Images for illustrative purposes only
Foundayo Pill
Orforglipron is a once-daily GLP-1 receptor agonist tablet developed by Eli Lilly. It was approved by the US Food and Drug Administration on 1 April 2026 under the brand name Foundayo for adults with obesity, or adults who are overweight with at least one weight-related condition [2,3]. It is not yet licensed in the UK [6].
- Once-daily tablet - no needles, no refrigeration [2]
- No food or water timing restrictions, unlike the Wegovy tablet [2,3]
- Average 11.2% body weight reduction at the 36 mg dose over 72 weeks in the ATTAIN-1 trial [4] (trial doses are not the licensed strengths)
- Prescription-only medicine - not available over the counter
- Currently under regulatory review in the UK; NICE appraisal expected 18 November 2026 [6]
Can you buy orforglipron in the UK?
No. Orforglipron has not been granted a marketing authorisation by the Medicines and Healthcare products Regulatory Agency (MHRA), which means it cannot legally be prescribed, supplied or sold in the UK - by Pharmacy Online or by anyone else [6].
That applies to private prescriptions too. A private prescription still requires the medicine to hold a UK licence, so no UK pharmacy can currently dispense orforglipron or Foundayo whatever route you go through.
If you see a website offering orforglipron or Foundayo for sale to UK customers today, treat it as a warning sign. Buying prescription medicines from unregulated sources carries a real risk of counterfeit or contaminated product. You can check whether a pharmacy is legitimate on the General Pharmaceutical Council register [9].
We will add orforglipron to our prescribing range only once it holds a UK licence and our prescribers are satisfied it is appropriate to offer.
What is orforglipron?
Orforglipron is a non-peptide, small-molecule GLP-1 receptor agonist taken as a once-daily tablet [2]. It was discovered by Chugai Pharmaceutical and licensed to Eli Lilly in 2018 [2]. In the United States it is sold as Foundayo; orforglipron is the generic drug name, and you will see both used interchangeably.
The distinction that matters clinically is “small molecule” versus “peptide”. Semaglutide - the active ingredient in Wegovy, Ozempic and Rybelsus - is a peptide, which is why oral semaglutide has to be taken on an empty stomach with strict timing rules around food and drink [1]. Orforglipron is a small molecule, so it survives digestion without those constraints and can be taken at any time of day, with or without food or water [2,3].
The US licence covers adults with obesity, or adults with overweight in the presence of at least one weight-related comorbid condition, alongside a reduced-calorie diet and increased physical activity [3].
Please note: orforglipron is not currently licensed for type 2 diabetes anywhere.
How does orforglipron work?
Orforglipron mimics glucagon-like peptide-1 (GLP-1), a hormone released by the gut after eating. Activating the GLP-1 receptor produces three effects that together support weight reduction [2,3]:
- Reduced appetite. GLP-1 signalling in the brain lowers hunger and reduces intrusive thoughts about food.
- Slower gastric emptying. Food stays in the stomach longer, so fullness lasts longer after a meal.
- Improved glucose handling. Insulin secretion increases in response to raised blood glucose.
As with every GLP-1 medicine, orforglipron is intended to be used alongside a reduced-calorie diet and increased physical activity, not instead of them [3].
How effective is orforglipron?
The evidence base is the ATTAIN Phase 3 programme, which enrolled more than 4,500 adults with obesity or overweight across two registration trials [2].
ATTAIN-1: the main weight loss trial for orforglipron
In the ATTAIN-1 trial, 3,127 adults took either orforglipron (Foundayo) or a dummy tablet (placebo) every day for 72 weeks - around 17 months. Everyone in the trial was living with obesity, or with overweight plus at least one related health condition such as high blood pressure or sleep apnoea. Nobody had diabetes.
Those on orforglipron were given one of three daily doses: 6 mg, 12 mg or 36 mg [4]. Here's how much weight each group lost on average by the end [4]:
| Dose | Mean weight change at 72 weeks |
|---|---|
| Orforglipron 6 mg | −7.5% |
| Orforglipron 12 mg | −8.4% |
| Orforglipron 36 mg | −11.2% |
| Placebo | −2.1% |
All three doses beat placebo by a margin unlikely to be down to chance (p<0.001) [4].
You may see a higher figure of 12.4% quoted elsewhere and both numbers are correct, they just answer different questions.
- The 11.2% figure includes everyone who joined the trial, whether or not they stuck with the treatment.
