Approved uses
- Wegovy® tablets: for adults who have obesity, or overweight together with a weight-related condition, to reduce excess body weight and maintain it long term; and to reduce the risk of cardiovascular death, heart attack or stroke in adults with established cardiovascular disease and obesity or overweight. The cardiovascular outcomes trial in the label was carried out with the injection [1].
- Foundayo™: for adults who have obesity, or overweight together with a weight-related condition, to lower excess body weight and keep the loss long term [2].
- Both: used with diet and activity, not combined with another GLP-1 receptor agonist, and not approved for children [1][2].
The labels at a glance
The table asks each label the same questions. The steps are the label’s schedule, not a dose for any individual.
| Label item | Wegovy® tablets [1] | Foundayo™ [2] |
|---|---|---|
| Active substance | Semaglutide, a peptide, with the absorption enhancer SNAC | Orforglipron, a small molecule not described as a peptide |
| Tablet strengths | 1.5, 4, 9 and 25 mg | 0.8 mg, 2.5 mg, 5.5 mg, 9 mg, 14.5 mg and 17.2 mg |
| Dose steps in the label | 1.5 mg (days 1–30), 4 mg (31–60), 9 mg (61–90), 25 mg maintenance from day 91 | 0.8 mg, then 2.5 mg, then 5.5 mg, each for at least 30 days; then 9, 14.5 or 17.2 mg depending on response and tolerability; 17.2 mg maximum |
| How it is taken | Morning, empty stomach, up to 4 ounces of plain water, then 30 minutes before food, drink or other oral medicines | Once daily with or without food, swallowed whole |
| Missed dose | Skip it; take the next one the following day | Take it as soon as possible without doubling; after 7 or more missed in a row, restart the steps lower |
| If the top step is not tolerated | The label points to switching to the 1.7 mg weekly injection | Further steps depend on response and tolerability |
| Storage | 20–25°C, in the original bottle to protect from moisture | 20–25°C, excursions between 15°C and 30°C allowed |
Two molecules, two timetables
Milligrams describe how much of each molecule a tablet holds, not how strong it is compared with another medicine. Semaglutide is a peptide of about 4,114 g/mol, combined in the tablet with SNAC to help it be absorbed in the stomach; orforglipron calcium is about 902 g/mol, and its label lists no absorption enhancer among the ingredients [1][2]. Their pharmacology sections show how differently the two behave once swallowed.
| Property | Semaglutide tablet (Wegovy®) [1] | Orforglipron (Foundayo™) [2] |
|---|---|---|
| Share of the dose absorbed | About 1% to 2% | 77% after a 0.8 mg dose |
| Time to peak level | About 1 hour | 4 to 8 hours |
| Effect of food and drink | Taken fasting with up to 4 ounces of water; other liquids are not used | No clinically relevant food effect |
| Half-life | About 1 week; present for about 5 to 7 weeks after the last 25 mg dose | About 29 to 49 hours; steady levels after about 1 week |
| How it is cleared | Breakdown of the peptide chain and fatty side chain; about 3% excreted unchanged in urine | Liver enzyme CYP3A4; 87% recovered in faeces, under 1% in urine |
| Interaction the label highlights | Levothyroxine exposure rose by 33% when taken with the tablet | Dose capped at 9 mg with strong CYP3A4 inhibitors; simvastatin limited to 20 mg |
The trials behind each label
Each label rests on its own placebo-controlled trials in adults who also received diet and activity counselling. They differ in length, size and population, and no trial has given Foundayo™ and Wegovy® tablets side by side, so we do not set their weight results against each other. The table describes how the trials were built; the results are in each label’s section 14 and in our article on Foundayo™’s clinical studies. Study 7 in the Wegovy® label was published as OASIS 4 [7].
| Trial | Who took part | Length | Groups | Main measure |
|---|---|---|---|---|
| Wegovy® Study 7 [1] | 307 adults with obesity, or overweight with a related condition, without type 2 diabetes | 64 weeks | 25 mg tablet or placebo, 2:1 | Percent change in body weight and share losing at least 5% |
| Foundayo™ Trial 1 [2] | 3,127 adults with obesity, or overweight with a related condition, without type 2 diabetes | 72 weeks | 5.5, 9 or 17.2 mg or placebo, 3:3:3:4 | Percent change in body weight |
| Foundayo™ Trial 2 [2] | 1,613 adults with a BMI of 27 or more and type 2 diabetes | 72 weeks | 5.5, 9 or 17.2 mg or placebo, 1:1:1:2 | Percent change in body weight |
The one head-to-head trial, and why it is not this comparison
ACHIEVE-3 is the only published trial in which orforglipron was given against an oral semaglutide. It enrolled 1,698 adults with type 2 diabetes on metformin, was open-label and lasted 52 weeks, and it gave orforglipron at the trial doses of 12 mg and 36 mg against semaglutide at 7 mg and 14 mg, the diabetes doses, not the 25 mg Wegovy® tablet [8]. HbA1c fell more with orforglipron; digestive side effects, stopping because of side effects and the rise in pulse were more frequent with it [8]. The trial registry adds weight change at week 52, a secondary outcome counted while people were on the study drug: −6.7% and −9.2% with orforglipron 12 mg and 36 mg against −3.7% and −5.3% with oral semaglutide 7 mg and 14 mg [9].
