Oral GLP-1 Comparison 2026: Aleniglipron vs Wegovy Pill vs Foundayo
Oral GLP-1 pills compared: aleniglipron 12.1% at 36 weeks, Wegovy pill, Foundayo, Rybelsus, elecoglipron — efficacy, dosing, food rules, FDA status.
By PeptidesBeat Staff
Last reviewed
Quick answer: As of August 2026 the only FDA-approved oral GLP-1s for weight management are the Wegovy pill (oral semaglutide 25 mg, approved Dec 22, 2025) and Foundayo (orforglipron, approved Apr 1, 2026). The most effective oral GLP-1 in trial data is aleniglipron (GSBR-1290) — 12.1% average weight loss at 36 weeks in the Phase 2b ACCESS trial, and 16.3% placebo-adjusted at 44 weeks in ACCESS II — but it is investigational and not yet approved. This page compares every oral GLP-1 in or near the clinic: efficacy, dosing, administration rules, and regulatory status.
The oral GLP-1 landscape in one table
| Drug (molecule) | Company | Regulatory status | Dosing | Key efficacy result | Food rules |
|---|---|---|---|---|---|
| Wegovy pill (oral semaglutide 25 mg) | Novo Nordisk | FDA-approved Dec 22, 2025 (first oral GLP-1 for weight management); EU July 15, 2026 | Once daily; 1.5 → 4 → 9 → 25 mg | OASIS 4 (64 wk): 16.6% mean weight loss when adhered to; ~14% average | Empty stomach, ≤4 oz water, 30-min wait |
| Foundayo (orforglipron) | Eli Lilly | FDA-approved Apr 1, 2026; UK MHRA Aug 10, 2026 (first in Europe) | Once daily; 0.8–17.2 mg | ATTAIN-1 (72 wk): 12.4% (27.3 lb) on-treatment | Anytime — no food or water restrictions |
| Rybelsus (oral semaglutide) | Novo Nordisk | FDA-approved 2019 (first oral GLP-1 ever) — type 2 diabetes only | Once daily; 7/14 mg | Type 2 diabetes indication (not weight loss) | Empty stomach, 30-min wait |
| Aleniglipron (GSBR-1290) | Structure Therapeutics | Investigational — Phase 3 ACCOMPLISH-1 recruiting (Q3 2026 start) | Once daily; 5 mg start → 45/90/120 mg (up to 240 mg studied) | ACCESS (36 wk): 12.1% LS mean @ 120 mg; OLE up to 16.2% @ wk 56; ACCESS II 16.3%/16.0% @ 44 wk | With or without food |
| Elecoglipron | AstraZeneca | Investigational — Phase IIb VISTA (Lancet, Jun 2026); Phase III planned | Once daily; 75 mg (VISTA) | VISTA (36 wk): 11.8% | Once-daily oral tablet |
Earlier-stage pipeline: Roche’s CT-996, Ascletis’ ASC30 and Viking’s oral VK2735 — Phase I–II. Two newer oral-peptide entries below state their delivery approach: a transport enhancement, and an effervescent gastric buffer explained in our BioLife patent post.
| Compound | Company | Class | Delivery approach (as stated) | Reported status (company-attributed) | Status date | Source |
|---|---|---|---|---|---|---|
| GZC8072 | Gan & Lee Pharmaceuticals | peptide GLP-1 receptor agonist | company-stated once-weekly oral platform (company-internal name) | first participant dosed in a Phase 1 study; the study’s own registry record NCT07784699 (last updated 2026-08-25) still reads not yet recruiting and lists a single site in Beijing | 2026-09-09 | company press release (company class) |
| ASC36 | Ascletis | peptide amylin receptor agonist | company-stated transport enhancement (company-internal name) | US Phase 1 initiated after IND clearance, 86 participants; no registry record exists for it in either registry | 2026-09-08 | company press release (company class) |
Both entries are recruitment events, not results: neither company has reported Phase 1 results in humans, and the ASC36 delivery figures are non-human-primate data reported by the company.
Top picks: how we’d rank them today
For patients who can get a prescription now, the choice is between the two approved pills:
- Wegovy pill — best efficacy among approved orals. Posted 16.6% mean weight loss when treatment was adhered to (OASIS 4, 64 weeks) and ~14% on average in US News’ analysis. The trade-off: the strictest administration rules in the class — empty stomach, ≤4 oz of water, and a 30-minute wait before eating or drinking.
