Short answer
Five GLP-1 medicines are FDA-approved for weight in the US: Wegovy (pen, pill and HD), Zepbound, Foundayo, Saxenda and generic liraglutide. Self-pay prices at the makers’ own pharmacies run from $149 to $449 a month, and you still need a prescription. Compounded copies are not FDA-approved. Your prescriber decides your dose.
Start here
What do you want to know?
Before you decide, we’d ask you
Do you meet the label’s criteria?
The labels cover a BMI of 30+, or 27+ with a weight-related condition. Your prescriber decides.
Any personal or family history of medullary thyroid cancer or MEN 2?
Every one of these drugs carries a boxed warning and is not for you.
Planning a pregnancy?
The Wegovy label says to stop at least 2 months before.
Ready to stay on it?
In the STEP 4 and SURMOUNT-4 trials, people who stopped regained most of the weight.
For weight · US
The FDA-approved options
Zepbound
Eli Lilly · Weekly injection · tirzepatide
About 20.9% average weight loss at the top dose over 72 weeks (SURMOUNT-1). Beat Wegovy head to head (SURMOUNT-5).
$299 to $449 a month self-pay at LillyDirect
Wegovy
Novo Nordisk · Weekly injection · semaglutide
About 14.9% over 68 weeks (STEP 1). Cut heart attacks, strokes and heart deaths by 20% in people with heart disease (SELECT).
$199 intro, then $349 a month at NovoCare
Wegovy pill
Novo Nordisk · Daily tablet · semaglutide 25 mg
About 13.6% over 64 weeks (OASIS 4). Approved 22 Dec 2025.
$149 to $299 a month at NovoCare
Foundayo
Eli Lilly · Daily tablet · orforglipron
About 11.2% over 72 weeks at the top dose (ATTAIN-1). Approved 1 Apr 2026.
$149 to $349 a month at LillyDirect
Wegovy HD
Novo Nordisk · Weekly injection · semaglutide 7.2 mg
For adults already on 2.4 mg who need more. Approved 19 Mar 2026.
$399 a month at NovoCare
Saxenda and generic liraglutide
Novo Nordisk, Teva and others · Daily injection · liraglutide 3 mg
About 8% over 56 weeks (SCALE). The first generic GLP-1 for weight arrived in August 2025.
Price varies by pharmacy
We earn nothing from these links. They go to the makers’ own pages, and you still need a prescription.
The evidence
What the trials found
Zepbound beat Wegovy head to head
20.2% vs 13.7% average weight loss over 72 weeks in 751 adults (SURMOUNT-5).
Aronne 2025, NEJM →Wegovy protects the heart
20% lower risk of heart attack, stroke or heart death in 17,604 people with heart disease (SELECT).
Lincoff 2023, NEJM →Stop, and the weight comes back
People switched to placebo regained most of the loss (STEP 4, SURMOUNT-4). These are long-term medicines.
Rubino 2021, JAMA →The pills work, a little less
Wegovy pill about 13.6% (OASIS 4); Foundayo about 11.2% at the top dose (ATTAIN-1). Trials differ, so don’t compare the numbers directly.
Wharton 2025, NEJM →The worries
Safety, straight from the label
The boxed warning
Every one of these drugs carries an FDA boxed warning for thyroid C-cell tumors, seen in rodents. Human relevance is unknown. Anyone with a personal or family history of medullary thyroid cancer or MEN 2 should not use them.
Common side effects
Nausea, diarrhea, vomiting, constipation, stomach pain, headache and fatigue lead the list. Hair loss appears on the Wegovy label at 5% or more.
Tell your surgeon
The labels warn about aspiration during anesthesia or deep sedation. Tell any surgical team you take one.
On the pill?
The Zepbound and Foundayo labels advise non-oral or backup contraception for weeks after starting and after each dose increase. Ask your prescriber.
From the FDA label · not advice
What the label says about using it
This summarizes the official FDA label. Your prescriber decides your dose. Always follow the Instructions for Use that come with your medicine.
