GLP-1 & Incretin Drug Comparison
Every GLP-1 receptor agonist and the newer dual and triple agonists in one table: what each targets, how it is taken, whether it is FDA approved, and the headline result from its key trial.
12 drugs
| Drug | Targets | How it’s taken | U.S. status | Key trial | Headline result |
|---|---|---|---|---|---|
| ExenatideAmylin Pharmaceuticals / AstraZeneca · Byetta, Bydureon, Bydureon BCise | GLP-1 | Twice-daily injection; once-weekly extended-release injection (discontinued) | FDA approved | Exenatide add-on to metformin (study 2993-112)Adults with type 2 diabetes not controlled on metformin, 30 weeksPubMedNCT00039013 | HbA1c change −0.78% with highest dose vs +0.08% with placebo; body-weight change −2.8 kg with highest doseDrugs@FDA lists Bydureon and Bydureon BCise as discontinued and the original Byetta NDA as discontinued; a generic exenatide injection (Amneal, approved 2024) remains listed for prescription. |
| LixisenatideSanofi · Adlyxin, Soliqua 100/33 | GLP-1 | Once-daily injection; also in a fixed combination with insulin glargine | FDA approved | GetGoal-MonoAdults with type 2 diabetes not on glucose-lowering therapy, 12 weeksPubMedNCT00688701 | HbA1c change vs placebo −0.54% (2-step titration) and −0.66% (1-step titration); single maintenance dose, no higher-dose armAdlyxin is still listed in Drugs@FDA but has no listing in FDA's NDC directory, so U.S. use is in practice through Soliqua 100/33. |
| LiraglutideNovo Nordisk · Victoza, Saxenda, Xultophy 100/3.6 | GLP-1 | Once-daily injection | FDA approved | SCALE Obesity and PrediabetesAdults with obesity, or overweight with dyslipidaemia or hypertension, without type 2 diabetes, 56 weeksPubMedNCT01272219 | Mean weight loss 8.4 kg vs 2.8 kg with placebo (single dose studied)Drugs@FDA lists multiple approved generic liraglutide injections, the first approved in December 2024. |
| DulaglutideEli Lilly · Trulicity | GLP-1 | Once-weekly injection | FDA approved | AWARD-1Adults with type 2 diabetes on metformin and pioglitazone, 52 weeks (primary end point at 26 weeks)PubMedNCT01064687 | HbA1c change −1.51% with highest dose vs −0.99% with exenatide and −0.46% with placebo at 26 weeksNo dedicated obesity trial, so the key trial shown is glycaemic; dulaglutide is not approved for weight management. |
| SemaglutideNovo Nordisk · Ozempic, Wegovy, Rybelsus | GLP-1 | Once-weekly injection; once-daily tablet | FDA approved9 approved usesType 2 diabetes (Ozempic), 2017Type 2 diabetes (oral) (Rybelsus), 2019Cardiovascular risk reduction in type 2 diabetes with established cardiovascular disease (Ozempic), 2020Chronic weight management (Wegovy), 2021Cardiovascular risk reduction in adults with cardiovascular disease and obesity or overweight (Wegovy), 2024Kidney and cardiovascular risk reduction in type 2 diabetes with chronic kidney disease (Ozempic), 2025MASH with moderate to advanced liver fibrosis (Wegovy), 2025Cardiovascular risk reduction in high-risk type 2 diabetes (oral) (Rybelsus), 2025Weight management (oral tablet) (Wegovy), 2025 |
STEP 1Adults with overweight or obesity without diabetes, 68 weeksPubMedNCT03548935 | Mean body-weight change −14.9% vs −2.4% with placeboThe only drug in this table approved as both an injection and a tablet for weight management (Wegovy tablets, December 2025). |
| TirzepatideEli Lilly · Mounjaro, Zepbound | GIPGLP-1 | Once-weekly injection | FDA approved5 approved usesType 2 diabetes (Mounjaro), 2022Chronic weight management (Zepbound), 2023Moderate to severe obstructive sleep apnea in adults with obesity (Zepbound), 2024Type 2 diabetes in children 10 years and older (Mounjaro), 2025Cardiovascular risk reduction in high-risk type 2 diabetes (Mounjaro), 2026 |
SURMOUNT-1Adults with obesity, or overweight with at least one weight-related complication, without diabetes, 72 weeksPubMedNCT04184622 | Mean body-weight change −20.9% with highest dose vs −3.1% with placeboThe only approved drug in this table that also activates the GIP receptor. |
| RetatrutideEli Lilly | GIPGLP-1glucagon | Once-weekly injection (in trials) | Investigational | Phase 2 obesity trial (J1I-MC-GZBF)Adults with obesity, or overweight with at least one weight-related condition, 48 weeksPubMedNCT04881760 | Mean body-weight change −24.2% with highest dose vs −2.1% with placeboNot FDA approved; an 80-week phase 3 trial in adults with obesity without diabetes (PMID 42814954, 2026) reported −25.0% with the highest dose vs −3.9% with placebo. |
| CagrilintideNovo Nordisk | amylin | Once-weekly injection (in trials) | Investigational | Phase 2 dose-finding trialAdults with obesity, or overweight with hypertension or dyslipidaemia, without diabetes, 26 weeksPubMedNCT03856047 | Mean body-weight change −10.8% with highest dose vs −3.0% with placebo and −9.0% with liraglutide (trial product estimand)Not FDA approved alone or as CagriSema; in REDEFINE 1 (NCT05567796, PMID 40544433), cagrilintide plus semaglutide (CagriSema) gave −20.4% vs −3.0% with placebo at 68 weeks. |
