GLP-1 pills explained: Wegovy tablets, Rybelsus and Foundayo

GLP-1 medicines used to mean a weekly shot. Now some come as a daily pill. They aren't all the same medicine, and they don't all follow the same rules. Here's what's in each one, what it's approved for, how to take it, and why the semaglutide pills are so particular about water and timing. Everything below comes from the FDA labels.

1.What GLP-1 pills are there?

• Wegovy tablets (often called the Wegovy pill): semaglutide. They share one label with the Wegovy shot (Wegovy label, section 1).
• Rybelsus and Ozempic tablets: semaglutide, on one shared label (Rybelsus label, section 1).
• Foundayo: orforglipron, a different medicine that also works on the GLP-1 receptor. The FDA approved it on April 1, 2026 (FDA).

2.What is each one approved for?

Each label pairs the medicine with diet and physical activity. People take these for different reasons, and your prescriber decides which one, if any, fits you.

3.How do you take each pill?

Wegovy tablets, Rybelsus and Ozempic tablets follow the same routine (Wegovy and Rybelsus labels, section 2.1):

• One tablet, once a day, on an empty stomach in the morning.
• With water only, up to 4 ounces. No coffee, tea, juice or other drinks with it.
• Swallow it whole. Don't split, crush, chew or dissolve it.
• Wait at least 30 minutes before eating, drinking anything, or taking other pills by mouth.

Foundayo is simpler: once a day, with or without food. Swallow it whole, and don't break, crush or chew it (Foundayo label, section 2.1).

All three labels say the same thing about how many: no more than one tablet a day.

4.Why are the semaglutide pills so particular?

Semaglutide is a peptide, a chain of amino acids (the Wegovy label calls it a "peptide backbone", section 12.3). Peptides are hard to absorb from a pill. So the tablets are made with a helper ingredient called SNAC.

Even with SNAC, only a small share gets into the blood. The Wegovy label puts it at approximately 1% to 2% for the tablets. For Rybelsus 3, 7 and 14 mg it's 0.4% to 1% (Rybelsus label, section 12.3). For the shot, it's 89%. That's why the pill doses are so much bigger in milligrams than the shot doses: up to 25 mg a day for Wegovy tablets, versus 2.4 mg once a week for the Wegovy 2.4 mg shot.

The water and waiting rules come from studies too. Absorption was higher with 50 mL of water (under 2 ounces) than with 240 mL (about a cup), and higher with a longer wait before eating (Wegovy and Rybelsus labels, section 12.3). Food, other drinks or a big glass of water in the stomach means less medicine gets in.

Foundayo works differently. Orforglipron is a much smaller molecule: its molecular weight is 902.0 g/mol, compared with 4113.58 g/mol for semaglutide (Foundayo and Wegovy labels, section 11). About 77% of a 0.8 mg dose was absorbed, and the label found "No clinically relevant food effect" (Foundayo label, section 12.3). So there's no water or waiting rule.

5.How do the dose steps work?

All of these start low and step up, so the stomach has time to adjust. This is what the labels describe. Your prescriber decides your dose and when it changes.

The first Rybelsus and Ozempic tablet steps are only for getting started: the label says they're "not effective for glycemic control." And Rybelsus and Ozempic tablets "are not substitutable on a mg-to-mg basis" (Rybelsus label, section 2). The same milligram number doesn't mean the same dose.

6.How long do they last in the body?

• Semaglutide tablets: a half-life of about one week. The Rybelsus label says it's in the blood for about five weeks after the last tablet; the Wegovy label says about 5 to 7 weeks after the last 25 mg tablet (section 12.3 of each).
• Foundayo: a half-life of about 29 to 49 hours. It reaches a steady level after about 1 week of daily doses (Foundayo label, section 12.3).

7.What if I miss a pill?

• Wegovy tablets, Rybelsus and Ozempic tablets: skip the missed dose and take the next one the following day (Wegovy label, section 2.4; Rybelsus label, section 2.1).
• Foundayo: take it as soon as you can, and don't double up. If 7 or more doses in a row are missed, the label says to restart the steps at a lower dose (Foundayo label, section 2.3). Ask your prescriber how.

8.Anything else to know?

• Birth control pills and Foundayo. The Foundayo Medication Guide says birth control pills by mouth may not work as well while taking it. Your provider may suggest another type of birth control for 30 days after you start and for 30 days after each dose increase.
• One GLP-1 at a time. The Wegovy and Foundayo labels say not to use them with another GLP-1 medicine (section 1).
• The same serious warnings as the shots, including the thyroid tumor warning and pancreatitis (see each Medication Guide).