GLP-1 Medications Directory

Compare all FDA-approved GLP-1 receptor agonist medications side by side. Pricing, dosing, weight loss data, and side effects — all in one place.

Medication9.5

Zepbound

Zepbound is the weight management brand of tirzepatide from Eli Lilly, FDA-approved in November 2023 for chronic weight management in adults with obesity or overweight with at least one weight-related condition. It contains the same dual GIP/GLP-1 receptor agonist as Mounjaro, but at the same dose range and with the explicit indication for weight loss rather than diabetes. The SURMOUNT clinical trial program produced some of the strongest weight loss data ever seen in a pharmaceutical trial. In SURMOUNT-1[1], participants achieved average weight reductions of 16% on the 5 mg dose, 21.4% on 10 mg, and 22.5% on the 15 mg dose at 72 weeks. More than half of patients on the highest dose lost 20% or more of their body weight. In the head-to-head SURMOUNT-5 trial[2], Zepbound demonstrated 20.2% weight loss compared to 13.7% with semaglutide (Wegovy), representing 47% greater relative weight reduction. Zepbound's list price is approximately $1,086 per month. Through Eli Lilly's LillyDirect self-pay program, single-dose vials are available starting at $299 per month for lower doses, with maintenance doses of 7.5-15 mg priced between $499 and $1,049. Insurance coverage for weight loss medications varies widely, with roughly 16% to 43% of employer plans covering GLP-1s for weight loss as of 2025. For insured patients with coverage, copays can be as low as $25.

Active Ingredient: tirzepatideDosing: Once weeklyList Price/mo: $1086

Medication9.2

Mounjaro

Mounjaro is a first-in-class dual GIP/GLP-1 receptor agonist developed by Eli Lilly, FDA-approved for type 2 diabetes management. What sets Mounjaro apart from single-agonist GLP-1 medications is its dual mechanism: it activates both the GIP and GLP-1 receptors simultaneously, which appears to produce stronger metabolic effects than targeting GLP-1 alone. This dual action has translated into some of the most impressive clinical trial results in the diabetes and obesity space. In the SURPASS clinical trial program[1], Mounjaro reduced A1C by 1.9% to 2.4% depending on dose, with nearly 90% of participants achieving an A1C below 7%. The weight loss results were equally striking. Participants on the 15 mg dose lost an average of 29 pounds at 36 weeks in the SURPASS trials[1], significantly outperforming both placebo and comparator drugs like insulin degludec. While only approved for type 2 diabetes, Mounjaro is widely prescribed off-label for weight loss. The list price is approximately $1,080 per month. Eli Lilly's savings card can reduce copays to as low as $25 for commercially insured patients using it for diabetes, but the card typically cannot be used for off-label weight loss prescriptions or with Medicare/Medicaid. Without insurance coverage, GoodRx coupons bring the price to around $1,070.

Active Ingredient: tirzepatideDosing: Once weeklyList Price/mo: $1080

Medication9.0

Retatrutide

Retatrutide is an investigational triple hormone receptor agonist being developed by Eli Lilly that targets GIP, GLP-1, and glucagon receptors simultaneously, making it the first drug to activate all three pathways at once. This triple mechanism is believed to enhance metabolic effects beyond what dual agonists like tirzepatide can achieve, with the glucagon component adding increased energy expenditure and fat oxidation to the appetite-suppressing and insulin-sensitizing effects of GIP and GLP-1. The clinical data for retatrutide has been remarkable. In the Phase 2 trial published in the New England Journal of Medicine[1], the 12 mg dose produced 24.2% average weight loss at 48 weeks. The first Phase 3 result from TRIUMPH-4[2] was even more striking: participants achieved up to 28.7% average weight loss (approximately 71 pounds) at the highest dose, along with substantial relief from osteoarthritis pain. However, the Phase 3 data also revealed tolerability concerns, with discontinuation rates of 12.2% and 18.2% for the 9 mg and 12 mg doses respectively, compared to 4% on placebo. Retatrutide is not yet FDA-approved. Seven additional Phase 3 trials in the TRIUMPH program are expected to complete in 2026, covering both obesity and type 2 diabetes indications. If results remain positive, Eli Lilly could submit for FDA approval as early as late 2026, with potential availability in 2027-2028. The drug could represent the next major leap in obesity pharmacotherapy if its safety profile proves acceptable across the broader Phase 3 program.

