GLP Watchdog

GLP-1: What It Is, How It Works, and Every FDA-Approved Medication (2026)

Your gut releases glucagon-like peptide-1 after a meal, and it governs appetite and blood sugar together. The drugs copying it — the GLP-1 receptor agonists — run from Wegovy and Zepbound through Foundayo, Ozempic, Mounjaro, Saxenda, Rybelsus, Trulicity, Victoza and Byetta. What follows: the hormone itself, what the drugs do with it, and all of them set against each other.

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About this page

Nothing appears in this table without an FDA approval and a published label on DailyMed or Drugs@FDA. Indication, mechanism, route and approval date all come out of our own primary-source-checked drug records. We do not reword what an indication says, and we do not manufacture comparisons the published evidence will not carry. Follow any drug's “Full guide” link for the label quoted verbatim and the trials cited.

What is GLP-1?

GLP-1 stands for glucagon-like peptide-1. It is a 30-amino-acid incretin hormone secreted by enteroendocrine L-cells further down the small intestine and in the colon, released when food arrives. One gene, proglucagon, encodes both glucagon in the pancreas and GLP-1 in the intestinal L-cells — two opposing signals built from related peptide structures.

GLP-1 has four well-characterized physiologic actions:

  • Glucose-dependent insulin secretion. Bound to its receptor on a pancreatic beta cell, GLP-1 pushes insulin out — but only while blood glucose is already high. That conditionality is the “glucose-dependent” property, and it is why the class carries so little hypoglycemia risk vs older diabetes drugs.
  • Glucagon suppression. It also quiets glucagon output from the pancreatic alpha cells, so the liver makes less glucose.
  • Delayed gastric emptying. Food leaves the stomach more slowly, which flattens the post-meal glucose spike and keeps you full for longer.
  • Central appetite suppression. The receptor is not confined to the gut. It appears in the brain too — hypothalamus and brainstem mainly — where switching it on turns down both hunger and the reward you get from eating.

Your own GLP-1 survives one to two minutes before dipeptidyl peptidase-4 destroys it. Every pharmaceutical version is therefore engineered to resist that enzyme, which stretches the half-life from minutes into hours (liraglutide, twice-daily exenatide) or into days (semaglutide, tirzepatide, dulaglutide).

How GLP-1 medications work

GLP-1 receptor agonists are a class of drugs that occupy and switch on the same receptor the natural hormone uses. All four actions above are reproduced, and two clinical consequences follow:

Type 2 diabetes glycemic control

More insulin, less glucagon and a slower stomach together pull down both fasting and post-meal glucose, and across the class that shows up as A1C falling by 1.0 to 2.5 percentage points. This was what the whole class was first approved for, beginning with Byetta in 2005.

Chronic weight management

A slower stomach and a quieter appetite center together mean people eat less, and keep eating less, which is where the weight loss comes from. Saxenda (liraglutide 3 mg) brought that indication in 2014; Wegovy (semaglutide 2.4 mg) widened it in 2021, Zepbound (tirzepatide) in 2023, and Foundayo (orforglipron) in 2026.

Tirzepatide (Mounjaro / Zepbound) is a works on two receptors at once — GLP-1 and also GIP, glucose-dependent insulinotropic polypeptide. Published head-to-head trials put that dual action ahead of the pure GLP-1 agonists on both A1C and weight. Retatrutide (investigational, see our retatrutide evidence article) extends this further to a triple agonist (GLP-1 / GIP / glucagon).

Foundayo (orforglipron) is the first oral, is a small molecule rather than a peptide, which makes it structurally unlike everything above it. Rybelsus is oral but still a modified peptide, so it needs an absorption enhancer and an empty stomach; Foundayo needs neither, and no particular volume of water.

Every FDA-approved GLP-1 medication, compared

Every one of the 11 GLP-1 receptor agonists the FDA has approved as of 2026 — approval date, indication, route and maker, each checked against the source. The labels below were fetched live from DailyMed (NIH) on 2026-05-09. Two drugs in the table — Byetta and Bydureon BCise — AstraZeneca stopped making both in October 2024, so they stand here as history rather than options.