- The 12.4% figure (27.3 lb) covers only those who stayed on it for the full 72 weeks [2]. The lower number is the more realistic guide to what happens in practice.
Among people on the highest dose who stayed on treatment, 59.6% lost at least 10% of their body weight and 39.6% lost at least 15% [4].
Orforglipron also improved several markers of cardiovascular risk across all doses, including waist circumference, non-HDL cholesterol, triglycerides and systolic blood pressure [2].
Of the 1,127 participants who had prediabetes when they started, up to 91% on orforglipron had near-normal blood glucose by 72 weeks, compared with 42% on placebo [4].
ATTAIN-MAINTAIN: keeping weight off after injections
Weight regain after stopping an injectable GLP-1 is one of the harder problems in obesity treatment. The Phase 3b ATTAIN-MAINTAIN trial, published in Nature Medicine in 2026, tested whether switching to an orforglipron tablet could hold the line [5].
Everyone taking part had already lost at least 5% of their body weight on tirzepatide or semaglutide injections. They then switched to either orforglipron or a placebo [5,8]:
| Previous treatment | Weight loss kept on orforgilpron | Weight loss kept on placebo |
|---|---|---|
| Tirzepatide (205 people) | 74.7% | 49.2% |
| Semaglutide (171 people) | 79.3% | 37.6% |
Over the year that followed, those who switched from semaglutide to orforglipron regained only about 1 kg of their earlier weight loss on average, while those who switched from tirzepatide regained about 5 kg [5].
These results are promising, but they describe a maintenance role after injectable treatment rather than a licensed use. No UK prescriber can act on them until orforglipron is licensed here.
How long does orforglipron take to work?
Appetite effects typically begin within the first few weeks. Because dose escalation takes a minimum of 30 days at each step, meaningful weight reduction builds gradually over several months, with the trial endpoint measured at 72 weeks [3,4].
Orforglipron side effects
In the US, orforglipron comes with a boxed warning - the strongest type of warning on a medicine's label - about a possible risk of a type of thyroid tumour (called C-cell tumours).
Orforglipron belongs to a family of medicines known as GLP-1 receptor agonists. Some medicines in this family have caused these thyroid tumours in rats and mice during testing.
Orforglipron is a bit different: it doesn't act on rats and mice the same way, and it did not cause any tumours when tested in them. Even so, scientists don't yet know whether this risk, seen with other medicines in the family, applies to people - so the warning stays in place as a precaution [3].
Common side effects
Reported in 5% or more of people treated with orforglipron [3]:
- Nausea
- Constipation
- Diarrhoea
- Vomiting
- Indigestion (dyspepsia)
- Abdominal pain
- Headache
- Abdominal distension (swollen tummy)
- Fatigue
- Belching
- Heartburn (gastro-oesophageal reflux)
- Flatulence
- Hair loss
Stomach and bowel (gastrointestinal) effects are the most frequent and are typically mild to moderate, easing as the body adjusts [4].
Serious side effects
The US prescribing information lists the following warnings and precautions [3]:
- Acute pancreatitis - stop and seek urgent medical advice if you develop severe, persistent abdominal pain, with or without vomiting
- Severe gastrointestinal reactions - not recommended in people with severe gastroparesis
- Acute kidney injury from dehydration - caused by persistent vomiting or diarrhoea
- Hypoglycaemia - risk increases if taken with insulin or a sulfonylurea
- Serious hypersensitivity reactions, including anaphylaxis and angioedema
- Diabetic retinopathy complications in people with type 2 diabetes
- Acute gallbladder disease
- Pulmonary aspiration during general anaesthesia or deep sedation - tell your healthcare team before any planned procedure
Anyone in the UK experiencing a suspected side effect from any medicine should report it through the MHRA Yellow Card scheme [10].
Who cannot take orforglipron
Orforglipron is contraindicated in people with [3]:
- A personal or family history of medullary thyroid carcinoma (MTC)
- Multiple endocrine neoplasia syndrome type 2 (MEN 2)
- Known serious hypersensitivity to orforglipron or any of its excipients
It should also be avoided in pregnancy - it may cause foetal harm and should be stopped when pregnancy is recognised. Breastfeeding is not recommended during treatment [2,3].