So the trial answers a diabetes question at different doses. It does not show how Foundayo™ and Wegovy® tablets compare for weight in people without diabetes.
Type 2 diabetes: a real label difference
According to the Wegovy® label, the tablets have not been studied for weight loss in adults who have type 2 diabetes. It adds that in people with type 2 diabetes, average semaglutide levels from the 25 mg tablet were lower than from the weekly 2.4 mg injection, and more variable, so some may not reach effective levels; with an inadequate response it suggests considering alternatives such as the injection [1].
Foundayo™ was studied in type 2 diabetes in Trial 2. There, low blood sugar below 54 mg/dL was reported in 2% of people on Foundayo™ compared with 0.2% on placebo, and in 7% of those also taking a sulfonylurea [2].
Side effects and stopping treatment
The Wegovy® label says the common side effects of its tablets were similar in type and frequency to those of the injection [1]. For Foundayo™, nausea was reported by 26% to 35% across the three doses against 10% on placebo, and vomiting by 13% to 24% against 4% [2]. The table lines up findings that both labels report for their tablet trials, each against its own placebo.
| Finding | Wegovy® tablets (Study 7) [1] | Foundayo™ (Trials 1 and 2 pooled) [2] |
|---|---|---|
| Stopped because of side effects | 6.9% vs 5.9% | 8% vs 3% |
| Severe digestive reactions | 2% vs 0% | About 3% vs 1% |
| Gallstones | 2.5% vs 1% | 1% vs 0.7% |
| Dysesthesia (abnormal skin sensations) | 5% vs 0% | 0.3% at 9 mg and 1% at 17.2 mg vs 0.1% |
| Resting pulse | Rise listed as a warning; findings similar to the injection trials | Average rise of 4 to 5 beats per minute vs 0.5 |
Warnings that differ
- Boxed warning: both carry a thyroid C-cell tumour warning and exclude anyone who has had medullary thyroid carcinoma, or whose relative has, and anyone with MEN 2. The Foundayo™ text adds that orforglipron is not active in rats or mice and caused no tumours in them, while the human relevance remains undetermined [1][2].
- Wegovy® tablets: breastfeeding is not recommended because SNAC passes into milk; levothyroxine exposure rose by 33% when taken with the tablet; women planning a pregnancy are asked to stop at least 2 months beforehand, given the long half-life [1].
- Foundayo™: CYP3A4 interactions as above; not recommended in severe liver impairment or while breastfeeding; stopped when a pregnancy is recognised; and the birth control pill needs a non-oral method, or a barrier method alongside it, for 30 days after starting and after each step [2].
Outside the US
The two tablets are at different stages elsewhere. The table shows what we found in the EU and Canadian records on 20 October 2026.
| Regulator | Wegovy® tablets | Foundayo™ |
|---|---|---|
| European Medicines Agency | In the EU product information as 1.5, 4, 9 and 25 mg tablets for weight management; taken after a fast of at least 8 hours with up to 120 mL of water, steps of at least four weeks [4] | Positive CHMP opinion on 15 October 2026 for weight management and type 2 diabetes; no EU product information yet [5] |
| Health Canada Drug Product Database | Listed only as injection pens [6] | No entry [6] |
Wegovy® is a registered trademark of Novo Nordisk A/S. Foundayo™ is a trademark of Eli Lilly and Company. PepLabo is not affiliated with or endorsed by Novo Nordisk or Eli Lilly and Company.
When to get help
| Sign | Who to contact | How fast | Source |
|---|---|---|---|
| A swollen face, lips, tongue or throat, difficulty breathing or swallowing, or feeling faint | Stop the tablet and get medical help right away (911 or your local number) | Emergency | Both Medication Guides [1][3] |
| Severe stomach pain that will not go away, sometimes reaching the back, with or without vomiting | Stop the tablet and call your healthcare provider right away | Emergency | Both Medication Guides [1][3] |
| Upper stomach pain with fever, yellow skin or eyes, or clay-coloured stools | Your healthcare provider right away | Emergency | Both Medication Guides [1][3] |
| Vomiting, diarrhoea or nausea that keeps going | Your healthcare provider, because of the risk of dehydration and kidney problems | Today | Both Medication Guides [1][3] |
| A racing or pounding heartbeat at rest that lasts several minutes | Your healthcare provider | Today | Wegovy® Medication Guide [1] |
| Wanting to move from one tablet to the other | Your prescriber; neither label describes a switch between them | At your next appointment | Section 1 of each label [1][2] |
