Weight and metabolism
Foundayo™ vs Wegovy® pill: two GLP-1 pills for weight management
Foundayo vs Wegovy pill: how two GLP-1 pills for weight management differ in how you take them, dosing, side effects and boxed warnings.
The short answer
Foundayo™ (orforglipron) and the Wegovy® pill (semaglutide tablets) are once-daily GLP-1 tablets FDA-approved for weight management. You take Foundayo with or without food, the Wegovy pill on an empty stomach in the morning with plain water. Wegovy tablets are also approved to lower cardiovascular risk in some adults. Both carry a boxed warning about thyroid C-cell tumors. Neither label includes a trial comparing the two.
Key takeaways
- Foundayo can be taken with or without food. The Wegovy pill is taken in the morning on an empty stomach with water only.
- Both carry a boxed warning about thyroid C-cell tumors and are not for people with a personal or family history of MTC or MEN 2.
- Wegovy tablets are also approved to lower cardiovascular risk in adults with established cardiovascular disease and obesity or overweight. Its heart trial tested the injection.
- No trial in either label compares the two. A licensed provider decides which, if either, is appropriate for you.
What are Foundayo and the Wegovy pill?
Foundayo™ (orforglipron) and the Wegovy® pill (semaglutide tablets) are prescription GLP-1 medicines you swallow once a day[1][2]. The FDA approved Foundayo on April 1, 2026[3] and Wegovy tablets on December 22, 2025[4]. Both are approved for use with a reduced-calorie diet and more physical activity in adults with obesity, or in adults with overweight and at least one weight-related health condition[1][2].
For Foundayo, that is the only approved use[1]. Wegovy tablets are also approved to lower the risk of major cardiovascular events (cardiovascular death, non-fatal heart attack or non-fatal stroke) in adults with established cardiovascular disease and either obesity or overweight[2][4]. The heart outcomes trial in the Wegovy label tested the injection, not the tablet[2].
Neither label recommends taking the medicine together with another GLP-1 receptor agonist[1][2]. Label details here are as of the July 2026 Foundayo label and the June 2026 Wegovy label[1][2].
Foundayo™ is a trademark of Eli Lilly and Company. Vitality Testosterone Replacement Therapy is not affiliated with or endorsed by Eli Lilly and Company.
Wegovy® is a registered trademark of Novo Nordisk A/S. Vitality Testosterone Replacement Therapy is not affiliated with or endorsed by Novo Nordisk A/S.
How do Foundayo and the Wegovy pill work?
Both medicines bind to and activate the GLP-1 receptor[1][2]. GLP-1 is a hormone that helps regulate appetite and how much you eat, and both medicines slow how fast your stomach empties[1][2]. Orforglipron is a small-molecule, nonpeptide GLP-1 receptor agonist[5], and semaglutide is a GLP-1 analogue[2].
How do you take Foundayo vs the Wegovy pill?
You take Foundayo once a day, with or without food[1]. You take the Wegovy pill once a day in the morning on an empty stomach with plain water, then wait before you eat, drink or take other oral medicines[2]. Swallow either tablet whole, without splitting, crushing or chewing it, and take no more than one a day[1][2].
| Item | Foundayo™ (orforglipron) | Wegovy® pill (semaglutide tablets) |
|---|---|---|
| Food and water | With or without food; swallow whole[1] | Morning, empty stomach, up to 4 ounces of water only; swallow whole[2] |
| After the dose | No waiting time in the label directions[1] | Wait at least 30 minutes before food, drinks or other oral medicines[2] |
| Tablet strengths | 0.8 mg, 2.5 mg, 5.5 mg, 9 mg, 14.5 mg, 17.2 mg[1] | 1.5 mg, 4 mg, 9 mg and 25 mg[2] |
| Missed dose | Take it as soon as possible; do not double up[1] | Skip it and take the next dose the following day[2] |
Doses and dose increases
Both start low and step up, which the labels say lowers the risk of stomach side effects[1][2].
Foundayo starts at 0.8 mg once daily, then moves to 2.5 mg and 5.5 mg, with at least 30 days on each dose[1]. After that, the prescriber may raise the dose to the next level (9 mg, 14.5 mg, or 17.2 mg once daily) depending on how well it works and is tolerated, up to a maximum of 17.2 mg[1].
The Wegovy pill starts at 1.5 mg once daily and steps up every 30 days through 4 mg and 9 mg to the maintenance dose of 25 mg[2]. If you have trouble with a step, the label lets the prescriber delay the next increase[2].
Foundayo vs Wegovy pill side effects and warnings
The most common side effects of both tablets are digestive: nausea, diarrhea, vomiting, constipation, indigestion, stomach pain, bloating, belching, gas and reflux[1][2]. Both labels also list headache, fatigue and hair loss [1][2]. The Wegovy list pools the injection and the tablets; in the tablet trial, common side effects were similar in type and frequency[2].