| SurvodutideBoehringer Ingelheim | GLP-1glucagon | Once-weekly injection (in trials) | Investigational | Phase 2 dose-finding obesity trialAdults with BMI 27 or higher without diabetes, 46 weeksPubMedNCT04667377 | Mean body-weight change −14.9% with highest dose vs −2.8% with placebo (planned-treatment analysis)Not FDA approved; phase 3 obesity results were published in 2026 (PMID 42253238). |
| MazdutideInnovent Biologics | GLP-1glucagon | Once-weekly injection (in trials) | Investigational | GLORY-1Chinese adults with obesity, or overweight with at least one weight-related coexisting condition, 48 weeksPubMedNCT05607680 | Mean body-weight change −14.01% with highest dose vs +0.30% with placebo at week 48Not FDA approved; most trials are in China, and a US phase 2 obesity trial was published in 2026 (PMID 42628555). |
| PemvidutideAltimmune | GLP-1glucagon | Once-weekly injection (in trials) | Investigational | MASLD liver-fat trial (ALT-801-105)Adults with MASLD (liver fat 10% or more) and BMI 28 or higher, with or without type 2 diabetes, 12 weeksPubMedNCT05006885 | Relative liver-fat reduction 57.1% with highest dose vs 4.4% with placeboNo obesity trial is published in PubMed; in the phase 2b IMPACT trial in MASH (NCT05989711, PMID 41237796) it met the MASH-resolution endpoint but not the fibrosis endpoint at 24 weeks. |
| OrforglipronEli Lilly · FoundayoSmall molecule, not a peptide | GLP-1 | Once-daily tablet | FDA approved | ATTAIN-1Adults with obesity without diabetes, 72 weeksPubMedNCT05869903 | Mean body-weight change −11.2% with highest dose vs −2.1% with placeboA non-peptide oral GLP-1 receptor agonist, approved by FDA as Foundayo on 1 April 2026 (NDA 220934); it has no peptide profile on this site. |
How the drugs in this table differ
All 12 drugs act on the hormone system that controls blood glucose and appetite after a meal, but they differ in which receptors they target, how they are taken and how far they have progressed. 7 are FDA approved for at least one use; the rest are investigational in the United States.
By target
- GLP-1: Exenatide, Lixisenatide, Liraglutide, Dulaglutide, Semaglutide and Orforglipron. GLP-1 receptor agonists copy the gut hormone GLP-1, which increases insulin release when blood glucose is high, suppresses glucagon, slows stomach emptying and reduces appetite.
- amylin: Cagrilintide. An amylin analogue, given together with semaglutide in trials. Amylin is a satiety hormone that acts mainly in the hindbrain.
- GIP + GLP-1: Tirzepatide. Adding GIP, the second incretin hormone, to GLP-1 activity in one molecule. Why the GIP component helps is still debated.
- GLP-1 + glucagon: Survodutide, Mazdutide and Pemvidutide. Adding glucagon receptor activity, mainly for its effects on energy expenditure and liver fat. These drugs are being studied for obesity and fatty liver disease.
- GIP + GLP-1 + glucagon: Retatrutide. One molecule acting on all three receptors. Trials test the whole molecule, so how much each receptor contributes is not known.
The background is explained in the incretin effect and multi-receptor agonists. How a drug can favour some signalling pathways over others at the same receptor is covered in biased agonism.
By how they are taken
Most are injected under the skin, because peptides are broken down in the gut. Semaglutide and Orforglipron are available as a tablet: oral semaglutide uses an absorption enhancer, while orforglipron is a small molecule rather than a peptide. Why injected peptides can last days rather than minutes is explained in peptide half-life.
By approval status
"Approved" applies to a specific product and use, listed under each drug with a link to the FDA source. A drug approved for type 2 diabetes is not automatically approved for weight management, and products sold online under these names are not the medicines tested in these trials. See what FDA approval means.
Read the results carefully
- Results from different trials aren’t directly comparable. Populations, durations and comparators differ. Only a head-to-head trial can show one drug beats another, as in our semaglutide vs tirzepatide comparison.
- Headline results use the highest dose studied. We describe it without amounts. Dosing decisions belong with a prescriber and the official label, linked under each approval.
- Investigational means not approved. Products sold online as “research” versions of these drugs are not the medicines tested in these trials. FDA has warned about unapproved GLP-1 products.
See also: which of these drugs are in active trials.
Cite or link to this page
Reference
Inside Peptides. (2026, October 11). GLP-1 & Incretin Drug Comparison. https://insidepeptides.org/tools/glp-1-drug-comparison/HTML link
<a href="https://insidepeptides.org/tools/glp-1-drug-comparison/">GLP-1 & Incretin Drug Comparison</a> (Inside Peptides)