Interactions that are easy to miss
The contraceptive pill. Orforglipron can make the combined oral contraceptive pill less effective. The US labelling advises switching to a non-oral method, or adding a barrier method (such as condoms), for 30 days after starting treatment and for 30 days after each dose increase [2,3].
Medicines processed by the liver (CYP3A4). Your body breaks down orforglipron using a processing system in the liver called CYP3A4. Some medicines interfere with it:
- Medicines that slow this system down (a "strong CYP3A4 inhibitor") can cause orforglipron to build up, so the dose is capped at 9 mg a day to stay safe.
- Medicines that speed it up (a "strong CYP3A4 inducer") can clear orforglipron too quickly and make it less effective, so they should be avoided.
Simvastatin. With this common cholesterol medicine, you shouldn't take more than 20 mg a day while on orforglipron.
Other tablets in general. Orforglipron slows how quickly your stomach empties, so tablets pass through more slowly. This can affect how well other tablets are absorbed [3].
Other weight-loss or diabetes injections. Taking orforglipron alongside another GLP-1 receptor agonist is not recommended [3].
The bottom line: orforglipron doesn't mix neatly with every medicine, so some doses need adjusting. Always tell your doctor or pharmacist everything else you take, including the pill and any supplements.
Is Foundayo available in the UK?
No. Foundayo (the US brand name for orforglipron) holds no UK marketing authorisation, so no pharmacy can lawfully prescribe or supply it here [6].
Where can I buy orforglipron in the UK?
Nowhere legitimate. Without a UK licence it cannot be sold, so anyone offering it to UK customers is operating outside the law. Once a licence is granted, it would be available on private prescription from registered pharmacies.
How do I get orforglipron on prescription?
You can't yet. Even a private prescription requires the medicine to hold a UK licence, and orforglipron doesn't have one [6].
How much does orforglipron cost?
There's no UK price yet. In the US, self-pay pricing starts at $149 a month for the lowest dose [2], but that won't reflect what UK patients would eventually pay.
Is orforglipron the same as Mounjaro?
No. Mounjaro contains tirzepatide, a peptide given as a weekly injection that acts on both the GIP and GLP-1 receptors. Orforglipron is a small-molecule daily tablet that acts on the GLP-1 receptor only. Both are made by Eli Lilly [2].
Is orforglipron better than Wegovy?
There's no head-to-head trial, so no reliable comparison can be made. In its own trials, orforglipron 36 mg produced a mean 11.2% weight reduction over 72 weeks [4]. The clearest practical difference is convenience: orforglipron has no food or water timing rules, whereas the Wegovy tablet must be taken after an 8-hour fast, with a 30-minute wait before eating or drinking [1,2].
Is orforglipron available on the NHS?
No. NICE is due to publish its appraisal on 18 November 2026, and NHS availability would then depend on both a positive recommendation and a UK licence [6].
What are the side effects of orforglipron?
The most common are nausea, constipation, diarrhoea and vomiting. It also carries a boxed warning for the risk of thyroid C-cell tumours, plus warnings covering pancreatitis, gallbladder disease and dehydration [3]. See the side effects section above for more detail.
Does orforglipron cause pancreatitis?
Acute pancreatitis has been reported in people taking GLP-1 receptor agonists, including orforglipron. If you develop severe, persistent abdominal pain, stop taking it and seek urgent medical advice [3].
Can I take orforglipron with my current weight loss injection?
No. Orforglipron shouldn't be taken alongside another GLP-1 medicine [3]. Never combine weight loss medicines without first speaking to your prescriber.
Is orforglipron approved for type 2 diabetes?
Not yet - it's still in clinical trials for type 2 diabetes [2].
How will I know when orforglipron becomes available?
We update this page as soon as the position changes, so it is worth checking back here for the latest status. Bear in mind that even after a licence is granted, it can take time for a medicine to reach pharmacies.
Orforglipron dosage
The US prescribing information sets out a six-step titration, with at least 30 days at each dose before moving up [3]:
| Stage | Dose | Minimum time at this dose |
|---|---|---|
| Starting dose | 0.8 mg once daily | 30 days |
| Step 2 | 2.5 mg once daily | 30 days |
| Step 3 | 5.5 mg once daily | 30 days |
| Step 4 | 9 mg once daily | 30 days |
| Step 5 | 14.5 mg once daily | 30 days |
| Maximum dose | 17.2 mg once daily | - |
Tablets are swallowed whole and must not be broken, crushed or chewed. No more than one tablet should be taken per day, and a missed dose should not be doubled up the following day [3].
