Every GLP-1 Medication Compared: The Complete 2026 Reference Guide

FDA-approved and pipeline GLP-1, dual, and triple agonists — efficacy, cost, dosing, and side effects at a glance.

Last updated: February 2026 • Sources cited from peer-reviewed clinical trials

How GLP-1 Medications Work

GLP-1 receptor agonists are a class of medications that mimic the incretin hormone GLP-1 (glucagon-like peptide-1), which your body naturally produces after eating. These drugs slow gastric emptying, increase insulin secretion, and suppress appetite through hypothalamic signaling in the brain.

🔬 Interactive Tool: Compare all 12 GLP-1 medications side-by-side — filter by mechanism, sort by weight loss, and find the right fit.

What makes this drug class revolutionary is how newer medications combine multiple receptor pathways to amplify weight loss and metabolic benefits.

Single agonists (GLP-1 only) include semaglutide, liraglutide, exenatide, dulaglutide, and the upcoming oral drug orforglipron. They target one receptor pathway — enough to produce 9–16% body weight loss in clinical trials.

Dual agonists (GLP-1 + GIP) like tirzepatide and VK2735 add the glucose-dependent insulinotropic polypeptide (GIP) pathway, enhancing insulin sensitivity. GIP may also improve bone density and reduce inflammation. Trials show 20–22.5% weight loss.

Dual agonists (GLP-1 + Glucagon) including survodutide, mazdutide, and pemvidutide add the glucagon pathway, increasing energy expenditure and directly reducing liver fat — a unique benefit for metabolic liver disease (MASH).

Triple agonists (GLP-1 + GIP + Glucagon) — currently just retatrutide — combine all three pathways simultaneously. This approach has produced the highest weight loss observed in trials to date: 24.2% at 48 weeks in Phase 2.

Combination therapies (GLP-1 + Amylin) like CagriSema pair semaglutide with cagrilintide (an amylin analog). GLP-1 suppresses appetite through one brain pathway while amylin drives satiety through a separate pathway — a complementary mechanism that produced 22.7% weight loss in the REDEFINE 1 trial.

Deep dive: Next-Gen GLP-1 Comparison — Dual and Triple Agonists

GLP-1 Medications Compared: The Complete Chart

FDA-Approved Medications

Pipeline and Investigational Medications

Use our calculators: Semaglutide Dosage Calculator · Tirzepatide Reconstitution Calculator · Retatrutide Dosage Calculator

Full comparison: All GLP-1s Head-to-Head

GLP-1 Medications Ranked by Weight Loss

Clinical trials show a clear hierarchy of weight loss efficacy, with newer multi-receptor agonists outperforming single-target drugs. However, direct comparisons require caution — trial durations, populations, and doses vary significantly.

Triple agonist:

• ●Retatrutide: ~24.2% body weight loss at 48 weeks (Phase 2, 12mg dose, n=338)

Combination therapy:

• ●CagriSema: ~22.7% (REDEFINE 1, Phase 3)

Dual GLP-1/GIP agonists:

• ●Tirzepatide: ~20–22.5% (SURMOUNT trials, Phase 3, 72 weeks)
• ●VK2735 (subcutaneous): ~14.7% at 13 weeks (Phase 2)

Dual GLP-1/Glucagon agonists:

• ●Mazdutide: ~20% at 60 weeks (GLORY-2)
• ●Survodutide: Phase 3 ongoing (SYNCHRONIZE trials)
• ●Pemvidutide: ~6.2% at 24 weeks (IMPACT, MASH-focused)

Single GLP-1 agonists:

• ●Semaglutide: ~15–16% (STEP trials, Phase 3)
• ●Cagrilintide (amylin, monotherapy): ~11.8% (REDEFINE 1)
• ●Liraglutide: ~9% (SCALE trials)
• ●Orforglipron (oral): ~8–9% at 6 months (Phase 2)
• ●Dulaglutide: ~3–5%
• ●Exenatide: ~3–4%

Important context: Trial durations range from 13 weeks to 78 weeks, making raw percentage comparisons imperfect. Retatrutide's 24.2% comes from Phase 2 (smaller trial); Phase 3 data will be definitive. Pipeline drugs have smaller sample sizes. Individual results depend on dosing, diet, exercise, and genetic factors.