Active Ingredient: retatrutideDosing: Once weekly

Medication8.9

Wegovy

Wegovy is a higher-dose formulation of semaglutide specifically approved by the FDA for chronic weight management in adults with obesity (BMI 30+) or overweight (BMI 27+) with at least one weight-related comorbidity. Manufactured by Novo Nordisk, it uses the same active ingredient as Ozempic but at a maximum dose of 2.4 mg compared to Ozempic's 2 mg, and it carries an explicit weight loss indication. The STEP clinical trial program[1] established Wegovy as one of the most effective non-surgical weight loss treatments available. In STEP 1[1], participants achieved an average weight loss of 14.9% at 68 weeks, with over half losing 15% or more of their body weight. The two-year STEP 5 trial[2] confirmed sustained results, showing 15.2% weight loss maintained at 104 weeks. In head-to-head comparisons, Wegovy demonstrated strong efficacy, though tirzepatide-based Zepbound showed superior results in the SURMOUNT-5 trial[3]. Wegovy is also available as an oral tablet (approved in late 2025), offering patients an alternative to weekly injections. The injectable version carries a list price of approximately $1,350 per month, though Novo Nordisk's partnership with GoodRx has brought introductory pricing to $199 per month for lower doses. Insurance coverage for weight loss medications remains inconsistent, with many plans still excluding anti-obesity drugs.

Active Ingredient: semaglutideDosing: Once weeklyList Price/mo: $1350

Medication8.7

Ozempic

Ozempic is a once-weekly injectable semaglutide medication manufactured by Novo Nordisk, FDA-approved for managing type 2 diabetes. It works by mimicking the GLP-1 hormone, which stimulates insulin secretion when blood sugar is high, slows gastric emptying, and reduces appetite. In the SUSTAIN clinical trial program[1], Ozempic demonstrated A1C reductions of 1.4% to 2.1% depending on dose, with the 2 mg dose showing the strongest glycemic control. While Ozempic is only approved for type 2 diabetes, it has become widely known for its weight loss effects. Patients in clinical trials lost an average of 6 to 14 pounds, though real-world weight loss often exceeds trial averages, especially at the 2 mg dose. Its popularity has led to intermittent supply shortages and significant off-label prescribing for weight management. Ozempic carries a boxed warning for risk of thyroid C-cell tumors based on animal studies, and the most common side effects are gastrointestinal: nausea, vomiting, diarrhea, and constipation. With commercial insurance and the Novo Nordisk savings card, most patients pay as little as $25 per month. Without insurance, the list price is approximately $1,028 per month, though GoodRx coupons can bring that down to $199 for introductory fills.

Active Ingredient: semaglutideDosing: Once weeklyList Price/mo: $1028

Medication8.5

CagriSema

CagriSema is Novo Nordisk's combination injection of cagrilintide (an amylin analog) and semaglutide 2.4mg, designed to achieve greater weight loss than semaglutide alone. The REDEFINE Phase 3 trial program demonstrated up to 22.7% body weight loss over 68 weeks, making it one of the most effective anti-obesity medications in clinical development. The combination targets multiple appetite and metabolic pathways simultaneously. Cagrilintide mimics the hormone amylin, which is co-secreted with insulin after meals and promotes satiety, slows gastric emptying, and reduces glucagon secretion. When combined with semaglutide's GLP-1 activity, the dual mechanism produces additive weight loss effects. Novo Nordisk filed for FDA approval in late 2025, with a decision expected in 2026. The drug is being positioned as a next-generation follow-up to Wegovy. CagriSema is delivered as a single once-weekly subcutaneous injection combining both active ingredients, so patients don't need two separate shots. Side effects are similar to other GLP-1 medications, primarily gastrointestinal. Pricing is expected to be premium, likely higher than Wegovy's $1,350 list price, given its superior efficacy. The combination approach represents Novo Nordisk's strategy to maintain market leadership against Eli Lilly's tirzepatide franchise.

Active Ingredient: cagrilintide + semaglutideDosing: Once weekly

Medication8.0

Semaglutide (oral, high-dose Wegovy equivalent)

Novo Nordisk is developing a high-dose oral semaglutide formulation (25mg and 50mg) designed to match or exceed the weight loss efficacy of injectable Wegovy (2.4mg weekly). Current oral semaglutide (Rybelsus) is only available at up to 14mg and produces modest weight loss compared to the injectable form. The new high-dose oral version showed 15.1% weight loss in the OASIS 1 trial, comparable to injectable semaglutide 2.4mg. The OASIS clinical trial program demonstrated that oral semaglutide 50mg produced statistically significant weight loss and A1C reduction, with results rivaling the injectable version. This is a technical achievement, as achieving adequate oral bioavailability for peptide drugs has been one of the biggest pharmaceutical challenges. The formulation uses the same SNAC absorption enhancer as Rybelsus but at higher semaglutide doses. Novo Nordisk submitted the high-dose oral semaglutide for FDA approval in 2025, with a decision expected in 2026. If approved, it could dramatically expand the GLP-1 market by offering patients an oral option with injection-level efficacy. The strict fasting requirement (30+ minutes before eating or drinking) remains, though Novo Nordisk is also researching formulations that reduce or eliminate this restriction.

