GLP-1 Medications: Every FDA-Approved Drug in the Class (2026)

Summary: Six FDA-approved GLP-1 receptor agonists are on the US market in 2026, plus the dual GIP/GLP-1 tirzepatide. This guide covers indications, dosing, weight loss and A1C data, side effects, and cash prices for every drug in the class.

This content is for informational purposes only and is not medical advice. Always consult a qualified healthcare provider before starting, changing, or stopping any medication.

GLP-1 medications are a class of injectable and oral drugs that mimic glucagon-like peptide-1, a gut hormone released after eating. Seven of them are FDA-approved in the United States as of 2026, counting tirzepatide, which technically activates both the GLP-1 and GIP receptors. They treat type 2 diabetes, obesity, and a growing list of cardiovascular, kidney, and liver conditions tied to metabolic disease. This page covers every drug in the class: what it is, who it is for, how it is dosed, what efficacy looks like in trials, what it costs, and the side effects you can expect.

The full list of FDA-approved GLP-1 medications

Tirzepatide is a dual GIP/GLP-1 receptor agonist, not a pure GLP-1 drug. It is on this list because every comparative guide includes it, every prescriber decision tree includes it, and it produces the largest weight loss of any incretin medicine on the market.

Two older drugs in the class have been discontinued. Albiglutide (Tanzeum) was pulled in 2018 because it underperformed competitors commercially, not for safety. Lixisenatide is still FDA-approved but Sanofi stopped US distribution in 2023, so most patients in the US no longer encounter it outside the academic literature.

How GLP-1 medications work

Native GLP-1 is released by L-cells in the small intestine within minutes of eating. It binds GLP-1 receptors on the pancreas, gut, and brain and produces four overlapping effects: more insulin when blood glucose is high, less glucagon, slower gastric emptying, and stronger satiety signals in the hypothalamus. Native GLP-1 has a half-life of about two minutes because DPP-4 enzymes degrade it almost as fast as it is released.

GLP-1 receptor agonists are engineered to resist that degradation. Exenatide is derived from exendin-4, a peptide in Gila monster saliva that happens to bind human GLP-1 receptors. Liraglutide and semaglutide are modified human GLP-1 sequences with fatty acid chains that bind albumin, extending the half-life from minutes to hours or days. Dulaglutide is a GLP-1 peptide fused to an antibody fragment, which slows clearance to about five days. The result is a class of drugs that produce sustained receptor activation at doses ranging from once-daily oral pills to once-weekly subcutaneous injections.

Tirzepatide adds GIP receptor activity on top of GLP-1. GIP is a second incretin hormone, and the dual-agonist approach appears to produce larger weight loss and A1C reductions than GLP-1 activation alone, although the exact mechanism for the additive effect is still debated.

Exenatide (Byetta and Bydureon)

Exenatide was the first GLP-1 receptor agonist approved in the US, in April 2005. Two formulations exist.

Byetta is the original twice-daily injection. The dose is 5 mcg subcutaneous within an hour before the morning and evening meals for the first month, increased to 10 mcg twice daily after that ^[1]. It is approved as an adjunct to diet and exercise for adults with type 2 diabetes.

Bydureon BCise is the once-weekly extended-release version. Dose is 2 mg subcutaneous in the abdomen, thigh, or upper arm, on any day of the week ^[2]. Bydureon uses a microsphere drug-delivery system, so the injection produces a small visible nodule that resolves over weeks.

A1C reduction in exenatide trials is about 0.8 to 1.5 percentage points. Weight loss is modest, typically 2 to 3 kg over six months. Exenatide is excreted by the kidneys and is not recommended in patients with creatinine clearance below 30 mL/min. It is the GLP-1 most associated with antibody formation, which occasionally reduces efficacy or causes injection-site reactions.

Cash price for Byetta is around 760 dollars per month. Bydureon BCise runs around 880 dollars per month at US retail pharmacies. Both are off-patent in much of Europe but no FDA-approved generic exists in the US.

