Switching From Wegovy Injections to Foundayo

As Foundayo tablets become available in the UK, many patients currently using Wegovy injections are asking whether they can switch from a once-weekly semaglutide injection to a once-daily orforglipron tablet.

However, Wegovy and Foundayo contain different active ingredients and there is no manufacturer-approved dose-for-dose conversion guide between the two medicines.

This means that switching should always take place following an individual clinical assessment.

At Pharmulous, our prescribing clinicians consider your current Wegovy dose, treatment history, tolerability, weight-management progress and the time since your last injection before recommending an appropriate Foundayo starting dose.

Can You Switch From Wegovy to Foundayo?

Some patients who are already established on Wegovy may be suitable for switching to Foundayo tablets following clinical review.

There are several reasons why someone may consider moving from an injection to a tablet, including:

• Preference for a tablet rather than an injection
• Needle anxiety
• A preference for incorporating treatment into a daily routine
• Easier storage and travel
• Long-term treatment planning
• Looking for an alternative option during weight maintenance
• Cost considerations

However, Foundayo is not simply Wegovy in tablet form.

The two medicines contain different active ingredients and their doses are not directly interchangeable.

Treatment decisions should take into account:

• Your current Wegovy dose
• How long you have been taking that dose
• When you took your last injection
• Any gaps in treatment
• Your response to Wegovy
• Side effects and tolerability
• Your current weight and weight-management goals
• Your medical history
• Other medicines you take

Wegovy vs Foundayo: What's the Difference?

Wegovy contains semaglutide and is administered as a once-weekly injection.

Semaglutide acts on GLP-1 receptors and helps regulate appetite and food intake.

Foundayo contains orforglipron, which is also a GLP-1 receptor agonist but is taken as a once-daily tablet.

Although both medicines act on the GLP-1 receptor, they are different medicines with different formulations, dosing schedules and pharmacological characteristics.

Foundayo should therefore not be viewed as a direct oral equivalent of a particular Wegovy dose.

Both medicines are prescription-only treatments and are used alongside appropriate dietary and lifestyle measures.

Pharmulous Wegovy to Foundayo Switching Guide

The table below outlines the switching approach currently used by Pharmulous clinicians for selected patients who are established and tolerating Wegovy treatment.

Important information about this switching guide

This table is a Pharmulous clinical switching guide and not a manufacturer-approved dose-equivalence chart.

The licensed Foundayo initiation schedule starts at:

• 0.8 mg once daily
• followed, where clinically appropriate, by 2.5 mg → 5.5 mg → 9 mg → 14.5 mg → 17.2 mg with at least 30 days at each dose before further escalation.

Starting Foundayo above 0.8 mg therefore differs from the standard licensed initiation schedule and requires an individual prescribing decision.

The purpose of the Pharmulous switching guide is to take into account a patient's recent GLP-1 exposure and demonstrated treatment tolerability, rather than treating every established Wegovy patient as though they were completely new to GLP-1 treatment.

What Evidence Is There for Switching From Wegovy to Foundayo?

An important study called ATTAIN-MAINTAIN, published in Nature Medicine in 2026, directly investigated the transition from injectable weight-management treatment to oral orforglipron.

One group of participants had previously completed 72 weeks of semaglutide treatment during the SURMOUNT-5 trial.

Those patients were established on either:

• semaglutide 1.7 mg weekly, or
• semaglutide 2.4 mg weekly.

Rather than restarting orforglipron at its lowest study dose, participants allocated to oral treatment began directly at 12 mg of the investigational orforglipron capsule.

The Foundayo product information confirms that:

12 mg investigational orforglipron capsule = Foundayo 9 mg tablet equivalent.

This means that the study provides direct clinical evidence for selected patients already established and tolerant on Wegovy 1.7 mg or 2.4 mg transitioning to the equivalent of Foundayo 9 mg once daily.

Importantly, the study did not directly investigate every Wegovy dose.

Therefore:

Direct ATTAIN-MAINTAIN evidence

• Wegovy 1.7 mg → Foundayo 9 mg
• Wegovy 2.4 mg → Foundayo 9 mg

Pharmulous clinical extrapolation

• Wegovy 1 mg → Foundayo 5.5 mg
• Wegovy 0.25 mg → Foundayo 0.8 mg
• Wegovy 0.5 mg → Foundayo 2.5 mg
• Wegovy 7.2 mg → Foundayo 9 mg

The lower-dose recommendations follow a cautious stepwise approach based on previous GLP-1 exposure and tolerability rather than proven dose equivalence.

What About Wegovy 7.2 mg?