Active Ingredient: semaglutideDosing: N/A (oral, once daily)

Medication8.0

Compounded Tirzepatide

Compounded tirzepatide became one of the most sought-after weight loss medications after the FDA placed Mounjaro and Zepbound on the drug shortage list. Compounding pharmacies were legally permitted to produce copies of tirzepatide at significantly lower prices, typically $150-450 per month compared to $1,000+ for brand-name versions. The compounded form uses the same active ingredient but is prepared by state-licensed or 503B outsourcing facilities rather than Eli Lilly. The legal landscape shifted dramatically in late 2024 when the FDA announced tirzepatide was no longer in shortage, which threatened compounders' ability to produce it. Multiple lawsuits were filed by compounding pharmacies and telehealth companies challenging this determination. As of early 2026, legal battles continue, with some compounders still operating under court injunctions while others have transitioned to alternative formulations. Patients who relied on affordable compounded tirzepatide face uncertainty about continued access. Compounded tirzepatide is typically available as a subcutaneous injection, though some pharmacies offer sublingual troches or oral formulations with varying bioavailability. Patients should verify their pharmacy holds proper state licensing and ideally 503B outsourcing facility registration. Sterility testing and potency verification are critical quality markers to look for when evaluating a compounding pharmacy.

Active Ingredient: tirzepatideDosing: Once weeklyList Price/mo: $300

Medication8.0

Amycretin

Amycretin is Novo Nordisk's oral GLP-1/amylin receptor co-agonist that generated enormous excitement after Phase 1 trial results showed up to 13% body weight loss in just 12 weeks. This rapid early weight loss, if sustained, would project to outcomes potentially exceeding any currently available anti-obesity medication. The oral formulation addresses one of the biggest barriers to GLP-1 adoption: needle aversion. Unlike oral semaglutide (Rybelsus), which requires fasting 30 minutes before and after dosing, amycretin is being developed with the goal of more flexible dosing conditions. The drug combines GLP-1 receptor agonism with amylin receptor agonism in a single molecule, targeting the same dual-pathway approach as CagriSema but in a convenient pill form. Phase 2 trials launched in 2025 with results expected through 2026. If amycretin's early promise holds through larger and longer trials, it could represent the most significant advance in oral anti-obesity medication. The combination of best-in-class weight loss with oral convenience would address the two biggest limitations of current GLP-1 therapies. However, oral bioavailability of peptide-based drugs remains a technical challenge, and dose optimization through Phase 2/3 will be critical.

Active Ingredient: amycretinDosing: N/A (oral, once daily)

Medication7.8

Rybelsus

Rybelsus is the first and only oral GLP-1 receptor agonist approved for type 2 diabetes, offering patients who are uncomfortable with injections an alternative way to take semaglutide. Manufactured by Novo Nordisk, Rybelsus is taken as a daily tablet rather than a weekly injection, using a special absorption enhancer (SNAC) that allows the semaglutide peptide to survive the stomach and enter the bloodstream. In the PIONEER clinical trial program[1], Rybelsus demonstrated meaningful A1C reductions of 0.9% to 1.1% at the 7 mg and 14 mg doses respectively, with results comparable to injectable liraglutide. Weight loss with oral semaglutide is more modest than injectable forms. The 14 mg dose produced around 2.3 kg of weight loss in trials. The convenience of a pill format does come with a trade-off: patients must take Rybelsus on an empty stomach with no more than 4 ounces of water, then wait at least 30 minutes before eating, drinking, or taking other medications. The list price is approximately $998 per month regardless of dose. With the Rybelsus savings card, commercially insured patients can pay as little as $10 to $25 per month. Without insurance, GoodRx coupons may reduce costs, but the out-of-pocket price remains substantial at around $1,200 per month at retail pharmacies.

Active Ingredient: semaglutideDosing: Once daily (oral)List Price/mo: $998

Medication7.5

Maritide

Maritide (MariTide, AMG 133) is Amgen's investigational anti-obesity biologic that combines a GLP-1 receptor agonist antibody with a GIP receptor antagonist. This is a fundamentally different approach from tirzepatide, which activates both GLP-1 and GIP receptors. Amgen's hypothesis is that blocking GIP while activating GLP-1 may produce superior or more durable weight loss. What makes maritide truly unique is its proposed monthly or less-frequent dosing. Early clinical data suggested the drug's antibody-based mechanism provides extended duration of action, with some patients maintaining weight loss for months after their last dose. Phase 2 results showed approximately 14.5% weight loss, with provocative signals that weight regain was slower after discontinuation compared to other GLP-1 medications. Amgen fast-tracked maritide into Phase 3 trials, with results expected in 2026-2027. The potential for monthly dosing and more durable post-treatment effects would address two major limitations of current GLP-1 therapies: weekly injection burden and rapid weight regain upon discontinuation. Amgen's manufacturing expertise in biologics also positions it well for the production challenges that have plagued GLP-1 supply chains.