Liraglutide (Victoza and Saxenda)

Liraglutide was the first daily GLP-1 with a meaningful weight-loss signal. Novo Nordisk markets it under two names with different dose ranges.

Victoza is approved for type 2 diabetes in adults and children ten and older. Starting dose is 0.6 mg subcutaneous once daily for one week, increased to 1.2 mg, with a maximum of 1.8 mg ^[3]. Victoza also carries an FDA indication to reduce major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease, based on the LEADER trial.

Saxenda is the same molecule at a higher dose, approved for chronic weight management. Titration goes from 0.6 mg to 3.0 mg over five weeks ^[4]. Saxenda is approved for adults with BMI 30 or higher, or 27 or higher with at least one weight-related condition such as hypertension or sleep apnea, and for adolescents 12 and older with a body weight above 60 kg and obesity by adult BMI cutoffs.

A1C reduction at 1.8 mg is about 1.0 to 1.5 percentage points. Weight loss at the 3.0 mg dose averages about 5 to 8 percent of body weight at 56 weeks, smaller than semaglutide or tirzepatide. Liraglutide is one of the first GLP-1 medications to lose patent protection in the US, and a generic liraglutide launched in 2024, dropping cash prices to roughly 350 to 500 dollars per month from the brand price of around 1,350 dollars.

Dulaglutide (Trulicity)

Dulaglutide is a once-weekly GLP-1 from Eli Lilly approved in 2014. It is a fusion of a modified GLP-1 peptide and an IgG4 antibody fragment, which extends the half-life to about five days and allows once-weekly dosing. It is supplied in single-dose pens at 0.75, 1.5, 3.0, and 4.5 mg ^[5].

Standard starting dose is 0.75 mg weekly for diabetes control, escalated to 1.5 mg and higher if needed. The maximum approved dose is 4.5 mg. A1C reduction at 1.5 mg in the AWARD trials was about 1.0 to 1.6 percentage points; the 4.5 mg dose added another 0.2 to 0.3 points. Weight loss is modest, typically 3 to 4 kg.

Dulaglutide has an FDA indication to reduce major adverse cardiovascular events in adults with type 2 diabetes, based on the REWIND trial. It is one of the few GLP-1 medications with cardiovascular outcomes data in patients without established cardiovascular disease, just risk factors. Cash price is around 990 dollars per monthly box of four pens.

Lixisenatide (Adlyxin)

Lixisenatide is a once-daily GLP-1 approved in the US in 2016. The dose is 10 mcg subcutaneous for 14 days, then 20 mcg daily, taken within one hour of the first meal of the day.

A1C reduction is modest at about 0.5 to 0.9 percentage points. Weight loss is also modest, typically 1 to 3 kg. The ELIXA cardiovascular outcomes trial showed neutral effects on major adverse cardiovascular events, neither benefit nor harm. Sanofi stopped distributing Adlyxin in the United States in early 2023, citing low commercial uptake. The drug remains FDA-approved on paper but is no longer commercially available in the US, so prescribers default to other options.

Semaglutide (Ozempic, Wegovy, Rybelsus)

Semaglutide is the most prescribed GLP-1 medication in the US and the molecule that turned this class into a cultural phenomenon. Novo Nordisk sells it under three brand names.

Ozempic is the once-weekly injection approved for type 2 diabetes. Doses are 0.25, 0.5, 1.0, and 2.0 mg ^[6]. A1C reduction at 1.0 mg is about 1.5 percentage points, slightly more at 2.0 mg. Weight loss is around 6 to 8 percent on average. Ozempic carries an FDA indication for reducing major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease, based on the SUSTAIN-6 trial, plus a more recent indication for reducing risk of sustained eGFR decline and cardiovascular death in adults with type 2 diabetes and chronic kidney disease, from the FLOW trial.