Boxed warning and who should not take them
Semaglutide caused thyroid C-cell tumors in rodents, and it is unknown whether Wegovy causes them in humans[2]. Foundayo also carries a boxed warning about thyroid C-cell tumors[1]. Orforglipron is not active in rats or mice and did not cause tumors in rodents, and the label says the human relevance of thyroid C-cell tumors seen in rodents with GLP-1 medicines has not been determined[1].
Neither medicine is for people with a personal or family history of medullary thyroid carcinoma (MTC) or with MEN 2, an inherited syndrome[1][2]. Neither is for people with a known allergy to the medicine or its ingredients (a serious allergy, in the Foundayo label)[1][2].
Other warnings in both labels
Both labels warn about acute pancreatitis, severe stomach and bowel side effects (neither is recommended with severe gastroparesis), kidney injury from dehydration, and low blood sugar, which is more likely if you also take insulin or a sulfonylurea, whose dose your provider may lower[1][2]. They also warn about serious allergic reactions, worsening diabetic eye disease in people with type 2 diabetes, gallbladder disease, and inhaling stomach contents during anesthesia or deep sedation, so tell your providers about any planned surgery or procedure[1][2].
The Wegovy label asks for heart rate checks at regular intervals[2]. The Foundayo label reports an average rise in heart rate compared with placebo in its trials[1]. For people with diabetes, both labels advise checking blood sugar before and during treatment[1][2]. Foundayo is not recommended for people with severe liver impairment[1].
Interactions with other medicines
Birth control pills may not work as well while you take Foundayo[1]. The label advises switching to a non-oral method, or adding a barrier method, for 30 days after starting Foundayo and for 30 days after each dose increase[1]. Hormonal birth control that is not taken by mouth should not be affected[1].
The Foundayo label says to avoid strong CYP3A4 inhibitors that also inhibit OATP1B, such as ritonavir, and to avoid strong CYP3A4 inducers[1]. With other strong CYP3A4 inhibitors, the maximum Foundayo dose is 9 mg once daily[1]. With a moderate CYP3A4 inducer, the prescriber checks how well Foundayo works and may raise the dose as needed[1]. The label also caps the simvastatin dose taken with Foundayo[1].
Because Wegovy slows stomach emptying, it may change how other oral medicines are absorbed[2]. In a study with the semaglutide tablet, levels of levothyroxine (a thyroid medicine) went up, and the label advises closer monitoring with oral medicines that need careful dosing[2].
Pregnancy and breastfeeding
Both medicines may harm an unborn baby, and both labels say to stop when pregnancy is recognized[1][2]. Semaglutide stays in the body a long time, so the Wegovy label also advises stopping it at least 2 months before a planned pregnancy[2]. Breastfeeding is not recommended with Foundayo or with Wegovy tablets[1][2].
Important Safety Information: GLP-1 weight-loss medications
What did the clinical trials study?
Each medicine was tested against placebo[1][2]. In each trial, the groups taking the medicine had a greater reduction in body weight than the placebo group[1][6]. These are results for groups of trial participants and do not predict what happens to any one person. Participants also got advice on diet and physical activity[1][2].
ATTAIN-1 was a 72-week trial that enrolled 3,127 adults with obesity, or with overweight and at least one weight-related condition; people with type 2 diabetes were excluded[1][5]. A second Foundayo trial of the same length enrolled 1,613 adults with overweight or obesity and type 2 diabetes[1]. Both trials compared three doses (5.5 mg once daily, 9 mg once daily, 17.2 mg once daily) with placebo, using an investigational form of orforglipron whose doses the label reports as equivalent Foundayo doses[1].
The Wegovy label describes a 64-week trial of the maintenance-dose tablet or placebo, taken once daily, in 307 adults with obesity, or with overweight and at least one weight-related condition, and without type 2 diabetes[2]. The publication names it OASIS 4[6]. The Wegovy label says the tablets have not been studied for weight reduction in adults with type 2 diabetes, and that some people with type 2 diabetes may have semaglutide blood levels that are too low on the tablets[2]. For those who do not respond well enough, it suggests considering other treatments, including switching to the Wegovy injection[2].
Is Foundayo better than the Wegovy pill?
Neither label includes a trial that compared Foundayo with the Wegovy pill, and their trials enrolled different groups for different lengths of time, so the labels do not show that one is better than the other[1][2].
Practical differences include the morning routine the Wegovy pill needs and its second approved use for cardiovascular risk[1][2]. A licensed provider weighs these against your health history and other medicines.
What this means for you
A licensed provider decides whether either one is appropriate for you. Not everyone is a candidate. Some states require an in-person or physical evaluation before a weight-loss medication is prescribed, and some require your provider to establish care first, so a first visit may not end with a prescription. You can find an office in your state, read about our medical weight management program, and see how GLP-1 medications for weight management are evaluated and prescribed.
Questions to bring to your visit:
- Which routine fits my mornings: an empty stomach and a wait, or a tablet with or without food?
- Do any of my medicines, such as thyroid medicine, birth control pills or a statin, interact with either tablet?
- What should I do with this medicine if I am planning a pregnancy or a surgery?