- Foundayo — best flexibility among approved orals. 12.4% on-treatment weight loss in ATTAIN-1 (72 weeks) and it can be taken anytime, with or without food. The first new-molecular-entity approval under the FDA’s National Priority Voucher pilot (Apr 1, 2026).
If aleniglipron is approved, it reshuffles the ranking. Its ACCESS II result — 16.3% placebo-adjusted weight loss at 44 weeks on 180 mg — is the highest efficacy signal for any oral GLP-1 to date, and like Foundayo it has no food restrictions. But it is an investigational drug: it cannot be prescribed, and anything sold online as “aleniglipron” is unapproved and unregulated. Treat it as the one to watch, not the one to buy.
How much do oral GLP-1s cost in 2026?
Price transparency is where the oral GLP-1 market has shifted in August 2026. Any comparison that quotes these figures, including the table below, should say who read each price and when — see How to Tell If a GLP-1 Price Comparison Is Trustworthy for that test. On Aug 28, DirectMeds announced expanded doctor-guided GLP-1 programs starting at $249/month for sublingual semaglutide (injectable semaglutide or tirzepatide from $297/month), with no separate membership fees or hidden charges — an all-in price covering provider oversight, medication when prescribed, clinical support, and shipping. The approved pills are sold through telehealth storefronts at similar price points, but nearly always on top of a membership fee:
| Option | Monthly price (observed Aug 29, 2026) | What’s included |
|---|---|---|
| DirectMeds — sublingual semaglutide | from $249/mo; injectable from $297/mo | All-in: provider oversight, medication (if prescribed), clinical support, shipping; no membership fee |
| Hims — Wegovy pill / Foundayo pill | meds from $149/mo (Wegovy/Ozempic pens from $199/mo) | Membership $39 first mo, then $149/mo — meds NOT included |
| Mochi — Wegovy pill / Foundayo pill | meds from $149/mo (compounded semaglutide pill from $62) | Membership $39 first mo, then $79/mo — meds separate |
The pattern to watch: the lowest headline prices on the approved pills are medication-only, with membership added on top — while DirectMeds’ $249 sublingual program bundles everything into one monthly number. “Starting at” pricing means not every patient qualifies at the advertised rate. For the full current comparison of every major telehealth GLP-1 program — prices, what’s included, and prescribing models — see our GLP-1 telehealth pricing in 2026 guide. For how much consultation those prescribing models actually include, see GLP-1 Telehealth: Fewer Than a Third Consult a Doctor.
What is aleniglipron (GSBR-1290)?
Aleniglipron is Structure Therapeutics’ once-daily oral small-molecule GLP-1 receptor agonist — a non-peptide chemical, unlike semaglutide-based pills. Because it is a small molecule, it can be taken with or without food, needs no refrigeration, and is designed to be manufactured at scale at lower cost. For the full breakdown of the Phase 2b ACCESS trial — design, dose-response, safety, and the open-label extension — see our aleniglipron explainer.
The Phase 2b ACCESS trial (Nature Medicine, June 5, 2026) randomized 230 adults with obesity or overweight across 38 US sites (Oct 28, 2024 – Feb 7, 2025). At week 36, least-squares mean weight change was:
| Dose | Weight change (LS mean) | Placebo-adjusted |
|---|---|---|
| 45 mg | −9.0% | −8.2% |
| 90 mg | −10.7% | −9.8% |
| 120 mg | −12.1% | −11.3% |
| Placebo | −0.8% | — |
At 120 mg, 86% of patients lost at least 5% of body weight, 70% at least 10%, and 38% at least 15%. There was no drug-induced liver injury and no deaths; 10.4% of participants discontinued, mostly due to GI effects early in titration. For the wider picture on how often people stop GLP-1s and what follows, see our discontinuation and regain analysis. A prespecified interim analysis of the open-label extension (week 56) showed continued loss — up to 16.2% — and ACCESS II (44 weeks, doses to 240 mg) hit 16.3% placebo-adjusted at 180 mg with no plateau. One caveat: 12.1% is a group least-squares mean, not an individual maximum.
Wegovy pill vs Foundayo: the two approved pills
The Wegovy pill (oral semaglutide 25 mg) was the first oral GLP-1 approved for weight management (FDA, Dec 22, 2025). It delivers the strongest approved-pill trial numbers (16.6% when adhered to in OASIS 4) but requires an empty stomach, ≤4 oz of water, and a 30-minute wait after dosing — it uses an absorption enhancer (SNAC) to survive stomach acid.
