Which GLP-1 Pills Are FDA-Approved?
Three GLP-1 pills are FDA-approved in the US, and only two of them are approved for weight loss. FDA approval records list Rybelsus (oral semaglutide, Novo Nordisk) on September 20, 2019, the Wegovy pill (oral semaglutide, Novo Nordisk) on December 22, 2025, and Foundayo (orforglipron, Eli Lilly) on April 1, 2026.
Rybelsus is a diabetes drug: its label covers blood sugar control in type 2 diabetes and cutting cardiovascular risk in high-risk patients, nothing about weight. That label now also covers newer Ozempic tablets (1.5, 4 and 9 mg), and it warns the two are not substitutable milligram for milligram.
The Wegovy pill and Foundayo are the weight-management pills, for adults with obesity or with overweight plus a weight-related condition. Foundayo is the odd one out chemically: the ATTAIN-1 trial paper calls orforglipron a small-molecule, nonpeptide drug, and its label carries none of the fasting rules below. Our semaglutide guide explains how the semaglutide brands relate.
How Do You Take Each GLP-1 Pill?
The two semaglutide pills are fussy and Foundayo is not. The Rybelsus and Wegovy labels say to take the tablet on an empty stomach in the morning with up to 4 ounces of plain water, then wait at least 30 minutes before eating, drinking or taking other pills. The Foundayo label says once daily, with or without food.
That 30-minute rule is not bureaucracy. The Rybelsus label estimates that only about 0.4% to 1% of the semaglutide in a Rybelsus tablet reaches your bloodstream. Coffee at minute 12 is not a rounding error.
All three pills start low and climb in 30-day steps to limit stomach side effects. The Wegovy pill goes 1.5, 4 and 9 mg, then 25 mg from day 91. Foundayo starts at 0.8 mg, then 2.5 and 5.5 mg, with optional steps up to 17.2 mg based on response and tolerability.
Missed doses differ too: the Wegovy pill label says skip it and carry on tomorrow, while the Foundayo label says take it as soon as possible, never double up, and restart lower after 7 or more missed days.
Rybelsus vs the Wegovy Pill vs Foundayo at a Glance
The fastest way to tell the three GLP-1 pills apart is by what each is approved for and how it fits your morning.
| Rybelsus | Wegovy pill | Foundayo | |
|---|---|---|---|
| Active ingredient | Semaglutide (Novo Nordisk) | Semaglutide (Novo Nordisk) | Orforglipron (Eli Lilly) |
| FDA-approved for | Type 2 diabetes; cardiovascular risk in type 2 diabetes | Weight management; cardiovascular risk reduction | Weight management |
| First approved | September 2019 | December 2025 | April 2026 |
| How to take | Empty stomach, up to 4 oz water, wait 30 minutes | Empty stomach, up to 4 oz water, wait 30 minutes | Any time, with or without food |
| Dose steps (daily) | 3 mg, 7 mg, 14 mg | 1.5, 4, 9, then 25 mg | 0.8, 2.5, 5.5 mg, up to 17.2 mg |
| Weight result in label trial | Not approved for weight loss | 13.6% vs 2.4% on placebo, 64 weeks | 11.1% vs 2.1% on placebo (17.2 mg), 72 weeks |
Summarized from the DailyMed prescribing information and FDA approval records listed under Sources. Trial results come from different studies and are not a head-to-head comparison.
Do GLP-1 Pills Work as Well as the Shots?
GLP-1 pills work, and the Wegovy pill lands close to the weekly shot. In the Wegovy label's 64-week trial of 307 adults without diabetes, the 25 mg pill cut body weight by 13.6% on average, against 2.4% on placebo, which Novo Nordisk describes as similar to injectable Wegovy 2.4 mg.
Foundayo rests on a bigger trial. ATTAIN-1, published in the New England Journal of Medicine and funded by Lilly, randomized 3,127 adults without diabetes for 72 weeks, and the Foundayo label reports 11.1% average loss on 17.2 mg versus 2.1% on placebo. Naming trap: the paper calls the doses 6, 12 and 36 mg, while the label restates them as the approved tablet's 5.5, 9 and 17.2 mg.
Don't rank the pills off those two numbers. The trials differed in length and people, and each tested one pill against placebo, not against the other. Side effects are the shared price: in Foundayo's pooled trials, nausea hit 35% on 17.2 mg against 10% on placebo, and the Wegovy label calls the pill's side effects similar to the injection's. Our GLP-1 side effects guide covers what to watch for.
Should You Switch From a Shot to a Pill?
A GLP-1 pill makes the most sense when needles keep you off treatment, and the least when a weekly shot already works. You trade one injection a week for a tablet every day. Before you switch, raise these label points with your prescriber:
- Birth control pills: the Foundayo label says to switch to a non-oral method or add a barrier method for 30 days after starting and after each dose increase.