The only head-to-head trial between top drugs — SURMOUNT-5 — showed tirzepatide producing greater weight loss than semaglutide at maximum doses (20.2% vs 13.7% at 72 weeks).

Oral GLP-1 Medications: What's Available and What's Coming

The oral GLP-1 space is rapidly expanding. Three options now exist or are nearing approval:

Oral semaglutide (Rybelsus / Wegovy pill) is the first approved oral GLP-1. Rybelsus treats type 2 diabetes; an oral Wegovy formulation launched in January 2026 for weight management. The main limitation: patients must fast for 30 minutes before and after taking it, and it's taken daily rather than weekly.

Orforglipron (Eli Lilly) is a non-peptide small molecule GLP-1 agonist — a fundamentally different approach. Because it's not a peptide, it doesn't require fasting restrictions and has better shelf stability. Eli Lilly submitted an NDA to the FDA, with potential approval in mid-2026. Phase 2 data showed 8–9% weight loss at 6 months, with Phase 3 ATTAIN results pending.

VK2735 oral (Viking Therapeutics) is a dual GLP-1/GIP agonist in oral form — combining the benefits of a pill with dual-receptor targeting. Phase 2 showed 12.2% weight loss (oral formulation). Phase 3 trials (VANQUISH) are underway.

Full breakdown: Oral vs. Injectable GLP-1s Compared

What Do GLP-1 Medications Cost in 2026?

Cost remains the biggest barrier to GLP-1 access. Here's the current pricing landscape:

Key developments in 2025–2026:

Medicare Part D now covers several anti-obesity medications. The TrumpRx program set negotiated Medicare prices at approximately $245/month with $50 copays for beneficiaries — a significant reduction from list prices.

Generic liraglutide (generic Saxenda) launched in August 2025, becoming the first generic GLP-1 available for weight loss. It's currently the most affordable branded-equivalent option at $150–350/month.

Employer coverage is expanding but uneven. About 19% of mid-size employers cover GLP-1s for weight loss, while 43% of employers with 5,000+ workers now offer coverage.

International prices remain significantly lower: $83–144/month in European markets, though these formulations aren't available in the US.

GLP-1 Medications: Every FDA-Approved Use

GLP-1 receptor agonists have expanded well beyond diabetes and obesity into cardiovascular, renal, liver, and respiratory medicine.

Active Phase 3 trials are investigating GLP-1s for peripheral artery disease, heart failure with preserved ejection fraction (HFpEF), Alzheimer's disease, prediabetes, diabetic retinopathy, and osteoarthritis.

Earlier-phase research includes cystic fibrosis-related diabetes, polycystic ovary syndrome (PCOS), COPD, Prader-Willi syndrome, asthma, substance use disorder, and alcohol use disorder.

GLP-1 receptor agonists may become one of the most versatile drug classes in modern medicine, with potential applications across 15+ conditions beyond their original diabetes indication.

Common Side Effects Across GLP-1 Medications

All GLP-1 medications share a similar gastrointestinal side-effect profile. These effects are most common during the initial dose-escalation period and typically improve within the first few weeks.

Serious but rare risks include pancreatitis, gallbladder events (gallstones, cholecystitis), and thyroid C-cell tumors (observed in animal studies; carries a boxed warning). Gastroparesis has been reported in rare cases.

Drug-specific safety notes worth knowing:

Pemvidutide showed notably low discontinuation rates in the IMPACT trial (0–1.2% vs 2.4% for placebo), suggesting a more tolerable GI profile than most GLP-1s.

CagriSema's side effects were consistent with its individual components — combining semaglutide and cagrilintide did not amplify GI side effects beyond what each drug causes alone.

