Wegovy Injections vs Oral GLP-1 Tablets

Wegovy is now available in the UK both as a weekly injection and, since the MHRA's authorisation in June 2026, as a daily tablet. Both contain semaglutide and act in the same way, and in separate trials they produced broadly similar average weight loss. The main differences are practical: the tablet is taken every morning on an empty stomach with a waiting period before eating, while the injection is taken once a week. The injection also has cardiovascular outcome evidence and a higher-dose option. A second tablet, Foundayo (orforglipron), is a different medicine with no food rules. This guide compares them so you can discuss the options with a prescriber.

The options being compared

Wegovy injection

The Wegovy injection is a once-weekly semaglutide injection given using a multi-dose FlexTouch pen. It was authorised by the MHRA for weight management in 2021 and recommended by NICE in TA875 for use within specialist weight-management services. In January 2026 the MHRA authorised a maximum dose of up to 7.2mg weekly for adults with a BMI of 30 or more. See our complete guide to Wegovy and the Wegovy hub.

Wegovy tablets

Wegovy tablets contain oral semaglutide combined with an absorption enhancer called SNAC. They were authorised by the MHRA in June 2026 for adults with obesity, or overweight with at least one weight-related condition, alongside a reduced-calorie diet and increased physical activity. The dose starts at 1.5mg daily and increases to 4mg, 9mg and then 25mg, with at least a month at each step. See our oral semaglutide guide.

Foundayo (orforglipron)

Foundayo is a daily small-molecule GLP-1 tablet made by Eli Lilly, authorised by the MHRA in August 2026 for weight management and type 2 diabetes. It is not semaglutide. It can be taken at any time, with or without food. See our Foundayo guide.

Not to be confused with Rybelsus or Ozempic

Rybelsus is oral semaglutide licensed for type 2 diabetes at lower doses, and Ozempic is injectable semaglutide licensed for type 2 diabetes. Neither is licensed for weight management. See Rybelsus and weight loss and Ozempic vs Wegovy.

At a glance

Check the current Summary of Product Characteristics (SmPC) and the MHRA for any changes.

Same molecule, different delivery

Semaglutide copies the gut hormone GLP-1. It acts on receptors in the brain to reduce hunger and increase fullness, and slows stomach emptying. Whether it arrives by injection or tablet, once in the bloodstream it acts in the same way and lasts about a week.

The difference is in how it gets there. An injection places semaglutide under the skin, from where nearly all of it is absorbed. A tablet must survive the stomach. SNAC protects semaglutide locally and helps a small fraction cross the stomach lining, which is why:

• Tablet doses are much higher in milligrams than injection doses
• The tablet must be taken daily to maintain steady levels
• Food, drinks and other medicines in the stomach can greatly reduce absorption

Because absorption from tablets varies more from day to day and person to person, keeping to the instructions consistently matters. More on this in how Wegovy works.

What the trials show

Placebo-controlled trials

Notes on reading this table:

• Separate trials. The injection and tablet have not been compared head to head for weight management at the time of writing. Differences in trial length, population and analysis mean the figures are approximate comparisons only.
• The 50mg dose in OASIS 1 is not the UK licensed dose; the UK tablet goes up to 25mg.
• Two estimates. Some trials report a lower figure that includes everyone who started and a higher figure estimating the effect in people who took the medicine as directed.
• Individual variation is large in every trial. See realistic weight loss expectations.

ATTAIN-MAINTAIN: switching from semaglutide injections to orforglipron

ATTAIN-MAINTAIN enrolled people who had lost weight on semaglutide or tirzepatide injections in the SURMOUNT-5 trial. They were randomly assigned to switch to orforglipron or placebo for 52 weeks. According to topline results announced by Eli Lilly in December 2025, people who switched from semaglutide to orforglipron maintained about 79% of their earlier weight loss on average, compared with about 38% for those switched to placebo. On average, they regained around 1kg. Full peer-reviewed results provide more detail.

