ACHIEVE-3, 1,698 adults) (checked on October 6, 2026)
An indirect, statistically adjusted comparison of the two obesity trials (OASIS 4 and ATTAIN-1), published in 2026, estimated about 3 percentage points more weight loss with the 25 mg semaglutide tablet. Indirect comparisons are much weaker evidence than a randomized head-to-head trial, so treat that estimate with caution.
Side effects and warnings
Both medicines mostly cause digestive side effects, especially while the dose is increasing. Foundayo’s label gives these rates at the highest dose; Wegovy’s label says the tablet’s side effects were similar to the injection’s.
| Item | Foundayo 17.2 mg | Wegovy 2.4 mg |
|---|---|---|
| Nausea | 35% | 44% |
| Diarrhea | 25% | 30% |
| Vomiting | 24% | 24% |
| Constipation | 24% | 24% |
Placebo: Foundayo trials nausea 10, diarrhea 11, vomiting 4, constipation 9%; Wegovy trials 16, 16, 6, 11%. Different trials; not a direct comparison. Wegovy tablet rates were described as similar to the injection.
Source: Foundayo and Wegovy prescribing information (DailyMed), adverse reaction tables (checked on October 6, 2026)
| Label point | Wegovy | Foundayo |
|---|---|---|
| Stopped because of side effects | Tablets 6.9% vs 5.9% placebo; injection 2.4 mg 6.8% vs 3.2% | 5.3% to 10.3% across doses vs 2.7% placebo (ATTAIN-1) |
| Birth-control pills | No added-method advice in the label sections we read; ask your prescriber | Switch to a non-oral method or add a barrier method for 30 days after starting and after each dose increase |
| Key interactions | Delayed stomach emptying can affect oral medicines; tablet timing rules for other pills | Strong CYP3A4 inhibitors limit the maximum dose to 9 mg; avoid strong CYP3A4 inducers |
| Pregnancy | Stop when pregnancy is recognized | Stop when pregnancy is recognized; not recommended while breastfeeding |
| Shared warnings | Thyroid C-cell tumor boxed warning (not used with a personal or family history of medullary thyroid carcinoma or MEN 2), pancreatitis, gallbladder disease, low blood sugar with insulin or sulfonylureas, kidney injury from dehydration, allergic reactions, aspiration during anesthesia | |
Neither medicine is used together with another GLP-1 medicine. More on what to expect in our GLP-1 side effects guide.
Cost and coverage (checked on October 6, 2026)
Both companies sell direct to self-pay patients with a prescription, and both prices depend on the strength. Foundayo has two temporary price cuts through December 31, 2026 (2.5 mg at $149 and 5.5 mg at $199), and its top two strengths cost $299 instead of $349 when each refill is completed within 45 days.
- With commercial insurance that covers the drug: both makers offer savings cards from $25 a month (Wegovy: maximum savings $100 a month; Foundayo card expires December 31, 2026). People in government health programs are excluded from both cards.
- Medicare: the temporary Medicare GLP-1 Bridge (July 1, 2026 to December 31, 2027) includes Foundayo and Wegovy (injection and tablets) for weight management with a $50 copay, with prior authorization and set BMI criteria.
- Compare all options: Wegovy cost, the GLP-1 cost comparison tool and GLP-1 insurance coverage.
Practical differences people weigh up
- Morning routine. The Wegovy pill’s empty-stomach rule and 30-minute wait suit some routines and not others, especially for people who take other morning medicines. Foundayo has no food rule.
- Needles. Foundayo has no injectable form. Wegovy lets people move between pen and pill under their prescriber’s guidance.
- Other conditions. Only Wegovy is approved to lower heart risk, for MASH and for teens.
- Track record. Semaglutide has been on the market since 2017 for diabetes; orforglipron is newer, approved in April 2026, so its long-term real-world record is shorter.
- Contraception and interactions. Foundayo’s label has specific advice on birth-control pills and CYP3A4 medicines; bring your full medication list to your appointment.
Stopping, and other options
Trials of GLP-1 medicines show weight tends to return after stopping (in STEP 4, +6.9% over 48 weeks after a switch to placebo), so a long-term plan matters; see life after a GLP-1. Other approved options include Zepbound (weekly injection) and non-GLP-1 pills on the weight-loss pills hub. Related pages: injections vs pills, Wegovy vs Zepbound and the medications hub. Compounded or “research-use” GLP-1 products sold online are not FDA approved; see compounded GLP-1s.
Compared with the items
FDA approved for weight managementPrescriptionInjectionWegovy (semaglutide): uses, side effects, cost and FDA statusSemaglutide: one ingredient, several brands · Injection · Weekly
FDA approved for weight managementPrescriptionPillFoundayo (orforglipron): status, uses and what is confirmedOrforglipron: the small-molecule GLP-1 pill and its current status · Pill (tablet) · DailyRelated comparisons
Related guides
Oral GLP-1 Pills: Wegovy pill, Foundayo, Rybelsus and Ozempic tablets comparedOral GLP-1 pills compared: Wegovy pill, Foundayo, Rybelsus and Ozempic tablets, with FDA status, label rules,…
GLP-1 Side Effects: common, serious and how they are managedGLP-1 side effects from the FDA labels: common digestive effects by brand, serious risks, the thyroid…
Stopping a GLP-1: regain, what trials show and keeping resultsWhat happens when you stop a GLP-1: STEP 1 extension, STEP 4, SURMOUNT-4 and BMJ meta-analysis…Questions to ask a professional
- Would a daily pill or a weekly injection fit my routine and other medicines better?