Active Ingredient: maritide (AMG 133)Dosing: Monthly (target)

Medication7.5

Trulicity

Trulicity is a once-weekly GLP-1 receptor agonist manufactured by Eli Lilly, FDA-approved in September 2014 for type 2 diabetes. Its active ingredient, dulaglutide, was designed for simplicity: Trulicity comes in a pre-filled, single-use pen with a hidden needle that automatically injects the medication when pressed against the skin, making it one of the most user-friendly injectable diabetes medications available. In the AWARD clinical trial program[1], Trulicity demonstrated A1C reductions of 1.5% to 1.8% across the 1.5 mg to 4.5 mg dose range. Weight loss at the higher investigational doses reached up to 10.4 pounds at 36 weeks, though these effects are modest compared to semaglutide and tirzepatide. Trulicity is not FDA-approved for weight loss but is sometimes prescribed off-label for this purpose. It also has cardiovascular outcome data from the REWIND trial[2], showing reduced risk of major cardiovascular events in patients with type 2 diabetes. The list price is approximately $987 per month for a 4-pen supply. With the Eli Lilly savings card, 92% of commercially insured patients pay $0 to $30 per month. Medicare Part D beneficiaries typically pay $0 to $100 monthly. No generic or biosimilar version is currently available, though one may emerge as early as 2026-2027 as key patents approach expiration.

Active Ingredient: dulaglutideDosing: Once weeklyList Price/mo: $987

Medication7.5

Orforglipron

Orforglipron is Eli Lilly's oral GLP-1 receptor agonist currently in late-stage clinical trials, representing a potential breakthrough as a once-daily pill alternative to injectable GLP-1 medications. Unlike Rybelsus (oral semaglutide), which is a peptide that requires strict fasting protocols for absorption, orforglipron is a small molecule that can be taken without food restrictions, making it significantly more convenient for patients. Phase 3 ATTAIN trial results published in 2025 showed orforglipron produced up to 14.7% body weight loss over 72 weeks in adults with obesity, with the 36mg dose showing the strongest efficacy. These results position it competitively against injectable semaglutide, though slightly below tirzepatide's 20%+ weight loss. The oral convenience factor could be a major differentiator for the large population of patients who are needle-averse or prefer pill-based treatments. Eli Lilly has submitted orforglipron for FDA review, with a potential approval expected in late 2026. If approved, it would be the first oral non-peptide GLP-1 medication, potentially opening the weight loss drug market to millions of patients who have avoided injectable options. Pricing has not been announced, but analysts expect it to be positioned below injectable GLP-1s to maximize market penetration.

Active Ingredient: orforglipronDosing: N/A (oral, once daily)

Medication7.3

Compounded Semaglutide

Compounded semaglutide refers to versions of semaglutide prepared by compounding pharmacies rather than manufactured by Novo Nordisk. These formulations gained popularity during the prolonged semaglutide shortage that began in 2022, offering patients a lower-cost alternative to brand-name Ozempic and Wegovy. Compounded versions are typically available as subcutaneous injections or sublingual tablets, often at 40-80% less than the brand-name price. The regulatory landscape for compounded semaglutide shifted significantly in early 2025 when the FDA removed semaglutide from its drug shortage list. This triggered restrictions on compounding pharmacies: 503A pharmacies had until April 22, 2025, and 503B outsourcing facilities until May 22, 2025, to stop producing "essentially a copy" of commercially available semaglutide. However, pharmacies can still legally compound semaglutide for patients with specific medical needs not met by commercial products, and many now offer combination formulations (such as semaglutide/cyanocobalamin) that fall outside the "essentially a copy" restriction. Pricing for compounded semaglutide typically ranges from $179 to $299 per month through telehealth platforms, making it substantially more affordable than brand-name options. However, patients should understand that compounded semaglutide is not FDA-approved, does not undergo the same rigorous manufacturing and testing processes as brand-name medications, and quality can vary between compounding pharmacies. The FDA has warned that some compounded versions may use semaglutide sodium salt rather than the semaglutide base used in approved products.