What happens when semaglutide stops

The STEP 4 trial (JAMA, 2021) showed that people who switched from semaglutide injections to placebo after 20 weeks regained a substantial part of their weight over the following year, while those who continued kept losing weight. This applies whatever form semaglutide is taken in. See Wegovy maintenance and stopping.

Heart health

The SELECT trial (NEJM, 2023) included more than 17,600 adults with overweight or obesity and established cardiovascular disease, without diabetes. Semaglutide 2.4mg weekly injections reduced major adverse cardiovascular events by 20% compared with placebo. Wegovy injections are licensed in the UK to reduce cardiovascular risk in eligible people.

The Wegovy tablet licence covers weight management. Oral semaglutide has cardiovascular outcome data in people with type 2 diabetes from the SOUL trial (NEJM, 2025), but that used a lower diabetes dose. For someone with established heart disease, this difference in licensing and evidence is worth discussing with a prescriber. See Wegovy and heart health.

Side effects compared

Both forms of Wegovy share semaglutide's side-effect profile. Foundayo, as a GLP-1 receptor agonist, has a similar profile.

These categories are approximate and based on trial reports and SmPCs at the time of writing; check the current SmPC for each product.

In STEP 1, around three-quarters of people on semaglutide injections reported gastrointestinal side effects, compared with under half on placebo. In OASIS 4, nausea affected just under half of people on the 25mg tablet and vomiting around three in ten. Most episodes were mild to moderate and occurred during dose escalation. See Wegovy side effects and oral GLP-1 side effects.

Specific points for tablets

• If you vomit soon after taking a Wegovy tablet, the leaflet explains what to do; usually you do not take another tablet that day.
• Semaglutide tablets can increase levels of levothyroxine (a thyroid medicine), so thyroid function may need monitoring. The SmPC lists other interactions.
• Taking the tablet with food or more than the permitted amount of water reduces absorption, which can make it less effective.

Daily routine compared

Taking the injection

One injection on the same day each week, at any time, with or without food. The pen needs to be refrigerated before first use and kept within temperature limits afterwards. The SmPC sets out what to do if a dose is missed. See how to use the Wegovy FlexTouch pen.

Taking Wegovy tablets

In general terms (follow your patient leaflet for the exact instructions):

1. Take the tablet first thing in the morning on an empty stomach.
2. Swallow it whole with a small sip of plain water, up to the maximum volume in the leaflet.
3. Wait at least the specified time, usually 30 minutes, before eating, drinking anything else or taking other oral medicines.

For people with a regular morning routine, this can become second nature. For those who need to take other medicines first thing, or who struggle to delay breakfast or coffee, it can be harder.

Taking Foundayo

One tablet a day, at any time, with or without food. This is the simplest daily routine of the three, though it is still daily.

Switching between injection and tablet

From Wegovy injections to Wegovy tablets

The Wegovy tablet licence describes switching people on semaglutide 2.4mg weekly injections directly to the 25mg daily tablet. In practice, a prescriber will usually advise starting the tablet around the time the next weekly injection would have been due. People on lower injection doses, or on 7.2mg, need individual advice. See switching from an injection to a tablet.

From Wegovy injections to Foundayo

This is a switch to a different medicine. ATTAIN-MAINTAIN suggests orforglipron may maintain much of the weight lost on semaglutide, but the starting dose and timing are a prescriber's judgement.

From a tablet back to injections

Someone who finds the daily routine difficult, or wants the option of a higher dose, may discuss moving to weekly injections. A prescriber will decide on an appropriate dose.

Never take semaglutide injections and tablets at the same time, or combine semaglutide with another GLP-1 medicine.

Who might each suit?

These are general considerations, not recommendations.