BrandGenericIndicationManufacturerGuide
WegovySemaglutideWeight managementNovo NordiskWegovy →
ZepboundTirzepatideWeight managementEli LillyZepbound →
FoundayoOrforglipronWeight managementEli LillyFoundayo →
OzempicSemaglutideType 2 diabetesNovo NordiskOzempic →
MounjaroTirzepatideType 2 diabetesEli LillyMounjaro →
SaxendaLiraglutide 3 mgWeight managementNovo NordiskDailyMed →
RybelsusSemaglutide (oral)Type 2 diabetesNovo NordiskDailyMed →
TrulicityDulaglutideType 2 diabetesEli LillyDailyMed →
VictozaLiraglutide 1.8 mg maxType 2 diabetesNovo NordiskDailyMed →
ByettaDiscontinuedExenatide (twice-daily)Type 2 diabetesAstraZenecaDailyMed →
Bydureon BCiseDiscontinuedExenatide extended-releaseType 2 diabetesAstraZenecaDailyMed →

Generic + discontinuation context for the legacy GLP-1s

  • Saxenda (Liraglutide 3 mg, Novo Nordisk) — FDA-approved Dec 2014. Teva launched this on 27 August 2025 — the first generic liraglutide licensed for weight management. DailyMed label
  • Rybelsus (Semaglutide (oral), Novo Nordisk) — FDA-approved Sep 2019. The class's first oral. On 17 October 2025 the SOUL trial added a cardiovascular risk-reduction indication, at 7 mg and 14 mg only. DailyMed label
  • Trulicity (Dulaglutide, Eli Lilly) — FDA-approved Sep 2014. Long-acting, and carrying a cardiovascular risk-reduction indication since REWIND (Lancet, 2019). Being an Fc-fusion biologic it can only be copied through the 351(k) biosimilar route, and none has been approved as of 2026-05-09. DailyMed label
  • Victoza (Liraglutide 1.8 mg max, Novo Nordisk) — FDA-approved Jan 2010. Saxenda's molecule at a lower dose, licensed for diabetes. Hikma's generic liraglutide — approved and launched December 2024 — was the first generic anyone brought to market in this class. DailyMed label
  • Byetta (Exenatide (twice-daily), AstraZeneca) — FDA-approved Apr 2005. The first of the class approved in the US, and DISCONTINUED by AstraZeneca on 25 October 2024. Amneal's generic exenatide followed on 21 November 2024, so this row is history now. No boxed warning. DailyMed label
  • Bydureon BCise (Exenatide extended-release, AstraZeneca) — FDA-approved Oct 2017 (BCise device). Exenatide in extended-release microspheres, DISCONTINUED by AstraZeneca on 28 October 2024. Nothing biosimilar exists — the microsphere-plus-autoinjector combination is too complex to copy. DailyMed label

All labels above were pulled live from DailyMed (NIH) on 2026-05-09 with verbatim text extraction. SetIDs are stable identifiers: revising a label does not change them. The discontinuation dates come from a UnitedHealthcare provider notice quoting AstraZeneca's October 2024 announcement.

One molecule, two brand names — and why the indication decides which

This trips up almost everyone starting out: one active ingredient, sold under different brand names according to which indication it was approved for.

Semaglutide

  • Wegovy — chronic weight management (subcutaneous, 2.4 mg weekly)
  • Ozempic — type 2 diabetes (subcutaneous, up to 2 mg weekly)
  • Rybelsus — type 2 diabetes (oral tablet, up to 14 mg daily)

Tirzepatide

  • Zepbound — chronic weight management + obstructive sleep apnea in obesity (subcutaneous, up to 15 mg weekly)
  • Mounjaro — type 2 diabetes (subcutaneous, up to 15 mg weekly)

Liraglutide

  • Saxenda — chronic weight management (subcutaneous, 3 mg daily)
  • Victoza — type 2 diabetes (subcutaneous, up to 1.8 mg daily). A generic liraglutide is now FDA-approved.

Orforglipron

  • Foundayo — chronic weight management (oral tablet, daily). The first oral non-peptide GLP-1 RA, FDA-approved April 2026.

Clinical relevance: insurance plans will usually pay for the brand under its approved indication and not a word beyond it. Writing Ozempic — or Mounjaro — for weight loss is perfectly legal off-label prescribing, and almost never covered. See our Cigna PA guide and Aetna PA guide for verbatim payer policy quotes.