- Do I have heart disease, fatty liver or another condition that makes Wegovy's other approvals relevant?
- How would Foundayo interact with my birth control or other medicines?
- Which dose steps would we follow, and how do we handle side effects?
- What would each cost me with my insurance, and am I eligible for Medicare's Bridge?
- What is our plan if I stop?
Frequently asked questions
Is Foundayo FDA approved?
Yes. Drugs@FDA lists Foundayo (orforglipron, Eli Lilly) as approved on April 1, 2026, as a new molecular entity, for weight reduction in adults with obesity or overweight with a weight-related condition.
Which works better, Wegovy or Foundayo?
There is no head-to-head trial in obesity. In separate trials, the Wegovy pill led to -13.6% average weight change at 64 weeks and Foundayo's highest dose to -11.1% at 72 weeks. An indirect analysis estimated slightly more loss with the semaglutide pill, but indirect comparisons are weak evidence.
Do I need to take Foundayo on an empty stomach?
No. The Foundayo label says once daily with or without food, swallowed whole. The Wegovy pill must be taken in the morning on an empty stomach with up to 4 ounces of water and a 30-minute wait.
Is the Wegovy pill as effective as the Wegovy shot?
In their own trials, the 25 mg pill led to -13.6% at 64 weeks (OASIS 4) and the 2.4 mg shot to -14.9% at 68 weeks (STEP 1). They were separate trials, so the numbers are not a direct comparison.
Does Foundayo affect birth control pills?
Its label advises switching to a non-oral method or adding a barrier method for 30 days after starting and after each dose increase. Ask your prescriber.
How much do they cost without insurance?
On 2026-10-06: Wegovy pill $149 (1.5 mg), $199 (4 mg) and $299 (9 and 25 mg) a month; Foundayo $149 to $349 by strength, with temporary prices of $149 (2.5 mg) and $199 (5.5 mg) through December 31, 2026 and $299 for the top strengths with on-time refills.
Does Medicare cover Foundayo or the Wegovy pill?
The temporary Medicare GLP-1 Bridge (July 1, 2026 to December 31, 2027) covers both for weight management with a $50 copay, with prior authorization and BMI criteria.
Can teens take either pill?
Both pills are approved for adults only. The Wegovy injection is approved for teens 12 and older with obesity.
References
- WEGOVY (semaglutide) injection and tablets: prescribing information. Novo Nordisk, via DailyMed, 2026. (accessed October 7, 2026) Drug label
- FOUNDAYO (orforglipron) tablets: prescribing information. Eli Lilly and Company, via DailyMed, 2026. (accessed October 7, 2026) Drug label
- Drugs@FDA: Foundayo, NDA 220934. U.S. Food and Drug Administration. (accessed October 7, 2026) Government page
- Drugs@FDA: Wegovy tablets, NDA 218316. U.S. Food and Drug Administration. (accessed October 7, 2026) Government page
- Wharton S, Lingvay I, Bogdanski P, et al.. Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity (OASIS 4). New England Journal of Medicine, 2025. doi:10.1056/NEJMoa2500969 · PMID 40934115 · NCT05564117 (accessed October 6, 2026) Randomized trial
- Wharton S, Aronne LJ, Stefanski A, et al.. Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment (ATTAIN-1). New England Journal of Medicine, 2025. doi:10.1056/NEJMoa2511774 · PMID 40960239 · NCT05869903 (accessed October 6, 2026) Randomized trial
- Wilding JPH, Batterham RL, Calanna S, et al.. Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1). New England Journal of Medicine, 2021. doi:10.1056/NEJMoa2032183 · PMID 33567185 · NCT03548935 (accessed October 7, 2026) Randomized trial
- Rosenstock J, Yabe D, Cox D, et al.. Efficacy and safety of once-daily oral orforglipron compared with oral semaglutide in adults with type 2 diabetes (ACHIEVE-3). Lancet, 2026. PMID 41765029 · NCT06045221 (accessed October 6, 2026) Randomized trial
- Michalak W, Bøg M, Bendixen T, et al.. Oral Semaglutide 25 mg Versus Orforglipron 36 mg in Obesity: A Population-Adjusted Indirect Treatment Comparison. Diabetes, Obesity and Metabolism, 2026. PMID 42225305 (accessed October 6, 2026) Other
- Rubino D, Abrahamsson N, Davies M, et al.. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance (STEP 4). JAMA, 2021. doi:10.1001/jama.2021.3224 · PMID 33755728 · NCT03548987 (accessed October 7, 2026) Randomized trial
- Wegovy at NovoCare Pharmacy: self-pay prices. Novo Nordisk (NovoCare Pharmacy). (accessed October 7, 2026) Other
- Foundayo coverage and savings. Eli Lilly and Company. (accessed October 6, 2026) Other
- Medicare GLP-1 Bridge: information for providers. Centers for Medicare and Medicaid Services. (accessed October 7, 2026) Government page
Facts checked on October 6, 2026
Educational information, not medical advice. Talk with a qualified healthcare professional about your own situation. In an emergency call 911.