Switching From Wegovy Tablets to Foundayo

With more oral GLP-1 treatments now available in the UK, patients taking Wegovy tablets may be wondering whether they can switch to Foundayo (orforglipron) tablets.

However, although Wegovy tablets and Foundayo are both oral GLP-1 treatments, they contain different active ingredients and there is currently no manufacturer-approved dose-for-dose conversion guide between them.

Wegovy tablets contain semaglutide.

Foundayo contains orforglipron.

This means that switching is not simply a case of exchanging one tablet strength for another.

At Pharmulous, our prescribing clinicians consider your current Wegovy tablet dose, how long you have been taking treatment, tolerability, treatment continuity, current weight and individual weight-management goals before deciding whether a switch is clinically appropriate.

Can You Switch From Wegovy Tablets to Foundayo?

Some patients who are already established and tolerating Wegovy tablets may be suitable for switching to Foundayo following an individual clinical assessment.

There are several reasons someone may consider changing oral GLP-1 treatment, including:

• Treatment effectiveness
• Appetite or craving control
• Side effects and tolerability
• Weight-maintenance goals
• Convenience of administration
• Treatment cost
• Personal preference
• Long-term treatment planning

However, Wegovy tablets and Foundayo are different medicines, even though they both act on GLP-1 receptors.

Any switch should therefore be supervised by an appropriately qualified prescribing clinician.

Wegovy Tablets vs Foundayo: What's the Difference?

Wegovy tablets contain semaglutide, a GLP-1 receptor agonist.

The licensed Wegovy tablet dose-escalation pathway is:

• 1.5 mg → 4 mg → 9 mg → 25 mg once daily
• with a minimum of one month at each dose level before escalation where appropriate.

Foundayo contains orforglipron, another GLP-1 receptor agonist taken once daily.

The licensed Foundayo dose-escalation pathway is:

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

Although both medicines target GLP-1 receptors, the numbers on the tablets cannot be compared directly.

For example, Wegovy 9 mg is not equivalent to Foundayo 9 mg.

The active ingredients have different pharmacological properties, formulations and absorption characteristics.

Pharmulous Wegovy Tablets to Foundayo Switching Guide

For selected patients who are established and tolerating Wegovy tablets, Pharmulous clinicians may consider the following starting-dose pathway:

Important information about this switching guide

There is currently no clinical trial that has directly tested each of these specific Wegovy tablet-to-Foundayo starting doses.

The recommendations therefore take into consideration:

• Previous GLP-1 exposure
• Current Wegovy tablet dose
• Duration on treatment
• Demonstrated tolerability
• Treatment continuity
• Individual clinical circumstances

The licensed Foundayo starting dose for a patient initiating treatment is 0.8 mg once daily.

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

Is There Research Comparing Oral Semaglutide and Orforglipron?

Yes, although it is important to understand what that research does — and does not — tell us.

The Phase 3 ACHIEVE-3 study compared once-daily oral orforglipron directly with oral semaglutide.

The study involved adults with type 2 diabetes who were taking metformin.

Participants were randomly assigned to oral orforglipron or oral semaglutide and followed for 52 weeks.

The trial showed that orforglipron was an effective oral GLP-1 receptor agonist and produced clinically meaningful improvements in blood glucose and body weight.

However, ACHIEVE-3 was not a switching study.

Patients were not established on Wegovy tablets and then transferred to Foundayo.

It also studied oral semaglutide doses used in a diabetes setting rather than the current UK Wegovy tablet obesity pathway of 1.5 mg, 4 mg, 9 mg and 25 mg.

Therefore, ACHIEVE-3 supports the clinical evidence behind oral orforglipron but does not provide a dose-conversion table from Wegovy tablets to Foundayo.

What Evidence Supports Wegovy 25 mg to Foundayo 9 mg?

Of the proposed Pharmulous conversions, the 25 mg Wegovy tablet → 9 mg Foundayo pathway has the strongest indirect rationale.

The Wegovy product information shows that oral semaglutide 25 mg provides systemic exposure suitable for weight management and that patients established on Wegovy injection 2.4 mg can be transitioned to Wegovy tablets 25 mg.

Separately, the ATTAIN-MAINTAIN study investigated patients established on injectable semaglutide 1.7 mg or 2.4 mg weekly who transitioned to orforglipron.

Those patients commenced an investigational 12 mg orforglipron capsule.

The Foundayo product information confirms that:

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

This provides useful indirect clinical support when considering Foundayo 9 mg in a patient established and tolerating the highest Wegovy tablet dose.

However, this is still not the same as a clinical trial directly studying:

Wegovy tablet 25 mg → Foundayo 9 mg.

The distinction is important.

What About the Lower Wegovy Tablet Doses?

The proposed Pharmulous pathway is:

• Wegovy 1.5 mg → Foundayo 0.8 mg
• Wegovy 4 mg → Foundayo 2.5 mg
• Wegovy 9 mg → Foundayo 5.5 mg

These represent a cautious stepwise clinical approach based on previous GLP-1 exposure.

They should be regarded as clinical extrapolations rather than proven dose equivalents.