Wegovy is the same molecule at higher doses approved for chronic weight management. Doses go up to 2.4 mg weekly ^[7]. In the STEP-1 trial, adults without diabetes lost an average of 14.9 percent of body weight at 68 weeks. Wegovy is also FDA-approved to reduce major adverse cardiovascular events in adults with established cardiovascular disease and obesity or overweight, based on the SELECT trial, and for MASH (metabolic dysfunction-associated steatohepatitis) with moderate-to-advanced liver fibrosis.

Rybelsus is oral semaglutide, a tablet taken once daily on an empty stomach with a sip of water. Doses are 3, 7, and 14 mg. It is approved for type 2 diabetes only, not for weight loss, although a higher-dose oral formulation for obesity is in late-stage development. A1C reduction at 14 mg is roughly 1.0 to 1.4 percentage points.

Cash price ranges: Ozempic about 1,000 dollars per month, Wegovy about 1,350 dollars per month, Rybelsus about 1,000 dollars per month. Novo Nordisk offers savings programs that can reduce out-of-pocket costs for commercially insured patients.

Tirzepatide (Mounjaro and Zepbound)

Tirzepatide is the newest entrant and the most effective drug in the class for both glucose lowering and weight loss. Eli Lilly received FDA approval for Mounjaro in May 2022 and for Zepbound in November 2023.

Mounjaro is approved as an adjunct to diet and exercise for type 2 diabetes in adults. Doses are 2.5, 5, 7.5, 10, 12.5, and 15 mg subcutaneous once weekly ^[8]. The starting dose is 2.5 mg for four weeks, then 5 mg, escalated by 2.5 mg every four weeks based on tolerance and glycemic response. In the SURPASS trials, A1C reduction at 15 mg was up to 2.3 percentage points, and weight loss reached 11 to 12 kg on average.

Zepbound is the same molecule and the same dose range, approved for chronic weight management ^[9]. In SURMOUNT-1, adults without diabetes on the 15 mg dose lost an average of 22.5 percent of body weight at 72 weeks, the largest weight-loss result of any FDA-approved obesity drug to date ^[10]. Zepbound also carries an FDA indication for moderate-to-severe obstructive sleep apnea in adults with obesity, the first obesity drug to win that indication.

Cash price for Mounjaro is around 1,070 dollars per month. Zepbound runs around 1,060 dollars per month for the auto-injector pens, and Lilly sells single-dose vials direct to cash-pay patients at lower prices (roughly 350 to 700 dollars per month depending on the dose).

Comparing the class: efficacy, dosing, and cost

The ranking changes when you slice the data differently. For pure A1C reduction in diabetes, tirzepatide is first, semaglutide second, dulaglutide and liraglutide tied for third, and exenatide last. For weight loss, tirzepatide is first by a wide margin, semaglutide is second, and the older drugs trail. For convenience, the weekly injectables (Trulicity, Ozempic, Wegovy, Mounjaro, Zepbound, Bydureon) all win over the daily and twice-daily options. For cost, generic liraglutide is the cheapest brand-equivalent option, although the once-daily dosing is a real drawback for most patients.

Side effects across the class

The dominant side effects are gastrointestinal and shared across every GLP-1 drug. They are dose-dependent, more common during titration, and usually improve over weeks to months as the gut adapts to slowed gastric emptying.

• Nausea: 15 to 45 percent of patients, depending on dose and drug. Tirzepatide and semaglutide at maximum doses are at the high end. Lixisenatide and dulaglutide at standard doses are at the low end.
• Vomiting: 5 to 20 percent.
• Diarrhea: 10 to 25 percent.
• Constipation: 5 to 15 percent.
• Decreased appetite: 10 to 25 percent (often a desired effect for patients on the obesity indications).
• Injection site reactions: more common with exenatide than with semaglutide or tirzepatide.

Less common but clinically important risks include acute pancreatitis (low absolute incidence, typically 0.1 to 0.3 percent), gallbladder disease and cholecystitis (slightly increased risk, attributable in part to rapid weight loss), acute kidney injury secondary to dehydration from severe nausea and vomiting, and worsening of diabetic retinopathy in patients with rapid A1C reductions on semaglutide and possibly other agents. Allergic reactions and injection-site nodules occur most often with exenatide due to antibody formation.

