GLP-1 Medications 2026: FDA-Approved Drugs & Pipeline

Compare US medicines by product, formulation, indication and evidence—not just brand name. This overview covers the major approved product families, fixed insulin combinations, historical brands, generic examples and selected pipeline programs. It is not a list of every compound in global development or a personal dosing plan.

What Are GLP-1 Medications?

GLP-1 receptor agonists act at the glucagon-like peptide-1 receptor. Individual labels describe their effects on glucose regulation and, for some products, weight or other outcomes. Related medicines can target additional receptors; that does not make their indications or benefits interchangeable.

FDA’s historical approval overview dates Byetta (exenatide) to 2005. The category now includes daily and weekly injections, oral products and multi-receptor agents. Some GLP-1 medicines are peptides; orforglipron is a small-molecule medicine, as described in its product label.

Reading key: T2D means type 2 diabetes; CVD means cardiovascular disease; OSA means obstructive sleep apnea; MASH means metabolic dysfunction-associated steatohepatitis. Indication summaries below omit detailed eligibility criteria: use the linked label for the actual population and instructions.

FDA-Approved GLP-1 Medications

Brand companies and approval history are shown separately from formulation. A historical approval or current label does not guarantee retail stock. Historical discontinued entries are identified explicitly; off-label weight loss is not listed as an approved indication.

Approval-date context: FDA lists Foundayo’s approval on April 1, 2026; the FDA Orange Book supplement records oral Wegovy on December 22, 2025. Original Bydureon dates to 2012, while the BCise formulation was approved in 2017. An ingredient’s “initial US approval” on a label is not necessarily the approval date of that brand or presentation.

Semaglutide Class (Novo Nordisk)

Ozempic injection: The injection label describes initiation at 0.25 mg weekly and subsequent 0.5, 1 or 2 mg regimens according to indication and need. It does not list a 2.4 mg Ozempic injection dose. Its adult T2D, cardiovascular and chronic-kidney-disease indications have specific eligibility criteria.

Wegovy: Current labeling includes injection and oral tablets. Injection escalation includes 0.25, 0.5, 1 and 1.7 mg stages; 2.4 mg is the usual maintenance dose, with a 7.2 mg option for selected adult weight-management patients after the specified period at 2.4 mg. Indication-specific maintenance and pediatric instructions differ. Tablets have a separate regimen; these are not interchangeable dose lists.

Rybelsus and Ozempic tablets: The current tablet label distinguishes Rybelsus 3/7/14 mg from Ozempic tablets 1.5/4/9 mg and says they are not substitutable mg-for-mg. Novo’s US product information describes Ozempic tablets replacing Rybelsus. The historical Rybelsus name remains relevant to older prescriptions and studies. The tablet label’s fasting and administration instructions are product-specific.

Evidence: An outcome from one semaglutide dose, formulation or population should not be treated as the expected result of all semaglutide products. The head-to-head weight study discussed below used semaglutide 1.7 or 2.4 mg weekly, not every current presentation.

Tirzepatide Class (Eli Lilly) — Dual GLP-1/GIP

Tirzepatide targets GIP and GLP-1 receptors. Mounjaro’s current label covers T2D in adults and ages 10 and older, plus major cardiovascular-event risk reduction in adults with T2D at high risk. Adult maximum dosage is 15 mg weekly; the pediatric maximum is 10 mg. Initiation and escalation are not the same as maintenance.

Zepbound’s label covers adult weight management and moderate-to-severe OSA in adults with obesity. The 2.5 mg starting dose is not a maintenance dose; labeled maintenance choices depend on indication and tolerability. Neither brand’s name alone establishes that it fits a particular person.

Diabetes trial example: In SURPASS-2, 1,879 adults with T2D inadequately controlled on metformin were randomized for 40 weeks. HbA1c changes were −2.01, −2.24 and −2.30 percentage points with tirzepatide 5, 10 and 15 mg, versus −1.86 with semaglutide 1 mg. These are not “20–23% A1C reductions” or a comparison with all weight-management formulations.

Weight trial example: SURMOUNT-5 randomized 751 adults with obesity without diabetes. At 72 weeks, mean weight change was −20.2% with maximum-tolerated tirzepatide 10/15 mg versus −13.7% with semaglutide 1.7/2.4 mg. Gastrointestinal events were common in both groups. This is a direct comparison of those regimens, not a universal ranking of all current or investigational drugs.

Liraglutide Class (Novo Nordisk) — Older GLP-1

Victoza is a daily injectable product for T2D with a specified adult cardiovascular indication. Its 0.6 mg initiation dose is distinct from the adult 1.2 or 1.8 mg treatment doses. Do not transfer its regimen to Saxenda merely because both contain liraglutide.

Saxenda is a daily weight-management product. Label escalation begins at 0.6 mg—not 1.2 mg—and progresses through specified stages. The adult maintenance dose is 3 mg; pediatric eligibility, tolerability provisions and response assessment are separately defined. Daily versus weekly dosing is a practical difference, not proof that an older medicine is inappropriate for everyone.

