The GLP-1 category is no longer just Ozempic and Mounjaro. There are now weekly injectables, daily injectables, daily oral tablets, dual and single receptor agonists, and a growing set of compounded formulations that have no approved equivalent. This guide maps the whole landscape so you can tell what a provider is actually offering you.
How this class of medication works
GLP-1 receptor agonists mimic glucagon-like peptide-1, a hormone released by the gut after eating. They slow gastric emptying, increase satiety and act on appetite regulation in the brain, and they stimulate glucose-dependent insulin release. Some newer agents also target GIP (glucose-dependent insulinotropic polypeptide), a second incretin hormone — that dual mechanism is why tirzepatide has generally produced larger average weight loss than single-agonist semaglutide in clinical trials.
The FDA-approved medications
| Medication | Active ingredient | Approved for | Administration |
|---|---|---|---|
| Wegovy | Semaglutide | Chronic weight management | Once-weekly injection; oral pill version also available |
| Ozempic | Semaglutide | Type 2 diabetes | Once-weekly injection |
| Rybelsus | Semaglutide | Type 2 diabetes | Daily oral tablet |
| Zepbound | Tirzepatide (GLP-1/GIP) | Chronic weight management | Once-weekly injection; pen, KwikPen and vial |
| Mounjaro | Tirzepatide (GLP-1/GIP) | Type 2 diabetes | Once-weekly injection |
| Foundayo | Orforglipron | Chronic weight management | Once-daily oral tablet, no food or water restrictions |
| Saxenda | Liraglutide | Chronic weight management | Daily injection |
| Victoza | Liraglutide | Type 2 diabetes | Daily injection |
| Trulicity | Dulaglutide | Type 2 diabetes | Once-weekly injection |
Approvals as of August 2026. Prescribing a diabetes-indicated product for weight loss is off-label use.
Foundayo (orforglipron) is a once-daily oral GLP-1 approved for weight management — notable because, unlike oral semaglutide, it can be taken at any time of day without food or water restrictions. Lilly reports average weight loss of roughly 7.4% to 11.1% at 72 weeks depending on dose in trial data, with up to about 25 pounds at the highest dose. It is now carried by several providers including Alloy, Maven Clinic, Amazon One Medical and Shapely.
Single agonist vs dual agonist
Targets the GLP-1 receptor alone. Well-established evidence base, generally lower cost, and some patients tolerate it better. Available as weekly injection or daily oral tablet.
Targets both incretin receptors. Has generally produced greater average weight loss in trials, at a higher price. Dosed at much higher milligram quantities, which drives the cost difference.
The older agent in the class, requiring daily rather than weekly injection, with more modest average weight loss. Still useful where weekly agents are unsuitable or unavailable.
A small-molecule oral GLP-1 rather than a peptide, which is why it avoids the food and water restrictions that apply to oral semaglutide.
Compounded formulations you will encounter online
Telehealth platforms offer compounded versions that have no FDA-approved equivalent. These are not different drugs — they contain the same active molecules — but the formulations and routes are not ones the FDA has reviewed.
- Compounded semaglutide injection, often combined with cyanocobalamin or methylcobalamin (B12).
- Compounded tirzepatide injection, often combined with niacinamide or pyridoxine (B6).
- Compounded oral or sublingual semaglutide — drops, tablets and under-the-tongue formulations. Offered by Midi Health, Rixa Health, LevelsRx, 24hrdoc and Fitish RX among others.
- Compounded oral tirzepatide tablets — offered by Fitish RX. There is no FDA-approved oral tirzepatide.
- Microdosed formulations — deliberately low-dose protocols offered by AgelessRx and Noom, targeting moderate weight loss with fewer side effects.
Peptides like semaglutide are poorly absorbed orally, which is why Rybelsus required a specialised absorption enhancer and strict dosing instructions to work. Compounded oral and sublingual GLP-1s have not been through that development process and have not been studied to the standard of the approved products. If a provider offers one, ask what evidence supports the absorption claim.
Which is right for you?
This is a clinical decision, not a shopping decision, and it depends on your comorbidities, tolerance, insurance formulary and preference for injection versus tablet. That said, the broad shape of the trade-off is worth understanding before your consultation.
| If you… | Consider discussing |
|---|---|
| Want the largest average weight loss and can afford it | Tirzepatide (Zepbound), or compounded tirzepatide if paying cash |
| Have type 2 diabetes alongside weight concerns | Semaglutide or tirzepatide under their diabetes indications, which are more often covered |
| Cannot or will not self-inject | Foundayo or the Wegovy pill — both FDA-approved orals |
| Have struggled with GI side effects at standard doses | A slower titration, a lower maintenance dose, or a microdosing protocol |
| Need the lowest possible cost | Compounded semaglutide, understanding it is not FDA-approved |
Where to go next
Frequently asked questions
What is the newest GLP-1 medication?
Foundayo (orforglipron) is the most significant recent approval — a once-daily oral GLP-1 for chronic weight management that can be taken at any time of day without food or water restrictions, unlike oral semaglutide. It is now offered by providers including Alloy, Maven Clinic, Amazon One Medical and Shapely.
Is there a generic Ozempic or Wegovy?
No. There is currently no FDA-approved generic semaglutide in the United States. Providers describing compounded semaglutide as 'generic Ozempic' are being misleading — compounded product is not an approved generic and is not therapeutically equivalent.
Which GLP-1 produces the most weight loss?
In trial data, tirzepatide has generally produced the largest average weight loss, followed by semaglutide, with liraglutide more modest. Oral orforglipron sits between them. Individual response varies substantially, and the best medication is the one you can tolerate, afford and stay on.
Can I switch between GLP-1 medications?
Yes, and many patients do — for tolerance, cost or availability reasons. Switching requires clinical guidance because dose equivalence between agents is not straightforward, and restarting titration is often necessary. Never switch or self-convert doses without your prescriber.
Sources
- Eli Lilly investor announcement on FDA approval of Foundayo (orforglipron) (accessed August 2026)
- Foundayo prescribing information at foundayo.lilly.com (accessed August 2026)
- FDA-approved labelling and indications for Ozempic, Wegovy, Rybelsus, Mounjaro, Zepbound, Saxenda, Victoza and Trulicity
- Provider-published medication catalogues collected August 2026
- Google Search results collected via Bright Data SERP API, August 2026
Medical disclaimer: This article is for informational purposes only and is not medical advice, a diagnosis, or a treatment recommendation. GLP-1 medications are prescription drugs with real risks and contraindications. Only a licensed clinician who has evaluated you can decide whether any medication is appropriate for you. Do not start, change or stop any medication without consulting your healthcare provider.
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