Factors that may point towards the injection

• Established cardiovascular disease, given the SELECT evidence and licence
• Preferring weekly over daily treatment
• Taking several morning medicines that would clash with the tablet's timing rules
• Being aged 12 to 17, where the injection has a licence
• Wanting access to the higher 7.2mg dose (if eligible)
• Eligibility for NHS specialist services under NICE TA875

Factors that may point towards a tablet

• Fear of needles or difficulty injecting
• Frequent travel
• A regular morning routine that makes the timing rules manageable (Wegovy tablets)
• Wanting a daily tablet without food rules (Foundayo)
• Wanting to continue semaglutide in a different form after a period on injections

Who should not take any of them

These medicines are generally unsuitable during pregnancy and breastfeeding, and caution or avoidance applies with a history of pancreatitis, severe gastrointestinal disease, a personal or family history of medullary thyroid cancer, or some eating disorders. See who should not take GLP-1 medications.

Supporting treatment, whichever form you take

The trials of Wegovy injections, Wegovy tablets and orforglipron all combined the medicine with advice on diet and physical activity, and the UK licences specify use alongside a reduced-calorie diet and increased activity. Some practical points apply to every option:

• Gradual dose increases. All three start low. If side effects are hard to manage, prescribers can extend the time at a dose.
• Protein and strength training. Eating much less can mean losing muscle as well as fat. Protein at each meal and regular resistance exercise help; see preserving muscle on GLP-1 treatment.
• Hydration. Sipping fluids through the day helps prevent dehydration, especially with nausea or diarrhoea.
• Smaller meals. Eating slowly and stopping when full reduces nausea and reflux. See what to eat on GLP-1 medication.
• Regular reviews. Your prescriber should check progress, side effects and whether the current dose and form are still right for you.

What remains uncertain

• No trial has compared Wegovy tablets directly with Wegovy injections for weight management.
• Real-world adherence to the tablet's morning routine, and how much that affects results outside trials, is not yet known.
• The long-term safety record of oral semaglutide at the 25mg weight-management dose, and of orforglipron, is still developing, although semaglutide itself has been widely used since 2018.
• Whether NICE will recommend either tablet for NHS use, and under what criteria, was undecided at the time of writing.

NHS and private access

Wegovy injections are recommended by NICE (TA875) for some adults within specialist weight-management services, for up to two years. At the time of writing, NICE had not recommended Wegovy tablets, and NICE had said the manufacturer had not yet submitted them for assessment. NICE was assessing orforglipron, with a decision expected later in 2026. Until NICE recommends them, the tablets are generally only available privately. See Wegovy on the NHS and private vs NHS weight loss treatment.

Cost: what affects it

We do not quote prices. Private costs for injections and tablets depend on:

• The medicine and dose. Pricing may differ between dose levels and between forms.
• Launch timing. The tablets launched in 2026, and early pricing can change.
• Supply format. Tablets are usually supplied monthly; injection pens contain several weekly doses.
• What is included. Consultations, support and delivery vary between providers.
• Long-term use. Treatment is often ongoing, so annual cost matters.

See our prices page for current comparisons.

Questions to ask your prescriber

• Would the injection or the tablet fit better with my routine and other medicines?
• Does my heart health make the injection's cardiovascular licence relevant to me?
• If I am on injections now, how and when would I switch to the tablet?
• What should I do if I vomit after taking a tablet, or miss a dose?
• How will we know if treatment is working, and when will it be reviewed?

When to speak to a professional

Speak to your GP, pharmacist or prescriber before starting, switching or stopping any form of semaglutide or other GLP-1 medicine. Tell them about all your medicines, particularly thyroid medicines, diabetes medicines and contraception, and about any history of pancreatitis, gallbladder disease, kidney problems, thyroid cancer, diabetic eye disease or eating disorders. Let them know if you are pregnant, planning pregnancy or breastfeeding.

Seek urgent medical help through NHS 111, or call 999 in an emergency, if you experience:

• Severe, persistent abdominal pain, especially spreading to the back, with or without vomiting
• Pain in the upper right abdomen, fever, or yellowing of the skin or eyes
• Vomiting or diarrhoea that stops you keeping fluids down, or signs of dehydration such as very little urine or dizziness
• Signs of a severe allergic reaction, such as swelling of the face or throat, or difficulty breathing
• Sudden changes in vision if you have diabetes

Report suspected side effects through the MHRA Yellow Card scheme. To compare regulated services, see our provider comparison.