Wegovy 7.2 mg once weekly is now an additional UK maintenance dose for weight management in adults with obesity where clinically required.

Patients reach the standard 2.4 mg maintenance dose first, and treatment may then be increased to 7.2 mg after at least four weeks at 2.4 mg where clinically appropriate.

However, Wegovy 7.2 mg was not studied in ATTAIN-MAINTAIN.

For this reason:

Wegovy 7.2 mg → Foundayo 9 mg should be considered clinical extrapolation rather than a trial-proven conversion.

Pharmulous currently uses 9 mg as the maximum proposed Foundayo starting dose when switching from established injectable treatment.

Patients should not routinely commence directly at Foundayo 14.5 mg or 17.2 mg simply because they have previously used higher-dose injectable treatment.

How Long Can the Gap Be Between Wegovy and Foundayo?

This is an important part of the Pharmulous switching pathway.

The switching table above is intended for patients who are currently established on Wegovy and have not had a gap of more than 14 days since their last injection.

In ATTAIN-MAINTAIN, the first dose of orforglipron was intended to be administered within 14 days of the patient's final injectable treatment.

For this reason, Pharmulous would not routinely apply the higher-dose switching pathway where more than 14 days have passed since the patient's last Wegovy injection.

In practical terms:

Up to 14 days since your last Wegovy injection:

The Pharmulous switching pathway may be considered, subject to clinical assessment and good tolerability of your previous treatment.

More than 14 days since your last Wegovy injection:

The switching table should not automatically be applied. Your treatment history and circumstances will need to be reviewed and a lower Foundayo starting dose may be recommended.

If the date of your last dose cannot be confirmed:

A clinician may recommend starting at a lower Foundayo dose.

The longer the interruption from GLP-1 treatment, the less confidently previous treatment tolerance can be assumed.

When Should I Take My First Foundayo Tablet?

For patients switching directly from Wegovy, Foundayo would commonly be started around the time the next weekly Wegovy injection would normally have been due.

For example:

If you take your final Wegovy injection on a Monday, you may be advised to start Foundayo approximately the following Monday.

This approximately seven-day interval is a practical switching approach based around Wegovy's weekly dosing schedule.

However, it is important to distinguish this from the clinical-trial evidence.

ATTAIN-MAINTAIN did not establish seven days as a mandatory washout period.

The study instead intended participants to commence orforglipron within 14 days of their final injectable dose.

The exact timing of your first Foundayo tablet should therefore be confirmed by your prescribing clinician.

Do I Need to Start Foundayo at 0.8 mg?

Not necessarily if you are already established and tolerating GLP-1 treatment, but this requires an individual clinical assessment.

For someone starting Foundayo without recent GLP-1 treatment, the licensed starting dose is:

• Foundayo 0.8 mg once daily.

However, patients who have already demonstrated good tolerance to Wegovy may be considered differently.

ATTAIN-MAINTAIN provides direct evidence that selected patients established on semaglutide 1.7 mg or 2.4 mg could transition directly to the equivalent of Foundayo 9 mg without first progressing through every lower Foundayo dose.

The study reported that the transition was generally well tolerated.

This does not mean every patient taking Wegovy should automatically start Foundayo at a higher dose.

Your prescriber will consider:

• Your current Wegovy dose
• How long you have been established on that doseYour date of last injection
• Whether treatment has been continuous
• How well you tolerate Wegovy
• Any current nausea, vomiting, diarrhoea or constipation
• Your current weight and weight trajectory
• Your medical history
• Other medicines you take

If there are concerns about tolerability or there has been a significant treatment interruption, a lower Foundayo starting dose may be more appropriate.

What If I Have Side Effects on Wegovy?

Previous dose does not override tolerability.

For example, a patient taking Wegovy 1.7 mg who is experiencing significant nausea or vomiting would not automatically be considered suitable to start Foundayo 9 mg simply because the switching table suggests that dose.

A prescribing clinician may recommend:

• starting one or more Foundayo dose levels lower;
• delaying the switch until symptoms resolve; or
• using the standard Foundayo 0.8 mg initiation pathway.

The switching table should therefore always be used alongside clinical judgement.

What Should I Expect After Switching?

Although Wegovy and Foundayo both act on GLP-1 receptors, they are different medicines and you may notice some changes following the switch.

These could include temporary differences in:

• Appetite suppression
• Hunger
• Food cravings
• Feelings of fullness
• Gastrointestinal symptoms
• Weight-loss rate
• Weight stability during maintenance

A change in appetite during the first few weeks does not necessarily mean that the new treatment is ineffective.

It can take time for your body to adjust to a different medicine and dosing schedule.