Orforglipron, as an oral medication, avoids injection-site reactions entirely.

Dual GLP-1/glucagon agonists (survodutide, mazdutide, pemvidutide) show unique liver-related benefits including direct hepatic fat reduction, making them particularly promising for MASH.

GLP-1 Pipeline: What's Expected in 2026 and Beyond

The GLP-1 landscape is evolving rapidly. Here are the key milestones to watch:

The broader research horizon extends well beyond weight loss. GLP-1 receptor agonists are being evaluated for approximately 15 conditions, from neurodegenerative diseases to addiction. If even a fraction of these trials succeed, the impact on clinical medicine will be profound.

PeptideIQ Dosage Calculators and Comparison Tools

Every GLP-1 medication has a unique dosing protocol. Use our calculators to understand dose escalation schedules, reconstitution ratios, and titration timelines.

Dosage Calculators:

• ●Semaglutide Dosage Calculator — dose escalation schedule for Ozempic and Wegovy
• ●Tirzepatide Reconstitution Calculator — reconstitution and dosing for Mounjaro/Zepbound
• ●Retatrutide Dosage Calculator — investigational triple agonist dosing
• ●CagriSema Dosage Calculator — combination therapy dose schedule
• ●Cagrilintide Dosage Calculator — amylin analog dosing
• ●Survodutide Dosage Calculator — dual GLP-1/glucagon dosing
• ●Mazdutide Dosage Calculator — dual agonist dosing protocol
• ●Orforglipron Dosage Calculator — oral non-peptide GLP-1 dosing
• ●Pemvidutide Dosage Calculator — MASH-focused dual agonist dosing

Comparison Tools:

• ●GLP-1 Head-to-Head Comparison — side-by-side analysis of all approved GLP-1s
• ●Next-Gen GLP-1 Comparison — dual and triple agonists compared
• ●Oral vs. Injectable GLP-1s — convenience, efficacy, and access compared

Compare GLP-1 Medications Interactively

Ready to explore the data yourself? Our Interactive GLP-1 Comparison Tool lets you filter by mechanism type, development status, and delivery route — then sort by weight loss efficacy, cost, or approval status. Compare all 12 medications at a glance.

→ Launch the Comparison Tool

Frequently Asked Questions About GLP-1 Medications

What is the most effective GLP-1 medication for weight loss?

Based on clinical trials, retatrutide (a triple GLP-1/GIP/glucagon agonist from Eli Lilly) has shown the highest weight loss at approximately 24.2% in Phase 2 trials at 48 weeks. Among FDA-approved medications, tirzepatide (Mounjaro/Zepbound) leads at 20–22.5% in Phase 3 trials (SURMOUNT program, 72 weeks), followed by semaglutide (Wegovy) at 15–16% (STEP trials). CagriSema (semaglutide + cagrilintide) showed 22.7% in Phase 3 (REDEFINE 1) and may receive FDA approval in 2026.

What is the difference between GLP-1, dual agonist, and triple agonist?

GLP-1 agonists like semaglutide activate one receptor pathway that controls appetite and blood sugar. Dual agonists add a second pathway — either GIP (as in tirzepatide, for enhanced insulin sensitivity) or glucagon (as in survodutide, for increased energy expenditure and liver fat reduction). Triple agonists like retatrutide activate all three pathways simultaneously, which has produced the greatest weight loss in clinical trials to date.

Are there any oral GLP-1 medications?

Yes. Rybelsus (oral semaglutide) is approved for type 2 diabetes, and an oral Wegovy formulation launched in January 2026 for weight management. Orforglipron from Eli Lilly is a new non-peptide oral GLP-1 that doesn't require fasting and has an NDA submitted to the FDA with potential approval in mid-2026. VK2735 from Viking Therapeutics is also being tested in oral form.

How much do GLP-1 medications cost?

