Novo Nordisk has started selling Wegovy (semaglutide) in pill form to patients in the U.S., marking the first oral GLP-1 available in the country.
The FDA approved the oral medication on December 22, 2025, based on the Oasis 4 phase 3 trial that showed an average weight loss of 16.6% when taking 25 mg tablets in conjunction with a reduced-calorie diet and exercise. In comparison, the average weight loss with the placebo was 2.7%. Patients in the 64-week trial were either obese or overweight with a weight-related comorbidity but without diabetes.
The starting dose for oral Wegovy will be 1.5 mg, available for $149 per month via easy to access self-pay offer. The pill is also available in 4 mg, 9 mg, and 25 mg doses. Unlike injections (which are administered once a week), the pill is a once-daily medication. Common adverse reactions in the trial included nausea, vomiting, and diarrhea, which are similar to those observed in the clinical trials with semaglutide injections.
Eli Lilly's oral GLP-1 drug, orforglipron, is currently awaiting regulatory approval. The phase 3 ATTAIN-2 trial assessed orforglipron in adults with obesity or overweight with type 2 diabetes. Orforglipron met the primary endpoint, reducing weight by an average of 10.5% when taken at the highest dose of 36 mg without food or water restrictions. This was compared to a weight loss of 2.2% with the placebo.