- Thyroid medicine: in a label interaction study, semaglutide tablets raised levothyroxine exposure by 33%.
- Other prescriptions: Foundayo interacts with some drugs that affect the CYP3A4 enzyme, and its dose is capped at 9 mg alongside strong inhibitors.
- Insulin or sulfonylureas: all three labels warn these raise the risk of low blood sugar alongside a GLP-1.
- Thyroid cancer history: all three pills carry a boxed warning and are not for anyone with a personal or family history of medullary thyroid carcinoma, or with MEN 2.
Talk to your prescriber before you switch, and never stop a shot on your own to start a pill. New to GLP-1s? Our guide to your first month on a GLP-1 explains why the slow start matters.
How Much Do GLP-1 Pills Cost?
The Wegovy pill has the clearest cash price. NovoCare, Novo Nordisk's pharmacy, lists self-pay pricing of $149 a month for 1.5 mg, $199 for 4 mg and $299 for 9 mg or 25 mg, one month being a bottle of 30 tablets, as of September 2026. For Foundayo, check Lilly's current self-pay price for your dose before you compare.
On Medicare, the CMS GLP-1 Bridge covers Foundayo and Wegovy tablets for weight management with a $50 copay; CMS keeps GLP-1s prescribed for conditions Part D covers, like type 2 diabetes, in your Part D plan. Our GLP-1 cost guide compares the injectables.
No GLP-1 pill is sold over the counter. All three are prescription-only, so a "GLP-1 pill" sold without a prescription is not one of these drugs. Read our guide to GLP-1s without a prescription before a bargain tempts you, and browse the rest of our GLP-1 guides.
Frequently Asked Questions
GLP-1 pills do work. The Wegovy pill label reports 13.6% average weight loss at 64 weeks against 2.4% on placebo, similar to the injection according to Novo Nordisk. The Foundayo label reports 11.1% at 72 weeks on its top dose against 2.1% on placebo, from a separate trial.
The best GLP-1 pill depends on your diagnosis and your mornings. Rybelsus is approved only for type 2 diabetes. The Wegovy pill must be taken fasting with up to 4 ounces of water; Foundayo can be taken any time. Their weight results come from separate placebo-controlled trials, so let your prescriber decide.
No. Rybelsus, the Wegovy pill and Foundayo are prescription-only in the US. A supplement sold as a "GLP-1 pill" without a prescription is not one of these FDA-approved drugs.
No. Rybelsus is FDA-approved for blood sugar control and cardiovascular risk reduction in adults with type 2 diabetes. The FDA-approved weight-management pills are the Wegovy pill and Foundayo.
Want a Clinician to Weigh Pill vs Shot?
Licensed online GLP-1 programs differ on which formulations they prescribe, so ask whether a program offers the Wegovy pill or Foundayo before you enroll. No program can promise a pill is right for you.
Prescription required. Medical screening and clinician review required. Not all patients will qualify. Affiliate disclosure: this site may earn a referral fee from programs listed.
Compare Online GLP-1 ProgramsSources
The following sources were used for the approvals, prescribing information, trial results, prices and program rules referenced on this page. Always verify against the most current version of each document.
- Rybelsus and Ozempic (semaglutide) tablets, US Prescribing Information, Novo Nordisk (DailyMed): indications, fasting and water instructions, dose steps, non-substitution with Ozempic tablets, oral bioavailability and the levothyroxine interaction.
- Wegovy (semaglutide) injection and tablets, US Prescribing Information, Novo Nordisk (DailyMed): tablet indications, administration, 30-day dose escalation, missed doses and the 64-week tablet trial.
- Foundayo (orforglipron) tablets, US Prescribing Information, Eli Lilly (DailyMed): indication, dosing with or without food, dose steps, missed doses, contraceptive and CYP3A4 guidance, adverse reactions and the 72-week trials.
- FDA, Drugs@FDA approval records via openFDA (NDA 213051, 218316, 220934): original approval dates of September 20, 2019, December 22, 2025 and April 1, 2026.
- Wharton S, et al. Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment (ATTAIN-1). N Engl J Med 2025;393:1796-1806: 3,127 randomized adults, 6, 12 and 36 mg trial doses, 72-week results, Lilly funding.
- Novo Nordisk: Wegovy pill FDA approval announcement (December 2025): approval and the comparison with injectable Wegovy 2.4 mg.
- NovoCare Pharmacy: Wegovy pricing: self-pay prices for the Wegovy pill by dose.
- CMS: Medicare GLP-1 Bridge, Information for Providers: eligible drugs including Foundayo and Wegovy tablets, the $50 copay and Part D routing for other indications.