Without insurance, brand-name GLP-1 medications list at $997–$1,349/month. Self-pay discount programs have reduced this to approximately $299–499/month. With commercial insurance and manufacturer savings cards, some patients pay as low as $25/month. Medicare Part D now covers several GLP-1s at negotiated prices of approximately $245/month with $50 copays. Generic liraglutide (generic Saxenda), launched in August 2025, is currently the most affordable option.

What are the main side effects of GLP-1 medications?

The most common side effects are gastrointestinal: nausea (20–45% of patients), diarrhea (15–30%), vomiting, and constipation. These are typically mild to moderate and occur most often during the dose-escalation period. They usually improve within the first few weeks of treatment. Serious side effects like pancreatitis and gallbladder events are rare but possible.

Which GLP-1 medications are covered by Medicare?

As of late 2025, Medicare Part D covers Ozempic, Wegovy, Mounjaro, and Zepbound at negotiated prices of approximately $245/month with ~$50 copay for eligible beneficiaries.

What new GLP-1 drugs are expected in 2026?

Two major decisions are anticipated: CagriSema (Novo Nordisk's semaglutide + cagrilintide combination, showing 22.7% weight loss) and orforglipron (Eli Lilly's first-in-class oral non-peptide GLP-1). Both could reach the US market by late 2026. Further out, retatrutide (triple agonist) and VK2735 (dual GLP-1/GIP) are in Phase 3 trials with potential approvals in 2027–2028.

Is tirzepatide better than semaglutide?

In the SURMOUNT-5 head-to-head trial, tirzepatide produced greater weight loss than semaglutide at maximum doses (20.2% vs 13.7% at 72 weeks). Tirzepatide is a dual GLP-1/GIP agonist while semaglutide targets only GLP-1. However, semaglutide has more approved indications (including cardiovascular risk reduction, CKD, and MASH) and more extensive long-term safety data. The choice between them depends on individual clinical factors, insurance coverage, and treatment goals.

Semaglutide Guide

For detailed information on semaglutide specifically, explore our comprehensive guide:

• ●Understanding Semaglutide: Basics — what it is, how it works, approved forms
• ●Semaglutide Side Effects and Risks — common and serious side effects
• ●What to Expect on Semaglutide — weight loss timeline, diet, lifestyle
• ●How to Inject Semaglutide — injection technique, storage, missed doses

Next-Generation Therapies

The GLP-1 landscape is evolving rapidly. These emerging treatments represent the next wave of obesity pharmacotherapy:

• ●CagriSema — Novo Nordisk's amylin + GLP-1 combination showing 22.7% weight loss in Phase 3. NDA filed December 2025, approval expected late 2026.
• ●Retatrutide — Eli Lilly's triple GIP/GLP-1/glucagon agonist producing record 28.7% weight loss. The most potent obesity drug in development.
• ●Orforglipron — The first non-peptide oral GLP-1 pill with no food restrictions and self-pay pricing starting at $149/month. FDA priority review expected 2026.

Practical Guides

• ●GLP-1 Side Effects Compared — Drug-by-drug comparison of side effect rates, management strategies, and when to seek medical attention
• ●GLP-1 Costs & Insurance Guide — Complete breakdown of pricing, insurance coverage, savings programs, and the cheapest options available

Related Reading

• ●Tirzepatide: The Ultimate Guide — deep dive into Mounjaro/Zepbound
• ●What Is Mazdutide? — China-approved dual GLP-1/glucagon agonist
• ●Survodutide for Weight Loss — Boehringer Ingelheim's pipeline candidate

This page is for informational and educational purposes only. It is not medical advice. Consult a qualified healthcare provider before starting, stopping, or changing any medication. Clinical trial results cited are from published peer-reviewed studies and may not reflect individual outcomes.

Sources: NEJM (SURMOUNT-5, REDEFINE 1, GLORY-1), StatPearls, FDA prescribing information, ClinicalTrials.gov, PMC systematic reviews. Full citations available in our research methodology.