Can Foundayo Help With Weight Maintenance After Wegovy?

This is particularly relevant because ATTAIN-MAINTAIN was specifically designed to investigate this question.

Participants had already achieved significant weight loss following injectable treatment and were then switched either to oral orforglipron or placebo.

Among participants previously treated with semaglutide who had reached a weight plateau:

Orforglipron maintained approximately 79% of their previous weight reduction after 52 weeks.

By comparison, those switched to placebo maintained approximately 38%.

This provides encouraging evidence that continuing incretin treatment with oral orforglipron can help preserve a substantial proportion of weight loss previously achieved with injectable semaglutide.

However, these are average study results and individual responses vary.

Weight maintenance should also involve ongoing attention to diet, physical activity, muscle preservation and other healthy lifestyle measures.

What Are the Common Side Effects of Foundayo?

Like other GLP-1 receptor agonists, Foundayo can cause gastrointestinal side effects.

These may include:

• Nausea
• Vomiting
• Diarrhoea
• Constipation
• Indigestion
• Abdominal discomfort

Patients already established on Wegovy may have developed some tolerance to GLP-1-related gastrointestinal effects, but this should never be assumed.

In ATTAIN-MAINTAIN, gastrointestinal events including nausea, vomiting or diarrhoea occurred in approximately 9.5% of patients in the semaglutide cohort during the first four weeks after transition.

Most gastrointestinal adverse events were mild to moderate.

Our Clinical Approach at Pharmulous

At Pharmulous, we do not believe switching treatment should simply involve matching one number to another.

Our clinicians assess every patient individually.

When considering a switch from Wegovy to Foundayo, we look at:

• Current treatment and dose
• Evidence of recent treatment
• Date of the last Wegovy injection
• Duration on the current dose
• Treatment gaps
• Previous side effects and tolerability
• Current weight and weight-management progress
• Treatment goals
• Maintenance requirements
• Medical history and other medication

Our approach continues to focus on finding the lowest effective and well-tolerated dose that supports the patient's individual weight-management goals.

If you are considering switching treatment, or wondering whether your current treatment is still the right fit for you, send us a message through the patient portal.

One of our prescribing clinicians will be happy to talk you through the available options and help you decide on the most appropriate next step for your individual needs.

Key Takeaways

• Some established Wegovy patients may be suitable for switching to Foundayo tablets.
• Wegovy and Foundayo are different medicines and there is no direct mg-for-mg conversion.
• Pharmulous uses a clinician-led switching pathway taking previous treatment exposure and tolerability into account.
• The standard licensed Foundayo starting dose is 0.8 mg once daily.
• Starting above 0.8 mg requires an individual prescribing decision.
• ATTAIN-MAINTAIN provides direct switching evidence for patients previously established on Wegovy 1.7 mg or 2.4 mg.
• The lower-dose Wegovy recommendations are clinical extrapolations rather than trial-proven dose conversions.
• Wegovy 7.2 mg → Foundayo 9 mg is also clinical extrapolation because Wegovy 7.2 mg was not studied in ATTAIN-MAINTAIN.
• 9 mg is the maximum Foundayo starting dose within the Pharmulous switching pathway.
• The higher-dose switching pathway should generally only be considered where the last Wegovy injection was within the previous 14 days.
• Patients with a gap longer than 14 days require individual review and may need a lower Foundayo starting dose.
• Good tolerability of the previous treatment is essential when considering an accelerated switch.
• The exact Foundayo starting dose and timing should always be confirmed by a qualified prescribing clinician.

References

• Aronne LJ, Horn DB, le Roux CW, et al. Orforglipron for maintenance of body weight reduction: the double-blind, randomized phase 3b ATTAIN-MAINTAIN trial. Nature Medicine. 2026;32:2679–2687.
• https://www.nature.com/articles/s41591-026-04386-7
• Eli Lilly and Company Limited. Foundayo (orforglipron) Summary of Product Characteristics. Electronic Medicines Compendium. 2026.
• https://www.medicines.org.uk/emc/product/102530/smpc
• Novo Nordisk Limited. Wegovy (semaglutide) Summary of Product Characteristics. Electronic Medicines Compendium.
• https://www.medicines.org.uk/emc/product/13803/smpc
• Novo Nordisk Limited. Wegovy 7.2 mg Summary of Product Characteristics. Electronic Medicines Compendium. 2026.
• https://www.medicines.org.uk/emc/product/102093/smpc
• Medicines and Healthcare products Regulatory Agency (MHRA). GLP-1 medicines for weight loss and diabetes: information for patients and healthcare professionals.