Active Ingredient: semaglutide (or semaglutide sodium)Dosing: Once weekly (injectable)List Price/mo: $249

Medication7.2

Victoza

Victoza was the original liraglutide brand, approved by the FDA in January 2010 for type 2 diabetes management. It was one of the earliest GLP-1 receptor agonists to reach the US market and helped establish the drug class as a cornerstone of modern diabetes treatment. Victoza is administered as a daily subcutaneous injection and is also approved to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease, based on results from the LEADER trial[2]. In the LEAD clinical trial program[1], Victoza reduced A1C by 1.0% to 1.5% depending on dose, with the 1.8 mg dose showing the strongest glycemic control. Weight loss is a secondary benefit, with patients typically losing 5-7 pounds during treatment. While these results were significant when Victoza launched, newer GLP-1 agonists like semaglutide and tirzepatide now deliver substantially greater A1C reductions and weight loss. A major development occurred in December 2024 when Hikma Pharmaceuticals received FDA approval for a generic version of liraglutide, making it the first generic GLP-1 agonist available in the US. With GoodRx, the brand-name Victoza costs approximately $229 per carton (3 pens), down from a retail price of around $924. The availability of generic liraglutide is expected to further reduce costs, making Victoza's active ingredient one of the most affordable GLP-1 options on the market.

Active Ingredient: liraglutideDosing: Once dailyList Price/mo: $924

Medication7.0

Alharo (semaglutide biosimilar)

As semaglutide patents begin to face challenges and the GLP-1 market expands, biosimilar versions are entering development. Several pharmaceutical companies have announced biosimilar semaglutide programs, aiming to provide lower-cost alternatives to Ozempic and Wegovy. These biosimilars must demonstrate equivalent efficacy and safety through rigorous clinical trials before receiving FDA approval. The path to semaglutide biosimilars is complex because biologics (large-molecule drugs produced in living cells) cannot be exactly replicated like small-molecule generics. Each biosimilar must undergo its own clinical testing to demonstrate biosimilarity, typically requiring 1-2 clinical trials. Several Indian and Chinese pharmaceutical companies have biosimilar semaglutide in clinical development, with the earliest potential approvals in the 2027-2028 timeframe. When biosimilar semaglutide products eventually reach market, they are expected to be priced 15-30% below brand-name Ozempic and Wegovy, based on typical biosimilar pricing dynamics. However, Novo Nordisk's extensive patent portfolio covering semaglutide formulations, delivery devices, and manufacturing processes may delay biosimilar entry in the US market. The availability of biosimilars would significantly improve patient access to these life-changing medications.

Active Ingredient: semaglutide (biosimilar)Dosing: Once weekly (expected)

Medication7.0

Saxenda

Saxenda was one of the first GLP-1 receptor agonists approved specifically for weight management, receiving FDA approval in December 2014 for adults with obesity or overweight with a weight-related comorbidity. It uses liraglutide at a 3 mg dose, higher than the 1.8 mg maximum used in the diabetes version (Victoza). In 2020, the FDA expanded its indication to include adolescents aged 12 and older with obesity. In the SCALE clinical trial program[1], Saxenda produced average weight loss of 8% over 56 weeks, with a 5.4 percentage point difference over placebo. While these results were groundbreaking at the time, they have since been surpassed by newer medications like semaglutide and tirzepatide, which achieve 15-22% weight loss. Saxenda also requires daily injections rather than the weekly dosing of newer alternatives, which many patients find less convenient. Saxenda remains one of the more expensive GLP-1 options at approximately $1,349 per month without insurance. The manufacturer savings card program has been discontinued, leaving patients more dependent on insurance coverage or GoodRx coupons (which can bring the price to around $372 at select pharmacies). A generic version of liraglutide became available in late 2024, which may eventually reduce costs. Saxenda carries the same thyroid C-cell tumor boxed warning as other GLP-1 agonists, and gastrointestinal side effects including nausea, vomiting, and diarrhea are common.

Active Ingredient: liraglutideDosing: Once dailyList Price/mo: $1349

Medication7.0

Survodutide

Survodutide is Boehringer Ingelheim's dual GLP-1/glucagon receptor agonist in Phase 3 clinical development for obesity and metabolic dysfunction-associated steatohepatitis (MASH). What sets survodutide apart from other GLP-1 medications is its dual mechanism: it activates both the GLP-1 receptor (appetite suppression, glucose control) and the glucagon receptor (increased energy expenditure, fat mobilization), theoretically offering complementary weight loss pathways. Phase 2 trial results were striking, showing up to 19% body weight loss over 46 weeks at the highest dose. The glucagon receptor component may provide particular benefits for liver fat reduction, making it a promising candidate for MASH treatment. Phase 3 trials (SYNCHRONIZE program) are ongoing across obesity, MASH, and type 2 diabetes indications, with results expected through 2026. The glucagon component does introduce some unique considerations. Glucagon naturally raises blood sugar, which the GLP-1 component must counterbalance. This dual mechanism requires careful dose titration to maintain glycemic control while maximizing weight loss. If successful in Phase 3, survodutide would offer a differentiated mechanism compared to the GLP-1-only and GLP-1/GIP drugs currently on market.

