Compounds / Orforglipron
Orforglipron (Foundayo)
Orforglipron is a once-daily GLP-1 tablet sold as Foundayo, and unlike Wegovy tablets you can take it with or without food1,7. FDA approved it for weight management in adults on April 1, 2026, and the UK MHRA authorised it on August 10, 20262–3.
- Taken
- Once a day, tablet
- Half-life
- About 29 to 49 hours
- US status
- FDA-approved April 2026 (Foundayo)
- Type
- GLP-1 agonist, not a peptide
What is orforglipron and how does it work?
Orforglipron is a GLP-1 medicine you swallow once a day, sold as Foundayo by Eli Lilly. It switches on the GLP-1 receptor, the same target as semaglutide. GLP-1 is a hormone your body makes that helps control appetite and how much you eat, and its receptors sit in the parts of the brain that handle hunger1.
In practice, Foundayo lowers how much people eat, most likely by making them less hungry. It also slows how fast food leaves the stomach, and that slowing is strongest after the first dose and fades over time1. Weight lost on it is more fat than lean mass, according to the label1.
One thing sets it apart. Semaglutide and tirzepatide are peptides, chains of amino acids. Orforglipron is a small molecule, not a peptide4, and food makes no meaningful difference to how much of it gets into your blood1.
Who is Foundayo approved for?
In the US, Foundayo is approved for adults with obesity, or with overweight and at least one weight-related condition, to lose weight and keep it off. It goes alongside a reduced-calorie diet and more physical activity1. The UK licence is wider and also covers type 2 diabetes3.
| US (FDA) | UK (MHRA) | |
|---|---|---|
| First approved | April 1, 20262 | August 10, 20263 |
| Weight management | Adults with obesity, or overweight with at least one weight-related condition1 | Adults with a BMI of 30 or more, or 27 to under 30 with a weight-related condition such as prediabetes, type 2 diabetes or high blood pressure3 |
| Type 2 diabetes | Not on the US label1 | Adults whose diabetes isn't controlled well enough, alone or with other diabetes medicines3 |
| Under 18 | Safety and effectiveness not established1 | Safety and efficacy not yet established3 |
The US label says not to take Foundayo with another GLP-1 medicine. It also rules it out for anyone with a personal or family history of medullary thyroid cancer (MTC), anyone with MEN 2, and anyone who has had a serious allergic reaction to orforglipron1. If you become pregnant, the label says to stop it1.
What are the Foundayo doses?
Foundayo starts at 0.8 mg once a day and steps up every 30 days or more, to 2.5 mg and then 5.5 mg. After that it can go to 9 mg, 14.5 mg or 17.2 mg, the maximum1. Each strength is a separate tablet.
| Daily dose | When | On the label |
|---|---|---|
| 0.8 mg | Day 1 | Starting dose |
| 2.5 mg | After at least 30 days on 0.8 mg | Standard step |
| 5.5 mg | After at least 30 days on 2.5 mg | Standard step |
| 9 mg | After at least 30 days on 5.5 mg | If needed. Maximum with a strong CYP3A4 inhibitor |
| 14.5 mg | After at least 30 days on 9 mg | If needed |
| 17.2 mg | After at least 30 days on 14.5 mg | Maximum |
Steps above 5.5 mg are based on how well it works and how well it's tolerated. A step can last longer than 30 days.
The slow start is there to cut the risk of stomach and gut side effects1. The UK uses the same steps and says never to take more than one tablet a day to reach a higher dose3. Tablet colors, the trial capsule doses and the medicines that cap the dose are in our Foundayo dosage guide.
What are the side effects of Foundayo?
The most common side effects of Foundayo are nausea, constipation, diarrhea and vomiting. In the two main 72-week trials, nausea affected 26% to 35% of people on Foundayo, depending on dose, compared with 10% on placebo1.
| Side effect | Placebo | 5.5 mg | 9 mg | 17.2 mg |
|---|---|---|---|---|
| Nausea | 10% | 26% | 34% | 35% |
| Constipation | 9% | 20% | 27% | 24% |
| Diarrhea | 11% | 21% | 23% | 25% |
| Vomiting | 4% | 13% | 21% | 24% |
| Indigestion | 4% | 12% | 16% | 13% |
| Stomach pain | 7% | 13% | 14% | 14% |
| Headache | 7% | 8% | 9% | 9% |
| Tiredness | 4% | 6% | 7% | 9% |
| Burping | 1% | 6% | 8% | 8% |
| Hair loss | 2% | 4% | 4% | 5% |
Nausea, vomiting and diarrhea were more common during the dose increases and eased over time. 8% stopped Foundayo because of side effects, compared with 3% on placebo.