Hypoglycemia is rare with GLP-1 monotherapy because the insulin-stimulating effect is glucose-dependent. The risk rises substantially when GLP-1s are combined with insulin or sulfonylureas, so doses of those companion medications often need reduction.

Cardiovascular and other benefits beyond glucose and weight

Five GLP-1 medications have FDA-approved cardiovascular indications based on dedicated outcomes trials:

• Victoza (liraglutide): LEADER trial, reduced major adverse cardiovascular events in T2D with established CV disease.
• Trulicity (dulaglutide): REWIND trial, reduced MACE in T2D with CV disease or multiple risk factors.
• Ozempic (semaglutide): SUSTAIN-6 trial, reduced MACE in T2D with established CV disease.
• Wegovy (semaglutide): SELECT trial, reduced MACE in adults with established CV disease and obesity or overweight (no diabetes required).
• Ozempic also carries a kidney indication from the FLOW trial in adults with T2D and chronic kidney disease.

Wegovy is the first weight-loss drug ever approved to reduce cardiovascular events in patients without diabetes, which fundamentally changed how cardiologists view obesity pharmacotherapy. Zepbound (tirzepatide) holds the first obstructive sleep apnea indication in the class, based on the SURMOUNT-OSA trial. The MASH approval for Wegovy is the first GLP-1 indication for liver disease.

Tirzepatide does not yet have a dedicated FDA cardiovascular outcomes approval. The SURPASS-CVOT trial reading out in late 2024 showed cardiovascular safety versus dulaglutide but the formal label update is pending.

How prescribers choose between them

For a patient with type 2 diabetes and no weight-loss priority, the typical first-line GLP-1 is whichever is cheapest and best-covered by insurance, with dulaglutide or semaglutide injection as common choices. For a patient who needs maximum A1C reduction, tirzepatide wins on efficacy. For a patient with established cardiovascular disease, semaglutide, liraglutide, or dulaglutide are favored because of the outcomes data. For chronic kidney disease, semaglutide (Ozempic) has the strongest indication.

For obesity without diabetes, the choice narrows to Wegovy, Zepbound, or Saxenda. Tirzepatide (Zepbound) produces the largest weight loss. Semaglutide (Wegovy) has the cardiovascular and MASH indications. Liraglutide (Saxenda) is daily-dosed and produces less weight loss but is the only one approved down to age 12.

Patients who cannot tolerate injections have one option for diabetes (Rybelsus, oral semaglutide). Higher-dose oral semaglutide for obesity is in late-stage trials but not yet approved.

A short history and timeline of FDA GLP-1 approvals

• 2005: Byetta (exenatide), first GLP-1 approved, for type 2 diabetes.
• 2010: Victoza (liraglutide), first daily injectable GLP-1.
• 2012: Bydureon (exenatide extended-release), first weekly GLP-1.
• 2014: Saxenda (high-dose liraglutide), first GLP-1 approved for chronic weight management.
• 2014: Trulicity (dulaglutide), once-weekly GLP-1 with antibody-fusion structure.
• 2016: Adlyxin (lixisenatide), once-daily GLP-1; later commercially withdrawn in 2023.
• 2017: Ozempic (semaglutide), once-weekly injection for type 2 diabetes.
• 2019: Rybelsus (oral semaglutide), first oral GLP-1.
• 2021: Wegovy (semaglutide), high-dose semaglutide for chronic weight management.
• 2022: Mounjaro (tirzepatide), first dual GIP/GLP-1 receptor agonist for type 2 diabetes.
• 2023: Zepbound (tirzepatide), tirzepatide for chronic weight management.
• 2024: Wegovy gains cardiovascular indication from SELECT trial.
• 2024: Zepbound gains obstructive sleep apnea indication from SURMOUNT-OSA.
• 2025: Wegovy gains MASH liver-disease indication.