Active Ingredient: survodutide (BI 456906)Dosing: Once weekly

Medication7.0

Xultophy (insulin degludec/liraglutide)

Xultophy combines insulin degludec (a ultra-long-acting basal insulin) with liraglutide (a GLP-1 receptor agonist) in a single once-daily injection. Approved by the FDA in 2016, it is prescribed for adults with type 2 diabetes who need both insulin and GLP-1 therapy. The combination uses Novo Nordisk's insulin degludec, which has a half-life exceeding 25 hours, providing exceptionally stable glucose control. Clinical trials demonstrated that Xultophy produces A1C reductions of 1.3-1.9% while being weight-neutral, a significant advantage over insulin alone which typically causes weight gain. The DUAL clinical trial program showed Xultophy was more effective than either component alone, with lower rates of hypoglycemia compared to uptitrated insulin. For patients already on basal insulin who need better control, Xultophy offers simplification without adding injection burden. The main limitation is cost, with list prices around $450-500 per pen without insurance. Xultophy is not indicated for weight loss and competes directly with Sanofi's Soliqua. Most endocrinologists consider Xultophy and Soliqua roughly equivalent, with selection often driven by insurance formulary positioning and patient familiarity with Novo Nordisk vs Sanofi devices.

Active Ingredient: insulin degludec + liraglutideDosing: Once dailyList Price/mo: $950

Medication7.0

Mazdutide

Mazdutide is Innovent Biologics' dual GLP-1/glucagon receptor agonist that has shown strong results in clinical trials conducted primarily in China. The drug received approval in China in 2025 for type 2 diabetes, making it one of the first dual-agonist GLP-1 medications to reach market anywhere in the world. Global development is ongoing with trials in the US and Europe. In Chinese clinical trials, mazdutide produced up to 17.4% body weight loss over 48 weeks at the 9mg dose. The drug demonstrated robust glucose control in diabetes trials as well, with A1C reductions comparable to semaglutide. Innovent has partnered with Eli Lilly for commercialization in China, though global rights outside China remain with Innovent. For western markets, mazdutide faces an uphill battle competing against established brands like Wegovy and Mounjaro. However, its approval in China gives it a commercial track record that could support global regulatory submissions. The drug also offers potential differentiation through its glucagon receptor activity, which may provide metabolic benefits beyond what pure GLP-1 agonists achieve.

Active Ingredient: mazdutide (IBI362)Dosing: Once weekly

Medication6.5

Pemvidutide

Pemvidutide is Altimmune's dual GLP-1/glucagon receptor agonist in clinical development for obesity and MASH (metabolic dysfunction-associated steatohepatitis). Like survodutide, it targets both the GLP-1 and glucagon receptors, but with a different molecular structure and dosing regimen. The dual mechanism aims to combine appetite suppression with increased energy expenditure and enhanced liver fat reduction. Phase 2 MOMENTUM trial results showed pemvidutide produced up to 15.6% body weight loss over 48 weeks. Perhaps more notably for the MASH indication, the drug demonstrated a 78% reduction in liver fat content, which is among the highest reported for any GLP-1 class medication. This liver-specific benefit positions pemvidutide as a strong candidate for the MASH market, which has limited treatment options. Altimmune is a smaller biotech company compared to the major GLP-1 players (Novo Nordisk, Eli Lilly), which may affect its ability to compete in the broader obesity market. However, a partnership or acquisition by a larger pharmaceutical company could accelerate development and commercialization. Phase 3 trials are being planned, with the company pursuing both obesity and MASH indications.

Active Ingredient: pemvidutide (ALT-801)Dosing: Once weekly

Medication6.5

Ecnoglutide

Ecnoglutide (MK-6024, formerly LY3502970) is a long-acting GLP-1 receptor agonist being developed by Merck after licensing it from Eli Lilly. The drug is being studied as both a once-weekly and a once-monthly injectable formulation, with the monthly dosing option potentially offering a major convenience advantage over current weekly injectables like Ozempic and Mounjaro. Phase 2 results showed ecnoglutide produced approximately 14% body weight loss, competitive with weekly semaglutide. The once-monthly formulation uses a slow-release mechanism to maintain steady drug levels over 28 days. If successful, a monthly injection could significantly improve adherence, as patients would only need 12 injections per year compared to 52 with weekly GLP-1s. Merck is positioning ecnoglutide as its entry into the GLP-1 market, which the company largely missed with its focus on other therapeutic areas. Phase 3 trials are underway with results expected in 2026-2027. The monthly dosing convenience could carve out a meaningful niche even in a crowded market, particularly for patients who find weekly injections burdensome.