Zepbound
HOW OFTENOnce a week, any time, with or without food
WHEREAbdomen or thigh; the back of the upper arm if someone else injects. Rotate sites
FRIDGE2–8 °C. A single-dose pen or vial can stay unrefrigerated up to 21 days at up to 30 °C
MISSED DOSETake within 4 days; after that, skip it
DOSE STEPSStarts at 2.5 mg weekly for 4 weeks, then 5 mg; increases of 2.5 mg after at least 4 weeks each; maximum 15 mg
Zepbound label §2.1–2.4, §16.2 →Wegovy pen
HOW OFTENOnce a week, same day each week
WHEREAbdomen, thigh or upper arm. Rotate sites
FRIDGE2–8 °C. Before first use, up to 28 days at room temperature
MISSED DOSETake it if the next dose is more than 2 days away; otherwise skip
DOSE STEPS0.25 mg weekly for 4 weeks, then 0.5, 1 and 1.7 mg at 4-week steps; maintenance 2.4 mg, or up to 7.2 mg (Wegovy HD) when more is needed
Wegovy label §2.1–2.4, §16 →Wegovy pill
HOW OFTENOnce a day, in the morning, on an empty stomach, with up to 4 oz of water
THENWait at least 30 minutes before food, drink or other pills
STORAGERoom temperature, in the original bottle
MISSED DOSESkip it; take the next one tomorrow
DOSE STEPS1.5 mg for 30 days, then 4 mg, then 9 mg; maintenance 25 mg from day 91
Wegovy label §2.1–2.5, §16 →Foundayo
HOW OFTENOnce a day, with or without food. Swallow whole
STORAGERoom temperature
MISSED DOSETake it as soon as possible; never double up
DOSE STEPS0.8 mg daily, then 2.5 and 5.5 mg at 30-day or longer steps; may go to 9, 14.5 or 17.2 mg; maximum 17.2 mg
Foundayo label §2.1–2.3, §16.2 →Why we don’t list compounded versions
The FDA ended the shortages in 2025, said in February 2026 it would act against mass-marketed compounded GLP-1s, and sent 30 telehealth firms warning letters in March 2026. Compounded copies aren’t FDA-approved, and nobody checks each batch the way an approved drug is checked. We’ll revisit if that changes.
Insurance · US
Paying for it
Medicare
Since 1 Jul 2026, eligible Part D members pay a $50 copay for Wegovy, Zepbound and Foundayo under the Medicare GLP-1 Bridge, which runs to the end of 2027.
Commercial insurance
With coverage, the makers’ savings cards bring it “as low as $25” a month. Terms apply, and government plans are excluded.
No coverage
The makers’ self-pay prices above are the cheapest legitimate route we found. You still need a prescription from a licensed clinician.
What people ask
Is Zepbound the same as Mounjaro?
Same molecule, tirzepatide, made by Lilly. Zepbound is approved for weight and for sleep apnea with obesity. Mounjaro is approved for type 2 diabetes, and since August 2026 for heart-risk reduction in type 2 diabetes. Same drug, different label.
Is Zepbound better than Wegovy?
For weight loss, yes in the one head-to-head trial: 20.2% vs 13.7% over 72 weeks (SURMOUNT-5). Wegovy has the heart-outcome evidence (SELECT). Which is right for you depends on the goal, and your prescriber decides.
Is Zepbound covered by Medicare?
Since 1 July 2026, eligible Medicare Part D members who meet the BMI and condition criteria pay a $50 copay for Zepbound, Wegovy and Foundayo under the Medicare GLP-1 Bridge.
Does Zepbound come in pill form?
No. Lilly’s pill is Foundayo (orforglipron), approved 1 April 2026. Novo’s is the Wegovy pill (oral semaglutide), approved 22 December 2025.
Should Zepbound be refrigerated?
The label says 2 to 8 °C. A single-dose pen or vial can stay unrefrigerated for up to 21 days at up to 30 °C. A multi-dose vial or KwikPen is discarded 30 days after opening. Follow the Instructions for Use in the box.
Does Wegovy cause hair loss?
Hair loss is listed among Wegovy’s common side effects, reported by 5% or more of people in trials. Talk to your prescriber if it happens.
Why don’t you list compounded semaglutide?
Compounded copies are not FDA-approved and nobody checks each batch the way an approved drug is checked. The FDA ended the shortages in 2025, and in 2026 it moved against mass-marketed compounded GLP-1s. We’ll revisit if that changes.
How we make money
Nothing, on this page. There are no affiliate links here: every link goes to the FDA, a trial, or the maker’s own price page.
Sources
- Wegovy prescribing information (Novo Nordisk, rev. 06/2026)
- Zepbound prescribing information and Instructions for Use (Lilly)
- Foundayo prescribing information (Lilly)
- FDA approval of Foundayo, 1 Apr 2026 (Lilly release)
- LillyDirect Zepbound self-pay prices
- NovoCare Pharmacy Wegovy self-pay prices
- Medicare coverage of weight-loss drugs
- FDA, 6 Feb 2026: action against non-approved GLP-1 drugs
- FDA, 3 Mar 2026: warning letters to 30 telehealth companies
- SURMOUNT-1, Jastreboff 2022
- SURMOUNT-5, Aronne 2025
- STEP 1, Wilding 2021
- STEP 4, Rubino 2021
- SELECT, Lincoff 2023
- OASIS 4, 2025
- ATTAIN-1, Wharton 2025
- SCALE, Pi-Sunyer 2015
Published 2026-09-30 · Labels, approvals and prices checked 2026-09-30 · Next check within 3 months
Educational content, not medical advice. Only a licensed prescriber can decide whether any of these medicines is right for you.