The pipeline is also crowded. Orforglipron, an oral non-peptide GLP-1 from Eli Lilly, is in late-stage trials and may be the next approval. CagriSema (cagrilintide plus semaglutide) and retatrutide (a triple agonist hitting GLP-1, GIP, and glucagon receptors) are also in Phase 3 development with weight loss results approaching tirzepatide and beyond.

GLP-1 vs semaglutide: the most common question

If you have searched "diferencia entre glp-1 y semaglutida," here is the answer. GLP-1 is a class of medications. Semaglutide is one specific molecule in that class. Ozempic, Wegovy, and Rybelsus are all brand names for semaglutide, made by Novo Nordisk. Every semaglutide product is a GLP-1, but not every GLP-1 is semaglutide. Other GLP-1s on the market include liraglutide (Victoza, Saxenda), dulaglutide (Trulicity), and exenatide (Byetta, Bydureon). Tirzepatide (Mounjaro, Zepbound) is sometimes grouped with the GLP-1s but is technically a dual GIP/GLP-1 agonist.

Common questions about GLP-1 medications

What are the FDA-approved GLP-1 medications?

Exenatide (Byetta, Bydureon), liraglutide (Victoza, Saxenda), dulaglutide (Trulicity), lixisenatide (Adlyxin), semaglutide (Ozempic, Wegovy, Rybelsus), and tirzepatide (Mounjaro, Zepbound). Lixisenatide is approved but no longer commercially distributed in the US.

Which GLP-1 produces the most weight loss?

Tirzepatide (Zepbound) at the 15 mg dose produced 22.5 percent body weight loss in SURMOUNT-1. Semaglutide (Wegovy) at 2.4 mg produced about 14.9 percent in STEP-1. Saxenda and the diabetes-dose drugs produce less.

Which GLP-1 has the best cardiovascular evidence?

Wegovy (semaglutide) is the first weight-loss GLP-1 approved to reduce major adverse cardiovascular events in adults without diabetes. Victoza, Ozempic, and Trulicity have CV outcomes data in type 2 diabetes patients.

Are all GLP-1 medications injectable?

No. Rybelsus is an oral once-daily tablet of semaglutide. Every other FDA-approved GLP-1 is a subcutaneous injection, given daily, twice daily, or weekly.

Is tirzepatide a GLP-1?

Tirzepatide is a dual GIP and GLP-1 receptor agonist, so it activates GLP-1 receptors plus a second incretin pathway. Most clinicians and patients include it in the GLP-1 conversation because of the overlapping mechanism and indications.

Why was albiglutide (Tanzeum) discontinued?

GSK withdrew Tanzeum from the global market in 2018 for commercial reasons, not safety. It was a once-weekly GLP-1 but underperformed dulaglutide and semaglutide in market uptake.

How long do I need to take a GLP-1 medication?

Chronic. Stopping a GLP-1 typically leads to appetite returning, weight regain, and rising A1C within months. Type 2 diabetes and obesity are chronic conditions, and GLP-1 therapy is a long-term management strategy, not a temporary intervention.

What is the cheapest GLP-1 medication in 2026?

Generic liraglutide launched in the US in 2024 and prices range from about 350 to 500 dollars per month, the lowest brand-equivalent cost in the class. Eli Lilly also sells Zepbound vials direct-to-patient at lower prices than the pen.

Are GLP-1 medications safe long term?

GLP-1s have been on the market since 2005 and post-marketing data is reassuring. Known long-term issues include gallbladder disease, low risk of pancreatitis, and the unconfirmed thyroid C-cell tumor signal from rodent studies. Cardiovascular outcomes are favorable, with reduced events in multiple large trials.

Can I switch from one GLP-1 to another?

Yes, and switching is common, usually from a less effective agent to a more effective one, or from a discontinued or out-of-stock product to an available one. Your prescriber will adjust the starting dose based on what you were tolerating previously.