Other Approved GLP-1s

Trulicity (dulaglutide) is a weekly T2D medicine with a specified adult cardiovascular-risk indication. Byetta is immediate-release exenatide given twice daily; Bydureon BCise is a different, extended-release weekly formulation. These are not equivalent injection schedules or a single weight-loss percentage.

Historical products: FDA’s discontinued list records Adlyxin presentations as discontinued entries from 2023. FDA’s historical review identifies Tanzeum as no longer marketed in the US; its original GSK label documents the former albiglutide product. Historical inclusion should not be read as a current purchasing recommendation.

Fixed insulin combinations: Soliqua 100/33 combines insulin glargine with lixisenatide; Xultophy 100/3.6 combines insulin degludec with liraglutide. Both have adult T2D labeling and product-specific dosing. Their approval does not establish the suitability of independently mixing or stacking other products.

Approved generics versus compounding: FDA documents approved generics referencing Byetta and Victoza and a generic referencing Saxenda. A generic approval is separate from actual availability. Compounded medicines are not FDA-approved drugs; “compounded semaglutide” is not synonymous with “FDA-approved generic semaglutide.” This distinction does not erase the role of compounding in meeting particular medical needs.

New oral option: Foundayo (orforglipron) is addressed in its retained topic section below. It is now approved, not a phase-2-only Viking program.

Pipeline GLP-1s & Future Medications (Under Development)

This section follows selected emerging programs and preserves an older pipeline topic that has since reached US approval. Status is dated to this review; sponsor announcements are identified as such, and a planned filing is not an approval date.

Retatrutide (Triple GLP-1/GIP/GCG Agonist)

Developer and status: Eli Lilly. Its July 23, 2026 update describes retatrutide as investigational and a planned US BLA submission in Q1 2027. That is a company plan, not a guaranteed approval. The reviewed sources do not establish the previously claimed general early-access program or a commercial monthly price.

Emerging trial results: Lilly’s May 2026 TRIUMPH-1 topline report described 2,339 randomized adults with obesity/overweight without diabetes. At 80 weeks, the 12 mg arm had 28.3% mean weight reduction versus 2.2% placebo under the efficacy estimand; the treatment-regimen analysis was 25.0% versus 3.9%. The former estimates benefit under continued-treatment assumptions, while the latter includes adherence-related effects. Adverse-event discontinuation was 11.3% versus 4.9%.

The same sponsor report described 30.3% at 104 weeks for the group initially assigned 12 mg in a selected extension of 532 participants with baseline BMI ≥35 who completed and tolerated the main study; extension treatment targeted a maximum tolerated 9 or 12 mg. These findings are not a head-to-head comparison with tirzepatide, and the extension is not the full randomized population.

Orforglipron (Oral GLP-1)

Now approved as Foundayo: FDA approved Lilly’s orforglipron in April 2026 for weight management in eligible adults. Its label describes once-daily oral administration with or without food. It is a nonpeptide small molecule—not a Viking Therapeutics compound and not the first oral GLP-1 of any kind. Current tablet strengths should not be inferred from older trial-capsule doses.

Survodutide (Dual GLP-1/GCG)

Developer and mechanism: Zealand’s current program summary identifies a glucagon/GLP-1 dual agonist licensed to Boehringer Ingelheim, which is responsible for global development and commercialization. The investigational program includes phase 3 obesity and MASH studies. It is not a Roche program or a phase-2-only asset.

Mazdutide (Dual GLP-1/GCG Agonist)

Developer and status: Innovent licensed mazdutide from Lilly for China. Innovent’s weight-management approval announcement and T2D approval announcement identify a dual glucagon/GLP-1 agonist with Chinese NMPA approvals. This is not a triple GIP/GLP-1/glucagon drug or a Structure Therapeutics program. Chinese approval is not US FDA approval.

Pemvidutide (Dual GLP-1/GCG Agonist)

Developer and mechanism: Altimmune describes pemvidutide as an investigational GLP-1/glucagon dual agonist, not a Viking GLP-1/GIP compound. Its 2026 company update reports initiation of the phase 3 PERFORMA MASH trial in July. Development stage depends on indication; an obesity result should not be substituted for a liver-disease endpoint or compared casually with tirzepatide.

Mechanism Comparison: GLP-1 Only vs. Dual vs. Triple

Receptor targets describe pharmacology, not a percentage-weight-loss ladder. Compare measured outcomes from appropriately matched trials; more receptor targets do not automatically mean greater benefit or better tolerability.

How to Choose: Which GLP-1 Is Right for You?

Start with the indication: Diabetes, weight management, cardiovascular risk, kidney disease, OSA and MASH are not interchangeable eligibility criteria. Read the actual product label and discuss which outcome matters for the individual situation.

Compare benefits fairly: Use a relevant head-to-head study where available; do not rank drugs by percentages from unrelated trials. There is no universal “best tolerated” drug established by this overview.

Consider practical fit: Frequency, oral-product administration requirements, contraindications, other medicines, coverage, total ongoing cost and follow-up all matter. “Weekly” is not automatically preferable to a daily option for every person.

Plan switching specifically: Some labels give instructions for particular transitions, including the semaglutide tablet label. Those instructions do not create a universal one-week washout or equal-milligram conversion between all GLP-1 medicines.