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    Orforglipron (Foundayo)

    Also known as Foundayo, LY3502970

    Orforglipron is a small-molecule, non-peptide GLP-1 receptor agonist taken by mouth once a day.[1] The FDA approved it as Foundayo for weight management on 1 April 2026. Unlike the Wegovy pill, it has no food or water restrictions.[2][3]

    Editor reviewedStrict sourcingUpdated GLP-1 and metabolic medicineHealth and medicineLife sciences
    Key facts

    Orforglipron is eli-lilly‘s GLP-1 pill for weight management. It is a different kind of molecule from earlier GLP-1 drugs: a small, non-peptide chemical rather than a modified hormone.[1] Unlike oral semaglutide, it can be taken at any time of day without food or water restrictions.[3]

    Evidence

    ATTAIN-1 randomised 3,127 adults with obesity and without diabetes to orforglipron or placebo for 72 weeks. Mean weight change was -7.5%, -8.4% and -11.2% at 6, 12 and 36 mg, versus -2.1% on placebo.[4] Waist size, blood pressure and some blood lipids also improved.[4] Adverse events led 5.3% to 10.3% of orforglipron patients to stop treatment, versus 2.7% on placebo. Gastrointestinal effects were the most common.[5]

    ATTAIN-MAINTAIN tested orforglipron as a maintenance pill. People who had lost weight on injectable tirzepatide or semaglutide in an earlier trial were switched to orforglipron or placebo. After 52 weeks the orforglipron groups kept an estimated 74.7% and 79.3% of their weight loss, against 49.2% and 37.6% on placebo.[6] The trial had no arm that stayed on injections, and it lasted one year, so it does not settle the questions in the long-term use debate.[7]

    Average weight loss was lower than with injectable tirzepatide in its main trial. An indirect comparison also favoured oral semaglutide 25 mg. No head-to-head trial had reported when that analysis was published in mid-2026.[8][9]

    Diabetes and heart safety

    In ACHIEVE-1, 559 people with early type 2 diabetes managed by diet and exercise took orforglipron or placebo for 40 weeks. HbA1c, a measure of average blood sugar, fell by 1.24 to 1.48 percentage points versus 0.41 on placebo, and weight fell by up to 7.6% versus 1.7%.[10]

    ACHIEVE-4 was the first cardiovascular outcomes trial of a non-peptide GLP-1 drug. It randomised 2,749 adults with type 2 diabetes and established heart or kidney disease to orforglipron or insulin glargine, without blinding. Over a median of two years, major cardiovascular events occurred in 4.2% on orforglipron and 5.0% on insulin (hazard ratio 0.84, 95% CI 0.59 to 1.20), meeting the non-inferiority goal.[11] Lilly highlighted pre-planned analyses showing 53% fewer cardiovascular deaths and 57% fewer deaths overall. These were not the trial’s primary test.[12] Gastrointestinal adverse events affected 62.1% on orforglipron versus 14.2% on insulin, while serious low blood sugar was less common (6.8% vs 19.2%).[13]

    Approval

    The FDA approved orforglipron, branded Foundayo, on 1 April 2026 for adults with obesity, or overweight with weight-related conditions. It was reviewed under the Commissioner’s National Priority Voucher pilot and approved about 50 days after filing.[2] Lilly filed it for type 2 diabetes in the second quarter of 2026.[14]

    Price and access

    Lilly’s self-pay price started at $149 a month for the lowest dose. STAT reported prices of up to $299 a month for patients who keep renewing, matching the Wegovy pill.[15] The November 2025 White House agreement had already set starting doses of future oral GLP-1s at about $150 a month through TrumpRx.[16] Foundayo is covered under Medicare’s GLP-1 Bridge.[17] Foundayo sales were $98 million in the second quarter of 2026, its first quarter on the market.[18]

    Questions readers ask

    How is orforglipron different from the Wegovy pill?

    Orforglipron is a small, non-peptide molecule and can be taken any time of day without food or water restrictions. The Wegovy pill contains the peptide semaglutide and must be taken in the morning at least 30 minutes before food.[1][3]

    How much weight did people lose on orforglipron?

    In ATTAIN-1, mean weight change at 72 weeks was -7.5%, -8.4% and -11.2% at 6, 12 and 36 mg, versus -2.1% on placebo.[4]

    Has orforglipron been compared directly with oral semaglutide?

    Not in a head-to-head trial. A 2026 indirect comparison estimated about 3 percentage points more weight loss with oral semaglutide 25 mg than with orforglipron 36 mg. Indirect comparisons carry more uncertainty than randomised head-to-head trials.[9]

    Is orforglipron safe for the heart?

    In ACHIEVE-4, in 2,749 people with type 2 diabetes at high cardiovascular risk, orforglipron was non-inferior to insulin glargine for major cardiovascular events (hazard ratio 0.84). The trial was designed to rule out harm, not to prove benefit.[11]

    Can orforglipron keep weight off after injections?

    In ATTAIN-MAINTAIN, people who switched from tirzepatide or semaglutide injections kept an estimated 75-79% of their weight loss at one year on orforglipron, versus 38-49% on placebo.[6]

    Sources

    Each numbered claim is a statement we checked against the sources listed with it. Status shows how well established it is.