Stop the medicine and call your provider right away if you have severe stomach pain that will not go away, sometimes spreading to your back, because it can be a sign of pancreatitis[1][2]. Get medical help right away for swelling of your face, lips, tongue or throat, or problems breathing or swallowing[1][2].
Drink fluids, and tell your provider right away if nausea, vomiting or diarrhea does not go away, because fluid loss can lead to kidney problems[1][2]. Call your provider about upper stomach pain, fever, yellow skin or eyes, or clay-colored stools, possible signs of gallbladder problems[1][2]. The Foundayo guide says to do so right away[1].
Ask your provider how to recognize and manage low blood sugar. Its signs include dizziness, sweating, shakiness, confusion, hunger and a fast heartbeat[1][2]. Tell your provider if you notice a lump or swelling in your neck, hoarseness, trouble swallowing or shortness of breath[1][2], or if your heart feels like it is racing while you are at rest[2].
Talk to a provider about weight care options
Our medical weight management page explains how care starts. A licensed provider reviews your health history and labs and decides whether a weight-loss medicine is appropriate.
Talk to a provider about weight care options
Prescription treatment requires an evaluation by a licensed healthcare provider, who decides whether treatment is appropriate for you. Not everyone qualifies. Completing an assessment, booking a visit, or paying a fee does not guarantee a prescription.
Talk to a provider about weight care options
See how medical weight management works, from the first call and labs to a visit with a licensed provider.
Start 2-minute checkTalk to a provider about weight care options
Prescription treatment requires an evaluation by a licensed healthcare provider, who decides whether treatment is appropriate for you. Not everyone qualifies. Completing an assessment, booking a visit, or paying a fee does not guarantee a prescription.
Questions
Is Foundayo a GLP-1?
Can I take the Wegovy pill at night?
The label says to take the Wegovy pill in the morning on an empty stomach with up to 4 ounces of plain water, then wait at least 30 minutes before eating, drinking or taking other oral medicines[2]. Ask your prescriber before you change when you take it.
Can you take Foundayo every other day?
Is the Wegovy pill safe?
Like every prescription medicine, the Wegovy pill has risks. Its label carries a boxed warning about thyroid C-cell tumors, lists people who should not take it, and warns about pancreatitis, gallbladder disease and severe stomach side effects, among others[2]. A licensed provider weighs these risks against your health history.
Is Foundayo safe?
Like every prescription medicine, Foundayo has risks. Its label carries a boxed warning about thyroid C-cell tumors, lists people who should not take it, and warns about pancreatitis, gallbladder disease and severe stomach side effects, among others[1]. A licensed provider weighs these risks against your health history.
Do you need a prescription for Foundayo?
Yes. Foundayo is a prescription-only medicine[1]. A licensed provider decides whether it is appropriate for you. Not everyone is a candidate. You can read how GLP-1 medications for weight management are evaluated and prescribed.
Sources
- FOUNDAYO (orforglipron) tablets — prescribing information (DailyMed). Eli Lilly and Company / U.S. National Library of Medicine (DailyMed). Accessed 2026-10-31. dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8ac446c5-feba-474f-a103-23facb9b5c62
- WEGOVY (semaglutide) injection and WEGOVY (semaglutide) tablets — prescribing information (DailyMed). Novo Nordisk / U.S. National Library of Medicine (DailyMed). Accessed 2026-10-31. dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b
- FDA NDA approval letter, NDA 220934 Foundayo (orforglipron) tablets. U.S. Food and Drug Administration. Accessed 2026-10-31. www.accessdata.fda.gov/drugsatfda_docs/appletter/2026/220934Orig1s000ltr.pdf
- FDA NDA approval letter, NDA 218316 Wegovy (semaglutide) tablets. U.S. Food and Drug Administration. Accessed 2026-10-31. www.accessdata.fda.gov/drugsatfda_docs/appletter/2025/218316Orig1s000ltr.pdf
- Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment (ATTAIN-1) — PubMed abstract. N Engl J Med 2025 (PubMed, NLM). Accessed 2026-10-31. pubmed.ncbi.nlm.nih.gov/40960239/
- Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity (OASIS 4) — PubMed abstract. N Engl J Med 2025 (PubMed, NLM). Accessed 2026-10-31. pubmed.ncbi.nlm.nih.gov/40934115/
Important Safety Information: GLP-1 weight-loss medications
GLP-1 weight-loss medicines such as the two in this guide carry a boxed warning about thyroid C-cell tumors and are not for people with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Their labels also warn about pancreatitis, gallbladder disease and severe stomach side effects, among others. A licensed provider weighs these risks against your health history.
Individual results vary and are not guaranteed.
Prescription treatment requires an evaluation by a licensed healthcare provider, who decides whether treatment is appropriate for you. Not everyone qualifies. Completing an assessment, booking a visit, or paying a fee does not guarantee a prescription.
This article is general health information and not medical advice. It does not replace a visit with a licensed clinician. If you have a medical emergency, call 911.
It follows our editorial and medical review policy. Spotted an error? Tell our editors.