Two oral GLP-1 medicines were approved within the same month
In April 2026 the FDA approved Eli Lilly's Foundayo, whose active ingredient is orforglipron, and Novo Nordisk's oral semaglutide, sold as Wegovy tablets. Both are taken daily. Both act on the GLP-1 receptor. The similarities largely end there.
The chemistry is the root of every other difference
Orforglipron is a small molecule. Semaglutide is a peptide. A peptide has to be protected from digestion, so oral semaglutide is formulated with an absorption enhancer, while orforglipron needs none.
That single difference drives the dosing rules. Orforglipron can be swallowed at any point in the day, with or without food and with or without water. Oral semaglutide formulations have carried instructions about taking the dose on an empty stomach with a limited amount of water and waiting before eating or taking other medicines. Check the label you are given, because these instructions are the ones people most often get wrong.
Both step the dose up slowly, for the same reason
Gastrointestinal side effects are dose dependent across this class. Both medicines start low and increase on a schedule, commonly no faster than every 30 days, so the body adjusts. Moving up faster is the main cause of avoidable nausea.
What the evidence does and does not let you conclude
There is no large head to head trial putting these two against each other for weight loss. Comparing figures across separate trials is unreliable, because trial populations, durations and endpoints differ. Anyone presenting a clean ranking of the two is going beyond what the published evidence supports.
For what the individual trials actually measured, see our summary of the recent trial results.
This is a comparison of published characteristics, not medical advice. Which medicine suits a given person is a question for their doctor.