Cost and access

Brand-name GLP-1 list prices range from ~$300/month (NovoCare Wegovy pen self-pay) to ~$1,300/month (full list), and the spread is wide once you factor in the maker's own self-pay program, a copay card, and which channel (pharmacy, telehealth, Costco / Sam's Club / Amazon Pharmacy, LillyDirect, NovoCare). 503A pharmacies still compound semaglutide and tirzepatide for cash, usually $99 to $400 a month — though the FDA's enforcement-discretion window for compounded semaglutide closed in February 2025. See our live GLP-1 pricing index for current channel-by-channel cash and insured pricing.

What's next: the GLP-1 pipeline

A queue of GLP-1s, dual agonists and triple agonists sits in late-stage trials without an approval yet. The ones drawing attention: retatrutide, Lilly's triple agonist; CagriSema, Novo's cagrilintide-plus-semaglutide combination; MariTide (maridebart cafraglutide, Amgen), survodutide (Boehringer Ingelheim with Zealand Pharma); and ecnoglutide from Sciwind. NCT identifiers, primary completion dates and checked topline results are all in our GLP-1 Pipeline Tracker (2026). What is already approved is mapped in our FDA-approved weight-loss medications hub or our retatrutide evidence article goes through the strongest weight-loss readout anyone has published so far.

Common questions about GLP-1

Only one trial has put the two leaders directly against each other: SURMOUNT-5, published in NEJM in 2025 (PMID 40353578), where tirzepatide took off −20.2% of body weight by week 72 against −13.7% for semaglutide. Four drugs hold an FDA chronic-weight-management indication — Wegovy, built on semaglutide; Zepbound, on tirzepatide; Foundayo, on orforglipron; and Saxenda, on liraglutide. Saxenda is the oldest and the weakest of them, around 5–8% at 56 weeks, and Foundayo is too recent for anyone to have long-term comparative data on it. Which is best for you personally is a different question, settled by what you tolerate, what it costs, which indication you qualify under, whether you will inject, and what your plan will pay for.
Incretin is the category; GLP-1 and GIP are two members of it. Both are hormones the gut releases when food arrives, and both amplify the insulin response to eating. They come from different places: GLP-1 from L-cells further down the small intestine and in the colon, GIP from K-cells nearer the top. Their effects overlap without being identical. Tirzepatide — sold as Zepbound and Mounjaro — is the drug that activates both receptors at once.
Same molecule, different licenses. Semaglutide is the active ingredient in both and Novo Nordisk makes both. What separates them is the approved indication and the dose: Ozempic covers type 2 diabetes and stops at 2 mg a week; Wegovy covers long-term weight management and goes to 2.4 mg. Insurers generally pay for each only under the indication it was approved for. A third semaglutide brand exists — Rybelsus, in tablet form — and that one is diabetes-only too.
Tirzepatide in both, at identical weekly doses, from Eli Lilly in both cases. Which name it carries follows the approval. Mounjaro took type 2 diabetes in May 2022; Zepbound for long-term weight management, approved November 2023, and picked up obstructive sleep apnea, in adults who also have obesity, in December 2024. Costs, coverage, quantity limits and the off-label question are worked through in our full Mounjaro and Zepbound comparison.
Two of them have FDA approval as of 2026. Rybelsus is semaglutide in tablet form from Novo Nordisk, approved in 2019 for type 2 diabetes — still a modified peptide, so it has to be taken fasted with a small amount of water. Foundayo is orforglipron from Eli Lilly, approved April 2026 for chronic weight management, and being a small molecule it carries none of those restrictions. Both are once daily. Every oral GLP-1 set against the others — including Novo's high-dose oral semaglutide for weight management, which was NOT approved as of May 2026 — is in our every oral GLP-1 compared for 2026. If you are thinking about moving from injected Zepbound to oral Foundayo, know first that no FDA label carries a dose-conversion table between them and no head-to-head trial has been published; our guide to switching between Foundayo and Zepbound puts the verbatim §2 dose ranges side by side alongside what the separate trials imply when read across, and how re-titration works in practice.
Foundayo — orforglipron, from Eli Lilly — approved in April 2026. Nothing in the class is newer, and nothing else is a once-daily oral non-peptide agonist licensed for long-term weight management, and unlike Rybelsus it does not have to be taken fasted with a measured sip of water. Behind it the late-stage pipeline holds retatrutide (Lilly's GLP-1/GIP/glucagon triple agonist, in phase 3 TRIUMPH), survodutide (Boehringer Ingelheim with Zealand, GLP-1/glucagon), maridebart cafraglutide (Amgen's MariTide, GLP-1/GIP) and ecnoglutide (Sciwind). Not one of those four was FDA-approved as of May 2026. Trial-by-trial status is in our GLP-1 pipeline tracker, and the label, dosing and access detail for the new approval is in our Foundayo FDA approval explainer.
Their safety profile is known and published, built from phase 3 trials and from what has surfaced since approval. In practice it is the gut that complains: nausea and vomiting, diarrhea or constipation, pain in the abdomen — and it clusters in the weeks when the dose steps up. A boxed warning about thyroid C-cell tumors sits on nearly every one, resting on rodent work whose bearing on humans is still genuinely argued over. Documented beyond that: gallbladder disease, pancreatitis, and loss of muscle mass where weight comes off fast. Take your own contraindications and risk factors to a prescriber. The evidence on each is covered in depth — the gallbladder, the thyroid question, ileus and blocked bowels, what happens to bone, and mood, anhedonia and the suicidality warning the FDA withdrew in February 2026.
Three, as of 2026. Hikma's generic liraglutide was approved and launched in December 2024 against Victoza for type 2 diabetes — the first generic GLP-1 receptor agonist in the country. Amneal's generic exenatide followed on 21 November 2024, referencing twice-daily Byetta, a brand AstraZeneca had itself discontinued a month earlier on 25 October 2024. Teva launched a second generic liraglutide on 27 August 2025, this one against Saxenda, making it the first generic in the class approved for weight loss. Nothing generic exists for semaglutide (Wegovy, Ozempic, Rybelsus), for tirzepatide (Zepbound, Mounjaro), for dulaglutide — Trulicity is a biologic on a BLA, so only the 351(k) biosimilar route is open to it — or for orforglipron. And compounded semaglutide and tirzepatide are not generics at all: they are 503A-pharmacy preparations under a separate regulatory framework, and the FDA's enforcement-discretion window for compounded semaglutide closed in February 2025.