This schedule reflects the US licence. If orforglipron is approved in the UK, dosing would be set by the MHRA-approved Summary of Product Characteristics, which may differ.
Note: the doses studied in ATTAIN-1 - 6 mg, 12 mg and 36 mg - are not the same as the licensed US tablet strengths [3,4].
How much will orforglipron cost in the UK?
We can't show a UK price yet, as orforglipron isn't licensed in the UK. Any figure you see quoted online right now is speculation.
For context only: in the US, Foundayo self-pay pricing starts at $149 per month for the lowest dose [2]. US prices aren't a reliable guide to what UK private pricing will look like, so it's best not to read too much into them.
As soon as orforglipron is licensed in the UK and available to us, we'll publish our pricing right here.
Orforglipron vs Mounjaro, Wegovy and Rybelsus
The most common question about any new weight loss medicine is how it stacks up against what’s already available. The short answer is that orforglipron’s trial results sit below the leading injectables but in the same territory as the oral options - with the practical advantage of no food or water timing rules.
| Foundayo | Mounjaro | Wegovy injection | Wegovy tablet | Rybelsus | |
|---|---|---|---|---|---|
| Molecule | Orforglipron | Tirzepatide | Semaglutide | Semaglutide | Semaglutide |
| Type | Small molecule | Peptide | Peptide | Peptide | Peptide |
| How it's taken | Daily tablet | Weekly injection | Weekly injection | Daily tablet | Daily tablet |
| Food/water rules | None [2] | None | None | 8-hour fast, 30-min wait [1] | Fasted, 30-min wait |
| Refrigeration | No | Yes | Yes | No | No |
| Licensed for weight loss in UK | No [6] | Yes | Yes | Yes [1] | No - licensed for type 2 diabetes |
Orforglipron vs Mounjaro (tirzepatide)
Both are made by Eli Lilly, but they work differently. Mounjaro’s tirzepatide acts on two receptors - GIP and GLP-1 - while orforglipron acts on GLP-1 only. Mounjaro is a weekly injection requiring refrigeration; orforglipron is a daily tablet that doesn’t. In their separate trials, tirzepatide has produced larger average weight reduction. Mounjaro is licensed and available in the UK today; orforglipron is not [6].
Orforglipron vs Wegovy (semaglutide)
The Wegovy tablet is the closest comparison, and the one you can actually get. Both are once-daily tablets for weight management. The practical difference is timing: the Wegovy tablet must be taken whole on an empty stomach after fasting for at least 8 hours, with a sip of water and nothing to eat or drink for 30 minutes afterwards [1]. Orforglipron has no such restrictions [2].
Orforglipron vs Rybelsus
Rybelsus is oral semaglutide, licensed in the UK for type 2 diabetes rather than weight loss. It shares the same fasting and timing requirements as other oral semaglutide products. It is not a weight loss treatment under its UK licence, so it isn’t an alternative for weight management.
What else is orforglipron being studied for?
Beyond weight management, Eli Lilly has orforglipron in trials for [2]:
- Type 2 diabetes
- Obstructive sleep apnoea
- Osteoarthritis knee pain
- High blood pressure (hypertension)
- Peripheral artery disease
- Stress urinary incontinence
None of the above uses are officially approved yet, and the trials still running may or may not end up backing them up.
In the diabetes research, a trial called ACHIEVE-1 looked at people with type 2 diabetes. It measured their HbA1c: a blood test that shows your average blood sugar over the past two to three months (the higher the number, the worse the control). Over 40 weeks, people's HbA1c dropped by 1.3% to 1.6%, starting from an average of 8.0%. In practice, that's a meaningful move in the right direction [11].
Separately, the manufacturer, Eli Lilly, says it has applied for approval of orforglipron - for weight management, type 2 diabetes, or both - in more than 40 countries [2].
When will orforglipron be available in the UK?
Orforglipron is not licensed in the UK as of July 2026. Eli Lilly has stated it has submitted orforglipron for weight management and/or type 2 diabetes in more than 40 countries and plans to launch shortly after approval in each [2].
NICE has an appraisal in progress - Orforglipron for managing overweight and obesity [ID6516] - with a committee meeting held on 14 July 2026 and publication expected on 18 November 2026. That appraisal is explicitly framed as assessing orforglipron “within its marketing authorisation”, so it depends on a licence being granted first [6].