Active Ingredient: ecnoglutide (MK-6024)Dosing: Once monthly (target)

Medication6.5

Soliqua (insulin glargine/lixisenatide)

Soliqua is a fixed-ratio combination of insulin glargine (a basal insulin) and lixisenatide (a GLP-1 receptor agonist) in a single once-daily injection. Approved by the FDA in 2016, it targets patients with type 2 diabetes who need both basal insulin coverage and the additional glucose-lowering and weight-neutral benefits of a GLP-1. The combination simplifies the treatment regimen from two daily injections to one. The key advantage of Soliqua is that the GLP-1 component offsets the weight gain typically associated with insulin therapy. In clinical trials, patients on Soliqua lost 0.7 kg on average, compared to weight gain of 0.7-1.2 kg with insulin glargine alone. A1C reductions were robust at 1.1-1.6%, with lower rates of hypoglycemia than insulin alone due to the GLP-1's glucose-dependent mechanism. Soliqua occupies a specific niche for patients who are already on basal insulin and need additional glucose control without the weight gain or complexity of adding a separate GLP-1 injection. It is not prescribed for weight loss. The drug competes with Xultophy (insulin degludec/liraglutide), another insulin/GLP-1 combination product.

Active Ingredient: insulin glargine + lixisenatideDosing: Once dailyList Price/mo: $900

Medication6.5

Petrelintide

Petrelintide is Novo Nordisk's long-acting amylin analog being developed as both a standalone obesity treatment and as a combination with semaglutide. Amylin is a hormone co-secreted with insulin that reduces appetite and slows gastric emptying. Petrelintide is designed to provide sustained amylin activity with once-weekly dosing, unlike the short-acting pramlintide (Symlin) that requires injection at each meal. Early clinical data for petrelintide showed promising weight loss when combined with semaglutide, complementing the results seen with CagriSema (which uses a different amylin analog, cagrilintide). The standalone petrelintide data showed more modest weight loss, suggesting amylin analogs work best when paired with GLP-1 agonists. Novo Nordisk is exploring multiple combination strategies. Petrelintide represents Novo Nordisk's broader pipeline strategy of developing complementary molecules that can be combined with semaglutide to push weight loss outcomes above 25%. The amylin pathway targets different brain regions than GLP-1, potentially addressing the appetite-reduction plateau that some patients experience on GLP-1 monotherapy.

Active Ingredient: petrelintideDosing: Once weekly

Medication6.0

Bydureon BCise (exenatide ER)

Bydureon BCise is the once-weekly extended-release formulation of exenatide, offering the convenience of weekly dosing over Byetta's twice-daily regimen. The drug uses microsphere technology to slowly release exenatide over seven days, providing more consistent GLP-1 receptor activation. It was approved by the FDA in 2012 and updated to the easier-to-use BCise autoinjector in 2017. Bydureon produces moderate weight loss of approximately 3-5% and meaningful A1C reductions of 1.0-1.5% in clinical trials. While these results are respectable, they fall short of newer GLP-1 medications like semaglutide and tirzepatide. The EXSCEL cardiovascular outcomes trial demonstrated cardiovascular safety but did not show a statistically significant reduction in major cardiovascular events. Bydureon BCise has been largely displaced by Ozempic and Mounjaro for new prescriptions, but it retains a niche among patients who have responded well to exenatide and prefer not to switch. The autoinjector device is user-friendly, though some patients report injection site nodules due to the microsphere delivery system. AstraZeneca discontinued active promotion of Bydureon in several markets, focusing on other therapeutic areas.

Active Ingredient: exenatide extended-releaseDosing: Once weeklyList Price/mo: $790

Medication6.0

Tefero (bufeclosemide)

Tefero (bufeclosemide) is a novel oral GLP-1 receptor agonist in development by Structure Therapeutics. It uses a proprietary small-molecule approach that differs fundamentally from both peptide-based oral GLP-1s (like Rybelsus) and Eli Lilly's orforglipron. The drug can be taken with food, removing the fasting requirement that limits oral semaglutide's convenience. Phase 2 trial results showed bufeclosemide produced weight loss in the range of 6-10%, with dose optimization still ongoing. While these early results are below injectable GLP-1 benchmarks, the oral convenience and food-flexible dosing could make it attractive for patients who prioritize ease of use. Structure Therapeutics is testing multiple dose levels to find the optimal balance of efficacy and tolerability. Structure Therapeutics is a smaller biotech company, and its success will likely depend on either partnership with a larger pharmaceutical company or generating Phase 2/3 data strong enough to attract acquisition interest. The oral GLP-1 space is increasingly competitive, with multiple molecules in development, and bufeclosemide will need to demonstrate differentiation beyond food flexibility to succeed commercially.

