How many GLP-1 pills are there now?

For years, a GLP-1 medication meant a weekly injection. That is changing fast. In under a year the pharmacy shelf has filled with pills, and the naming is confusing enough that many people cannot tell how many there actually are or which one does what.

Here is the short version. Four GLP-1 pills are approved in the United States right now, but two of them are the same medicine under different brand names. One more pill is in late-stage testing. This article maps all of them in plain language, then explains the one practical difference that matters most day to day.

Which GLP-1 pills can I get now?

Four GLP-1 pills are FDA-approved and on the US market as of August 2026. Three of them are semaglutide, the same drug found in the Ozempic and Wegovy injections. The fourth is a different, newer molecule called orforglipron.

Rybelsus and the Ozempic pill are both oral semaglutide, approved for type 2 diabetes and to reduce the risk of heart attack, stroke and cardiovascular death in high-risk patients with diabetes.1 Rybelsus has been available since 2019; higher-dose Ozempic-branded tablets reached US pharmacies in 2026.1

The Wegovy pill is also oral semaglutide, but at a 25 mg dose and approved for a different purpose: chronic weight management in adults with obesity, or overweight plus a weight-related condition.2 The FDA cleared it on December 22, 2025, making it the first GLP-1 pill approved for weight loss.3

Foundayo (orforglipron) is the newcomer and the odd one out. It is not semaglutide and not even a peptide; it is a small-molecule drug, approved by the FDA on April 1, 2026, for weight management.4 Our separate guide covers how much weight you can lose on Foundayo in detail.

*Elecoglipron (AstraZeneca) is not approved; it is in phase 3 testing.5 Approval status current as of August 4, 2026.

Is the Ozempic pill the Wegovy pill?

No, and this is where most of the confusion lives. All three of the approved semaglutide pills contain the same active drug, so the difference is dose and what each is approved to treat.

Rybelsus and the Ozempic pill are the diabetes versions. They are approved to improve blood sugar in adults with type 2 diabetes and to lower cardiovascular risk in those at high risk, and their labels do not include weight loss as an approved use.1 Rybelsus comes in 3, 7 and 14 mg tablets; the Ozempic tablet is a higher-strength version of the same drug.1

The Wegovy pill is the weight-loss version. It is a single 25 mg daily tablet of oral semaglutide, approved for chronic weight management rather than diabetes.2 Same molecule, different dose, different job. Foundayo, by contrast, is a completely different drug (orforglipron), so it does not belong to the semaglutide family at all.4

Why take some pills on an empty stomach?

This is the practical difference that matters most, and it splits the pills into two groups. Semaglutide is a peptide, a small protein, and stomach acid and enzymes would normally destroy a protein before it could be absorbed.

To get around that, the three semaglutide pills include an absorption helper called SNAC and must be taken on an empty stomach in the morning with no more than a small sip of water.1 After swallowing one, you wait at least 30 minutes before eating, drinking anything else or taking other pills.1 The Wegovy pill carries the same instruction.2 Skip the routine and the drug may not absorb properly.

Foundayo works differently because it is a small molecule, not a peptide, so it survives digestion on its own. Its label says it can be taken once daily with or without food, at any time of day.4 That freedom from the empty-stomach ritual is the main practical selling point of the non-peptide pills, and it is why the newer pills are getting so much attention.

Three of the four pills are semaglutide, the same molecule as the Ozempic and Wegovy shots, wrapped in a coating that survives the stomach. The real newcomer is the pill you can swallow with breakfast. Based on the current US prescribing information for each drug

Do the pills work as well as shots?

Roughly, but not identically, and the answer depends on which pill. For semaglutide the story is reassuring: Novo Nordisk reports that the Wegovy pill produced 16.6% mean weight loss in its OASIS 4 trial when taken as directed, and that about one in three participants lost 20% or more, which the company describes as similar to the injection.3

Foundayo lands a step lower. Its FDA label shows about 11% of body weight lost over 72 weeks at the top dose, against roughly 2% on placebo.4 That is a strong result for a pill, but it sits below the highest-performing injection, tirzepatide (the drug in Mounjaro and Zepbound), which reaches around 20% in its trials.

So the honest framing is this. The pills are not yet beating the strongest injections on pure weight loss. What they add is a needle-free option and, for the non-peptide pills, freedom from the empty-stomach routine. For many people that convenience is the difference between staying on treatment and giving up, which is its own kind of result.

Is a new GLP-1 pill coming?

Yes. The most advanced newcomer is elecoglipron (also called AZD5004), an oral small-molecule GLP-1 drug from AstraZeneca that, like Foundayo, is taken once daily with no food or fluid restriction.5

In its phase 2 VISTA trial, published in The Lancet in 2026, adults with obesity and no diabetes lost up to 10.5% of their body weight at the highest dose after 26 weeks, against 0.6% on placebo.5 The trial's authors concluded that the results support moving into phase 3, the last stage before a company can seek approval.5

Elecoglipron is not approved and will not be for some time, since phase 3 trials take years. But it signals where the field is heading: away from finicky peptide pills and toward small-molecule pills that behave like ordinary daily tablets. More such drugs are in early development behind it.

In one sentence: four GLP-1 pills are approved in the US as of August 2026, Rybelsus and the Ozempic pill (oral semaglutide for diabetes), the Wegovy pill (oral semaglutide for weight loss) and Foundayo (orforglipron for weight loss), with elecoglipron the most advanced of the pills still in trials.