    1. [1]

      Orforglipron is a small-molecule, non-peptide GLP-1 receptor agonist taken by mouth once daily. confirmedas of 2026-10-10

    2. [2]

      On 1 April 2026 the FDA approved Lilly's orforglipron, branded Foundayo, for adults with obesity or overweight with weight-related conditions, under the National Priority Voucher pilot about 50 days after filing. confirmedas of 2026-04-01

    3. [3]

      Foundayo can be taken at any time of day without food or water restrictions, whereas the Wegovy pill must be taken in the morning at least 30 minutes before food or drinks other than water. confirmedas of 2026-04-01

    4. [4]

      In the phase 3 ATTAIN-1 trial of 3,127 adults with obesity without diabetes, orforglipron produced mean weight changes of -7.5%, -8.4% and -11.2% at 6, 12 and 36 mg at 72 weeks, versus -2.1% with placebo, with improvements in waist circumference, systolic blood pressure, triglycerides and non-HDL cholesterol. confirmedas of 2025-09-16

    5. [5]

      In ATTAIN-1, adverse events led to treatment discontinuation in 5.3% to 10.3% of orforglipron groups versus 2.7% on placebo, mostly from gastrointestinal effects. confirmedas of 2025-09-16

    6. [6]

      In the phase 3b ATTAIN-MAINTAIN trial, people who switched from injectable tirzepatide or semaglutide to daily orforglipron kept an estimated 74.7% and 79.3% of their prior weight loss at 52 weeks, versus 49.2% and 37.6% with placebo. confirmedas of 2026-05-13

    7. [7]

      The ATTAIN-MAINTAIN authors noted that the trial had no comparator arm continuing injectable obesity medicines and lasted only one year. confirmedas of 2026-05-13

    8. [8]

      In SURMOUNT-1, which enrolled 2,539 adults with obesity or overweight and no diabetes, weekly tirzepatide produced mean weight changes of -15.0%, -19.5% and -20.9% at doses of 5, 10 and 15 mg at 72 weeks, versus -3.1% with placebo. confirmedas of 2022-06-04

    9. [9]

      A 2026 indirect (not head-to-head) comparison using OASIS 4 and ATTAIN-1 data estimated about 3 percentage points more weight loss and fewer adverse-event discontinuations with oral semaglutide 25 mg than with orforglipron 36 mg. confirmedas of 2026-06-01

    10. [10]

      In the 40-week ACHIEVE-1 trial of 559 people with early type 2 diabetes, orforglipron lowered HbA1c by 1.24 to 1.48 percentage points versus 0.41 with placebo, with weight change of up to -7.6% versus -1.7%. confirmedas of 2025-06-21

    11. [11]

      In the open-label ACHIEVE-4 trial of 2,749 adults with type 2 diabetes at increased cardiovascular risk (The Lancet, 30 September 2026), oral orforglipron was non-inferior to insulin glargine for major adverse cardiovascular events (4.2% vs 5.0%; hazard ratio 0.84, 95% CI 0.59 to 1.20) over a median 2 years. confirmedas of 2026-09-30

    12. [12]

      Lilly reported that in pre-planned ACHIEVE-4 analyses, cardiovascular death was 53% lower and all-cause death 57% lower with orforglipron than with insulin glargine; these were not the trial's primary test. confirmedas of 2026-09-30

    13. [13]

      In ACHIEVE-4, gastrointestinal adverse events occurred in 62.1% of orforglipron patients versus 14.2% on insulin glargine, while clinically significant or severe hypoglycaemia was less frequent (6.8% vs 19.2%). confirmedas of 2026-09-30

    14. [14]

      In the second quarter of 2026 Lilly submitted orforglipron to the FDA for type 2 diabetes. confirmedas of 2026-08-05

    15. [15]

      At launch, Lilly's self-pay price for Foundayo started at $149 a month for the lowest dose, and STAT reported prices of up to $299 a month for patients who keep renewing, matching the Wegovy pill. reportedas of 2026-04-01

    16. [16]

      The November 2025 agreement set the starting dose of future oral GLP-1 drugs from the two companies at about $150 a month through TrumpRx. confirmedas of 2025-11-06

    17. [17]

      Novo Nordisk reported that the Bridge programme began on 1 July 2026 and covers a majority of Medicare beneficiaries, and Lilly reported Foundayo and Zepbound coverage under it. confirmedas of 2026-08-05

    18. [18]

      Lilly's second-quarter 2026 revenue rose 48% to $23.0 billion, including $9.9 billion from Mounjaro, $4.9 billion from Zepbound and $98 million from Foundayo. confirmedas of 2026-08-05

    Revision history (2)
    1. Page created.
    2. Refresh: added ACHIEVE-1 and ACHIEVE-4 (cardiovascular safety, Lancet September 2026) results and the ATTAIN-MAINTAIN switch trial.

    Created Oct 10, 2026. Last reviewed by an editor on Oct 10, 2026. Next scheduled review: Jan 10, 2027.

    Cite this page

    "Orforglipron (Foundayo)." ContentLora, updated Oct 10, 2026. https://contentlora.com/wiki/orforglipron

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