Active Ingredient: bufeclosemide (GSBR-1290)Dosing: N/A (oral)

Medication6.0

Bimagrumab

Bimagrumab is a monoclonal antibody that blocks activin type II receptors, promoting muscle growth while reducing fat mass. It's being studied in combination with GLP-1 medications to address one of the biggest concerns with GLP-1-induced weight loss: loss of lean muscle mass. Studies show that 20-40% of weight lost on GLP-1s can be lean body mass, which has negative metabolic and functional consequences. A Phase 2 study of bimagrumab combined with semaglutide showed that patients lost significantly more fat mass while preserving or gaining lean mass compared to semaglutide alone. This body composition improvement is clinically meaningful because maintaining muscle mass supports metabolic rate, physical function, and long-term weight maintenance. The combination addresses the "Ozempic face" and muscle wasting concerns that have received widespread media attention. Bimagrumab was originally developed by Novartis for sporadic inclusion body myositis but failed to gain approval for that indication. Versanis Bio (now acquired by Eli Lilly) took over development for the obesity combination indication. Eli Lilly's acquisition of Versanis signals its intent to offer a muscle-preserving add-on to its tirzepatide franchise, potentially creating a comprehensive obesity treatment portfolio.

Active Ingredient: bimagrumabDosing: Monthly

Medication5.5

Byetta (exenatide)

Byetta was the first GLP-1 receptor agonist approved by the FDA in 2005, marking the beginning of the GLP-1 era in diabetes treatment. It uses exenatide, a synthetic version of a peptide originally found in Gila monster saliva. While it has been largely superseded by more effective weekly injectables, Byetta remains available and is still prescribed for some patients with type 2 diabetes. Byetta requires twice-daily injections before meals, which is its biggest disadvantage compared to modern weekly GLP-1s. Weight loss with Byetta is modest, averaging 2-4% of body weight, and it is not FDA-approved for obesity treatment. The drug primarily targets post-meal blood sugar spikes due to its short duration of action. It was a pioneering medication but is now considered a first-generation GLP-1 with limited use. Generic exenatide became available after patent expiration, making Byetta one of the more affordable GLP-1 options. However, the inconvenience of twice-daily dosing and inferior efficacy mean most new patients are started on newer agents. Byetta's historical significance as the drug that launched the GLP-1 class remains its most notable legacy.

Active Ingredient: exenatideDosing: Twice dailyList Price/mo: $850

Medication5.5

Danuglipron

Danuglipron is Pfizer's oral small-molecule GLP-1 receptor agonist that has had a turbulent development history. The twice-daily formulation showed modest weight loss of around 6-8% in Phase 2 trials, disappointing compared to injectable GLP-1s. Pfizer subsequently pivoted to developing a once-daily formulation to improve both efficacy and adherence, though this required essentially restarting clinical development. The reformulated once-daily version entered Phase 2 trials in 2025, with Pfizer investing heavily to remain competitive in the GLP-1 market. Early data from the reformulation showed improved tolerability compared to the twice-daily version, with lower rates of nausea and vomiting. However, Pfizer has acknowledged it is behind competitors like Eli Lilly (orforglipron) in the oral GLP-1 race. Despite the setbacks, Pfizer's massive commercial infrastructure and manufacturing capacity could make danuglipron a significant player if it achieves competitive efficacy. The oral GLP-1 market is expected to be enormous, potentially exceeding the injectable market, and there may be room for multiple products. Analysts remain cautious given the earlier Phase 2 disappointment, but Pfizer's commitment to the program suggests internal data may be more promising than what has been publicly disclosed.

Active Ingredient: danuglipronDosing: N/A (oral, once daily)

Medication5.0

Adlyxin (lixisenatide)

Adlyxin is a once-daily GLP-1 receptor agonist approved by the FDA in 2016 for type 2 diabetes. It uses lixisenatide, a short-acting GLP-1 analog that primarily targets post-meal glucose excursions rather than providing 24-hour GLP-1 activity. This makes it somewhat unique among GLP-1s but also limits its overall efficacy compared to longer-acting agents. Weight loss with Adlyxin is modest at 1-3%, and A1C reductions average around 0.7-0.9%. The ELIXA cardiovascular outcomes trial confirmed cardiovascular safety but showed no cardiovascular benefit. These relatively modest results have made Adlyxin a rarely prescribed GLP-1 in current practice, overshadowed by the efficacy of semaglutide and tirzepatide. Adlyxin is also available as a combination product with insulin glargine called Soliqua 100/33, which combines basal insulin and GLP-1 activity in a single daily injection. This combination has found more clinical utility than standalone Adlyxin, particularly for patients who need both insulin and GLP-1 therapy.

Active Ingredient: lixisenatideDosing: Once dailyList Price/mo: $750