Where to go next

GLP-1 shot — beginner guide →
New to GLP-1 shots? Plain-English explainer: which brands count (Wegovy, Zepbound, Saxenda), how the mechanism works, shot vs pill comparison, what weight loss to expect from the trials, and how to start.
Weight loss injections guide →
Every FDA-approved injectable weight-loss option (Wegovy, Zepbound, Saxenda) plus off-label T2D injectables, the investigational pipeline, side effects, cost, and the cross-trial caveats SURMOUNT-1 vs STEP-1 vs SCALE require.
State-by-state Medicaid coverage →
Per-state Medicaid GLP-1 coverage deep-dives anchored in primary-source PDLs and provider notices. The taxonomy spans explicit non-coverage (TX), the budget-driven reversal (CA), the strongest-evidenced triple-anchor (NY), and the silent operational-by-absence exclusion (FL) — start with the Texas anchor article.
Full GLP-1 medication list →
One table holding every approved GLP-1 — brand, maker, indication, dose ladder, route, and the DailyMed SetID links.
FDA-approved weight-loss medications →
The full picture: every drug licensed for weight loss, what is still in trials, and the non-GLP-1 anti-obesity medications.
Best semaglutide providers →
Every telehealth and retail route to Wegovy, Ozempic or compounded semaglutide, ranked.
Best tirzepatide providers →
Every telehealth and retail route to Zepbound, Mounjaro or compounded tirzepatide, ranked.
Live GLP-1 pricing index →
Brand list prices, NovoCare/LillyDirect/Costco/Sam's Club self-pay, and compounded cash-pay across every channel we track.
Insurance coverage by insurer →
What Cigna, Aetna, UnitedHealthcare, Humana, BCBS, Kaiser, Medicare and Medicaid each demand before they pay, and what the copay comes to.
Research library →
Our writing on side effects, what happens over years, what surgeons need to know, and bariatric surgery against GLP-1 decision support.