Foundayo (orforglipron, Eli Lilly) is the second approved oral GLP-1 for obesity (FDA, Apr 1, 2026; UK MHRA Aug 10, 2026 — first in Europe). It’s a small molecule like aleniglipron, so it can be taken anytime with no food or water restrictions. On-treatment weight loss in ATTAIN-1 was 12.4% (27.3 lb) at 72 weeks.
Both are once-daily, refrigeration-free pills. If you can tolerate fasting rules, the Wegovy pill’s trial numbers are higher; if you want dosing flexibility, Foundayo wins.
Oral GLP-1 market data (as of Sept 11, 2026)
Which oral GLP-1 is winning? On the most recent weekly read, the Wegovy pill is still well ahead — roughly 183,000 prescriptions in the week reported Sept 11, 2026, against roughly 47,500 for Foundayo in the same week (both read from the tracker’s Sept 11, 2026 edition). Both are the highest weekly totals either product has recorded, and every figure on this page carries the tracker edition it was read from.
| Product | Weekly prescriptions | Reporting week (as of) | Source |
|---|---|---|---|
| Wegovy pill (oral semaglutide, Novo Nordisk) | ~183,000 | Sept 11, 2026 | Fierce Pharma Oral GLP-1 Tracker, Sept 11, 2026 edition — IQVIA data cited by Citi |
| Foundayo (orforglipron, Eli Lilly) | ~47,500 (up nearly 8% on the week) | Sept 11, 2026 | Fierce Pharma Oral GLP-1 Tracker, Sept 11, 2026 edition — IQVIA data cited by Citi |
| Wegovy pill (oral semaglutide, Novo Nordisk) | ~181,000 | Sept 4, 2026 | Fierce Pharma Oral GLP-1 Tracker, Sept 4, 2026 edition — IQVIA data cited by Citi |
| Foundayo (orforglipron, Eli Lilly) | ~44,000 (up ~8% on the week) | Sept 4, 2026 | Fierce Pharma Oral GLP-1 Tracker, Sept 4, 2026 edition — IQVIA data cited by Citi |
Data last updated: Sept 11, 2026 (tracker edition of Sept 11, 2026). Previous edition: Sept 4, 2026. Each row states the week it was read from; figures from different editions are never combined in one sentence on this page.
For how these oral totals sit against the injectable form of the same molecule — dosing, food rules, refrigeration and price — see our GLP-1 pill vs injection comparison.
Is the oral market expanding GLP-1 demand, or taking it from injections?
The tracker’s own read on Sept 11, 2026 is that the whole GLP-1 class is growing again. Using the last four weeks as a guide, Citi reported total GLP-1 prescriptions up 5.4%, against a 6.8% decline in the same period a year earlier, and attributed the 12-percentage-point swing to the expansion of oral GLP-1 therapies, which it said is likely broadening access to the class and drawing in new patients.
The same Sept 11, 2026 edition supports that reading in a second way: Lilly’s tirzepatide holds nearly 57% of the total GLP-1 market, against around 49.5% a year earlier, while Novo’s semaglutide has stayed relatively flat at a 37% share. If the Wegovy pill were mostly diverting patients from injectable semaglutide, Novo’s overall semaglutide share would be expected to fall as the pill climbs. Instead the pill has grown from roughly 135,000 weekly prescriptions in the week ended April 24 (tracker’s May 4, 2026 edition) to ~183,000 (Sept 11, 2026 edition) while the semaglutide share held at 37% (Sept 11, 2026 edition). The market reading is therefore expansion so far, not pure cannibalisation.
What the data cannot settle — read these limits before quoting the numbers. The tracker publishes totals by product, not an oral-versus-injectable split of the whole class, so a growing total market cannot by itself rule out substitution inside it. Citi also cautions that IQVIA may still be missing some Foundayo prescriptions made through telehealth channels, so Foundayo is more likely to be understated than the Wegovy pill — the two counts are not perfectly like-for-like. And a single week can mislead: Foundayo’s series includes 36,620 (tracker’s Aug 21, 2026 edition) and 40,862 the following week (tracker’s Aug 28, 2026 edition), after 38,928 the week before that (tracker’s Aug 14, 2026 edition). One or two weeks is noise; the direction of travel is the story.
Where these numbers come from, and how often they update
Every figure above is read from Fierce Pharma’s weekly Oral GLP-1 Tracker, which is built on IQVIA prescription data cited by Citi. The tracker is a single rolling page, so a number only means something next to its edition date — which is why each table row carries one. It publishes weekly, on Fridays; the next edition is expected Sept 18, 2026. This section is refreshed after each new edition, and its as-of date moves with it. Nothing here is a forecast, and no figure is carried over between editions.