The label also lists rarer, serious risks. It carries a boxed warning about thyroid C-cell tumors, though orforglipron isn't active in rats or mice and caused no tumors in them. The other warnings cover pancreatitis, severe stomach and gut reactions (about 3% vs 1% on placebo), kidney injury from dehydration, gallbladder problems, low blood sugar when taken with insulin or a sulfonylurea, serious allergic reactions, worsening diabetic eye disease (retinopathy) in people with type 2 diabetes, and food being inhaled into the lungs during anesthesia1. Our GLP-1 side effects guide puts these next to the injections.
How do you take Foundayo, and what if you miss a dose?
Take one Foundayo tablet once a day, with or without food, and swallow it whole without breaking, crushing or chewing it1. The UK SmPC says any time of day, with no food or water rules3. Levels in the blood settle after about 1 week of daily doses1.
- Missed dose: take it as soon as possible, and don't double up the next one. If 7 or more doses in a row are missed, the US label says to restart the dose increases at a lower dose1. You can check a gap with our missed dose checker.
- Storage (US): room temperature, 20°C to 25°C (68°F to 77°F), with short spells between 15°C and 30°C (59°F to 86°F) allowed. Tablets come in bottles of 30 with a drying packet1.
- Storage (UK): no special temperature. Keep the blister pack in its box to protect it from light3.
- Birth control pills: Foundayo may make them work less well. The label says to switch to a non-oral method, or add a barrier method, for 30 days after starting and for 30 days after each dose increase1.
How much weight do people lose on orforglipron?
In the main 72-week trial of adults without diabetes, average weight loss was 7.4% on 5.5 mg, 8.3% on 9 mg and 11.1% on 17.2 mg, compared with 2.1% on placebo1,4. In adults with type 2 diabetes it was 5.1% to 9.6%, compared with 2.5%1,5.
| Trial | Placebo | 5.5 mg | 9 mg | 17.2 mg |
|---|---|---|---|---|
| ATTAIN-1: 3,127 adults without diabetes, average weight change | −2.1% | −7.4% | −8.3% | −11.1% |
| ATTAIN-1: lost 10% or more | 13% | 32.5% | 39.8% | 54.5% |
| ATTAIN-2: 1,613 adults with type 2 diabetes, average weight change | −2.5% | −5.1% | −7% | −9.6% |
| ATTAIN-2: lost 10% or more | 9.2% | 22.5% | 31.1% | 45.6% |
The papers report these as 6 mg, 12 mg and 36 mg, because the trials used capsules. The UK SmPC lists the 5.5 mg, 9 mg and 17.2 mg tablets as equal to those doses3.
A third trial looked at keeping weight off. People who had lost weight on tirzepatide or semaglutide switched to orforglipron or placebo. Among those whose weight had levelled off, the orforglipron groups kept about 75% and 79% of their lost weight at 52 weeks, compared with 49% and 38% on placebo6. Week-by-week averages for each medicine are in our weight loss by week guide.
How does orforglipron compare with Wegovy tablets and Zepbound?
Foundayo and Wegovy tablets are both daily GLP-1 pills, but Wegovy tablets go on an empty stomach in the morning with up to 4 ounces of water and a 30-minute wait7. Foundayo has no food rule1. The oral semaglutide side is covered in our Rybelsus and Wegovy tablets guide.
None of the Foundayo trials above compared it with Zepbound or Wegovy injections. Results from separate trials can't be lined up directly, because each one enrolled different people. The tirzepatide page has the Zepbound trial results.
Orforglipron fact sheet
- Type
- GLP-1 receptor agonist taken as a tablet1. It's a small molecule, not a peptide like semaglutide or tirzepatide4.
- Status (US)
- Approved April 1, 20262, for weight reduction and keeping weight off in adults with obesity, or with overweight and at least one weight-related condition1. The US label doesn't include type 2 diabetes.
- Status (UK)
- First authorised August 10, 2026, for weight management in adults with a BMI of 30 or more, or 27 to under 30 with a weight-related condition, and for type 2 diabetes in adults3
- How it's taken
- One tablet once a day, with or without food. Swallow it whole, don't break, crush or chew it, and don't take more than one a day1. The UK SmPC says any time of day, with no food or water rules3.
- Doses on the label
- Start at 0.8 mg a day. After at least 30 days, 2.5 mg. After at least 30 more days, 5.5 mg. Then 9 mg, 14.5 mg or 17.2 mg if needed, at least 30 days at each step. Maximum 17.2 mg a day, or 9 mg with a strong CYP3A4 inhibitor medicine1.