A NICE recommendation would govern NHS availability. Private availability through pharmacies like ours would follow the MHRA licence and typically comes sooner than NHS access - as happened with the Wegovy tablet, which was licensed on 11 June 2026 but is not available on the NHS [1].
We cannot give a firm date. We will update this page as soon as the position changes.
What can I take instead of orforglipron?
While orforglipron is unavailable, several licensed treatments can be prescribed in the UK today. The table below sets out mean weight reduction reported in the main Phase 3 trials for each.
Because these come from separate trials with different populations, durations and dosing, they are a general guide rather than a head-to-head comparison. Your prescriber can help you choose during an online consultation.
| Medication (max studied dose) | Molecule | Mean weight reduction | Trial follow-up | How it's taken | UK licensed for weight loss |
|---|---|---|---|---|---|
| Foundayo pill (36 mg) | Orforglipron | 11.2% [4] | 72 weeks | Once-daily tablet | No - not UK licensed |
| Wegovy tablet (25 mg) | Semaglutide | 13.6% | 64 weeks | Once-daily tablet | Yes |
| Wegovy injection (2.4 mg) | Semaglutide | 14.9% | 68 weeks | Once-weekly injection | Yes |
| Wegovy injection (7.2 mg) | Semaglutide | 20.7% | 72 weeks | Once-weekly injection | Yes |
| Mounjaro injection (15 mg) | Tirzepatide | 20.9% | 72 weeks | Once-weekly injection | Yes |
| Orlistat | Orlistat | - | - | Capsule with meals | Yes |
The closest licensed equivalent in format is the Wegovy tablet, the first GLP-1 tablet for weight loss approved in the UK, licensed on 11 June 2026 for adults with a BMI of 30 or above, or a BMI of 27–30 with at least one weight-related health condition [1].
It differs from orforglipron in one practical respect: it must be taken whole on an empty stomach after fasting for at least 8 hours, with a sip of water and nothing to eat or drink for 30 minutes afterwards [1].
References
- Medicines and Healthcare products Regulatory Agency. First GLP-1 tablet for weight loss approved in the UK. GOV.UK, 11 June 2026. https://www.gov.uk/government/news/first-glp-1-tablet-for-weight-loss-approved-in-the-uk
- Eli Lilly and Company. FDA approves Lilly’s Foundayo™ (orforglipron), the only GLP-1 pill for weight loss that can be taken any time of day without food or water restrictions. 1 April 2026. https://investor.lilly.com/news-releases/news-release-details/fda-approves-lillys-foundayotm-orforglipron-only-glp-1-pill
- Eli Lilly and Company. FOUNDAYO (orforglipron) tablets, for oral use - US Prescribing Information. US Food and Drug Administration, 2026. https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/220934Orig1s000lbl.pdf
- Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment (ATTAIN-1). New England Journal of Medicine, 16 September 2025. doi:10.1056/NEJMoa2511774. https://www.nejm.org/doi/full/10.1056/NEJMoa2511774
- Orforglipron for maintenance of body weight reduction: the double-blind, randomized phase 3b ATTAIN-MAINTAIN trial. Nature Medicine, 2026. doi:10.1038/s41591-026-04386-7. https://www.nature.com/articles/s41591-026-04386-7
- National Institute for Health and Care Excellence. Orforglipron for managing overweight and obesity [ID6516]. GID-TA11650, in development, expected publication 18 November 2026. https://www.nice.org.uk/guidance/indevelopment/gid-ta11650
- ClinicalTrials.gov. A Study of Orforglipron in Adult Participants With Obesity or Overweight (ATTAIN-1). NCT05869903. https://clinicaltrials.gov/study/NCT05869903
- ClinicalTrials.gov. A Study of Orforglipron for the Maintenance of Body Weight Reduction (ATTAIN-MAINTAIN). NCT06584916. https://clinicaltrials.gov/study/NCT06584916
- General Pharmaceutical Council. Registers. https://www.pharmacyregulation.org/registers
- Medicines and Healthcare products Regulatory Agency. Yellow Card scheme.https://yellowcard.mhra.gov.uk/
- Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist, in Early Type 2 Diabetes (ACHIEVE-1). New England Journal of Medicine, 2026. doi:10.1056/NEJMoa2505669. https://www.nejm.org/doi/full/10.1056/NEJMoa2505669