For the trend rather than a single week’s read — how wide the Wegovy pill’s lead has been, and how far Foundayo has come since its first weeks — see our breakdown of what the weekly prescription data shows.
For how pill and injectable options are priced side by side, see our GLP-1 telehealth pricing comparison. For the regulatory backdrop behind the two approved pills — including the split between the oral Wegovy pill and compounded semaglutide products — see our coverage of the compounded GLP-1 ruling, and follow the FDA peptide timeline tracker for approval updates.
Regulatory status: what’s approved vs what’s coming
No oral GLP-1 was FDA-approved in August 2026 — the timeline is:
- Wegovy pill — FDA Dec 22, 2025 (first oral GLP-1 for weight management); EU July 15, 2026
- Foundayo (orforglipron) — FDA Apr 1, 2026; UK MHRA Aug 10, 2026
- Rybelsus — 2019, first oral GLP-1 ever, but type 2 diabetes only
- Aleniglipron — investigational; End-of-Phase-2 meeting done; Phase 3 ACCOMPLISH-1 (NCT07654361) recruiting since July 13, 2026, on track for a Q3 2026 start at a 2.5 mg starting dose
- Elecoglipron (AstraZeneca) — Phase IIb VISTA data published (Lancet, Jun 2026); Phase III program planned
Follow the FDA peptide timeline tracker for approval updates, and see our coverage of the compounded GLP-1 ruling, the FDA’s GLP-1 compounding policy and the compounded GLP-1 ban push.
FAQ
Can you take oral GLP-1 for weight loss?
Yes — two oral GLP-1s are FDA-approved for weight management: the Wegovy pill (Dec 22, 2025) and Foundayo/orforglipron (Apr 1, 2026). Aleniglipron is not yet approved; it is available only through clinical trials.
What is aleniglipron?
Aleniglipron (GSBR-1290) is Structure Therapeutics’ investigational once-daily oral small-molecule GLP-1 receptor agonist. In the Phase 2b ACCESS trial it produced up to 12.1% average weight loss at 36 weeks (120 mg), with no drug-induced liver injury and no deaths. Phase 3 (ACCOMPLISH-1) is recruiting.
What is the strongest oral GLP-1?
By reported data, aleniglipron’s ACCESS II result — 16.3% placebo-adjusted weight loss at 44 weeks on 180 mg — is the highest efficacy signal for any oral GLP-1 to date, though it is investigational. Among approved pills, the Wegovy pill’s 16.6% (adherent OASIS 4 analysis) is the top figure. Cross-trial comparisons should be read with caution.
Can you take a GLP-1 pill with food?
It depends on the drug. Aleniglipron and Foundayo can be taken with or without food. The Wegovy pill must be taken on an empty stomach with ≤4 oz of water and a 30-minute wait before eating or drinking.
What are the side effects of oral GLP-1 pills?
Gastrointestinal effects dominate: nausea, vomiting, diarrhea, constipation, and decreased appetite. In ACCESS, nausea reached 71.1% and vomiting 44.6% in some dose groups — mostly mild to moderate and decreasing over time; 10.4% of aleniglipron patients discontinued, mostly due to GI effects early in titration.
How does aleniglipron compare to Wegovy pill and Foundayo?
On trial data, aleniglipron’s efficacy is at or above the approved pills (12.1% at 36 weeks; 16.3% placebo-adjusted at 44 weeks) and, like Foundayo, it has no food restrictions. The deciding factor is timing: aleniglipron won’t reach patients until its Phase 3 program completes.
Bottom line
The oral GLP-1 market now has two approved pills (Wegovy pill, Foundayo) and a high-efficacy investigational contender (aleniglipron) that would reshuffle the ranking if approved. Today, choose the Wegovy pill for the strongest approved-pill trial data or Foundayo for flexibility. Watch aleniglipron’s Phase 3 readouts — for the broader context on GLP-1s beyond the scale, see our explainer on GLP-1s and visceral belly fat.
Stay ahead of the GLP-1 and peptide landscape — subscribe to the PeptidesBeat newsletter for weekly research and regulatory digests, and follow the FDA peptide timeline tracker as the aleniglipron Phase 3 program gets underway.
PeptidesBeat is an independent editorial publication covering peptide research, policy, and industry developments. We do not sell peptides, recommend dosing, or provide medical advice. All content is informational. Aleniglipron is an investigational drug not approved by the FDA; it is not available for clinical use outside registered trials. Consult a licensed healthcare provider for any medical question.
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