- Half-life
- About 29 to 49 hours. Levels settle after about 1 week of daily doses1.
- Storage
- Room temperature, 20°C to 25°C (68°F to 77°F), in bottles of 30 with a drying packet1. UK blister packs: no special temperature, keep in the original pack away from light3.
- Boxed warning
- Risk of thyroid C-cell tumors. Don't take it with a personal or family history of medullary thyroid cancer (MTC) or with MEN 2. The label notes orforglipron doesn't act in rats or mice and didn't cause tumors in them, and that the human relevance of these rodent tumors isn't known1.
Orforglipron guides
Also useful: Dose schedule planner · Missed dose checker · Units to dose
Questions
How do you take Foundayo? Does it need an empty stomach?
No. The US label says to take one tablet once a day, with or without food, swallowed whole. The UK SmPC says any time of day, with no food or water rules. That's different from Wegovy tablets, which are taken on an empty stomach in the morning with up to 4 ounces of water, then a 30-minute wait before eating, drinking or other pills.
What if I miss a dose of Foundayo?
The US label says to take it as soon as possible, but don't double up the next dose. If you miss 7 or more doses in a row, the label says to restart the dose increases at a lower dose to lower the chance of stomach side effects. The UK SmPC also says never more than one tablet a day.
How much weight did people lose on orforglipron in the trials?
In ATTAIN-1 (adults without diabetes), average weight change at 72 weeks was -7.4% on 5.5 mg, -8.3% on 9 mg and -11.1% on 17.2 mg, compared with -2.1% on placebo. In ATTAIN-2 (adults with type 2 diabetes) it was -5.1%, -7% and -9.6%, compared with -2.5%. The published papers call these doses 6 mg, 12 mg and 36 mg because the trials used capsules. The UK SmPC lists 5.5 mg, 9 mg and 17.2 mg tablets as equal to those capsules, and says the two forms aren't swapped mg for mg.
What are the most common side effects of Foundayo?
Stomach and gut effects. In the two main trials, nausea affected 26% to 35% of people on Foundayo (depending on dose) compared with 10% on placebo, and constipation 20% to 27% compared with 9%. Overall, 8% stopped Foundayo because of side effects, compared with 3% on placebo.
Does Foundayo affect the birth control pill?
It may. The US label says Foundayo may make oral hormonal contraceptives work less well. It advises switching to a non-oral method, or adding a barrier method, for 30 days after starting and for 30 days after each dose increase.
Can you switch from Wegovy or Zepbound to Foundayo?
The US label doesn't give a switching schedule, and it says not to use Foundayo with another GLP-1 medicine. In the ATTAIN-MAINTAIN trial, people who had lost weight on tirzepatide or semaglutide switched to orforglipron or placebo. Among those whose weight had levelled off, the orforglipron groups kept about 75% (after tirzepatide) and 79% (after semaglutide) of the weight they had lost at 52 weeks, compared with 49% and 38% on placebo. Your prescriber decides how to switch.
Sources
- 1Foundayo (orforglipron) tablets: US prescribing information, Eli Lilly (DailyMed, revised 07/2026). boxed warning; sections 1, 2.1 to 2.3, 6.1 (Table 1), 8.3, 12.3, 14 (Table 6), 16 and 17
- 2FDA news release: FDA approves first new molecular entity under National Priority Voucher program (Foundayo). April 1, 2026
- 3Foundayo 0.8 mg film-coated tablets: UK Summary of Product Characteristics (eMC, revised August 10, 2026). sections 4.1, 4.2, 5.1 (Table 2), 5.2, 6.4 and 9
- 4Wharton S, et al. Orforglipron, an oral small-molecule GLP-1 receptor agonist for obesity treatment (ATTAIN-1). N Engl J Med. 2025;393(18):1796-1806. PubMed 40960239
- 5Horn DB, et al. Orforglipron for the treatment of obesity in people with type 2 diabetes (ATTAIN-2). Lancet. 2026;406(10522):2927-2944. PubMed 41275875
- 6Aronne LJ, et al. Orforglipron for maintenance of body weight reduction: the ATTAIN-MAINTAIN trial. Nat Med. 2026;32(7):2679-2687. PubMed 42120723
- 7Wegovy (semaglutide) injection and tablets: US prescribing information, Novo Nordisk (DailyMed, revised 06/2026). section 2.1 (Wegovy tablets)
This page explains what labels and published studies say. It isn't medical advice and doesn't replace your prescriber or pharmacist.
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