The first transition is particularly conservative because a patient taking Wegovy 1.5 mg would commence Foundayo at its normal licensed initiation dose of 0.8 mg.

As previous Wegovy exposure increases, a clinician may consider a higher Foundayo starting dose where treatment has been continuous and well tolerated.

How Long Should I Wait Between Wegovy Tablets and Foundayo?

At Pharmulous, our proposed switching pathway uses a 7-day interval between the final Wegovy tablet and the first Foundayo tablet.

For example:

If your final Wegovy tablet is taken on a Monday, Foundayo would usually be commenced approximately the following Monday, subject to confirmation by your prescribing clinician.

Why does Pharmulous use 7 days?

Semaglutide has an elimination half-life of approximately one week.

For patients established on Wegovy tablets, Pharmulous uses a seven-day interval as a conservative clinical switching approach designed to reduce unnecessary overlap in the pharmacological effects of two GLP-1 receptor agonists.

However, it is important to be clear about the evidence:

Seven days has not been established by a clinical trial as the required washout period when switching specifically from Wegovy tablets to Foundayo.

It is a Pharmulous clinical policy rather than a manufacturer-approved switching instruction.

Semaglutide also remains within the circulation for considerably longer than seven days. The Wegovy product information states that, because of its approximately one-week half-life, semaglutide may remain in circulation for around 5–7 weeks after the final 25 mg tablet.

Therefore, the seven-day interval should not be interpreted as meaning that semaglutide has completely left the body.

The exact timing of a switch should always be confirmed by the prescribing clinician.

What If I Have Already Had a Break From Wegovy Tablets?

The switching table is designed for patients who are currently established on Wegovy tablets and have been taking treatment consistently.

If you have already stopped Wegovy tablets, the suggested conversion should not automatically be applied.

The clinician will need to consider:

• Your last Wegovy tablet dose
• The date you last took it
• The length of the treatment interruption
• How long you had been established on that dose
• Previous side effects
• Current appetite and weight
• Your overall clinical circumstances

A longer treatment interruption may mean that previous gastrointestinal tolerance can no longer safely be assumed.

In that situation, a lower Foundayo starting dose may be more appropriate.

Do I Have to Start Foundayo at 0.8 mg?

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

• 0.8 mg once daily.

However, patients already established and tolerating GLP-1 treatment may be considered differently following clinical assessment.

The Pharmulous switching pathway therefore takes previous treatment exposure into account.

This does not mean that everyone taking a particular Wegovy dose will automatically receive the corresponding Foundayo dose.

The prescriber may recommend a lower starting dose depending on:

• Side effects
• Treatment gaps
• Duration on the current dose
• Weight trajectory
• Medical history
• Other medication
• Individual risk factors

Clinical history always takes priority over the switching table.

What If I Have Side Effects on Wegovy Tablets?

Previous dose does not automatically mean you are suitable for the corresponding Foundayo starting dose.

For example, someone taking Wegovy 25 mg who is experiencing significant nausea, vomiting, diarrhoea or poor oral intake should not automatically start Foundayo 9 mg simply because the table suggests this dose.

The clinician may instead recommend:

• A lower Foundayo starting dose
• Delaying the switch until symptoms settle
• The standard Foundayo 0.8 mg initiation pathway
• An alternative treatment strategy

The aim is always to find a treatment and dose that is both effective and well tolerated.

How Is Foundayo Taken?

One practical difference between Wegovy tablets and Foundayo is how the tablets are taken.

Wegovy tablets need to be taken:

• On an empty stomach
• Following a fasting period of at least 8 hours
• With a small amount of water
• Whole, without crushing or chewing
• With at least 30 minutes before food, drink or other oral medicines

Foundayo has a different administration routine and can be taken once daily without the same food and water restrictions.

For some patients, this may make Foundayo easier to incorporate into everyday life.

What Should I Expect After Switching?

Although both treatments act on GLP-1 receptors, they are different medicines.

You may therefore notice temporary changes in:

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

This does not necessarily mean the new medication is ineffective.

It may take time for appetite and gastrointestinal effects to settle following a switch.

Can Foundayo Support Weight Maintenance?

Yes.

Foundayo is licensed for weight management, including weight loss and weight maintenance, in eligible adults.

There is also encouraging research supporting orforglipron following successful weight loss with injectable GLP-1-based treatment.

The ATTAIN-MAINTAIN study found that people who continued treatment with oral orforglipron maintained substantially more of their previous weight reduction than people who stopped active treatment and received placebo.

Although ATTAIN-MAINTAIN did not study patients switching directly from Wegovy tablets, it provides useful evidence supporting orforglipron as a potential longer-term oral weight-management treatment.

Individual results will vary.

What Are the Common Side Effects of Foundayo?

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

These can include:

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

Previous tolerance of Wegovy may be helpful when assessing a switch, but it does not guarantee that Foundayo will be tolerated at the same level.

This is why the patient's previous treatment experience forms an important part of the prescribing assessment.

Our Clinical Approach at Pharmulous

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

Our clinicians assess each patient individually.

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

• Current Wegovy tablet dose
• Evidence of recent treatment
• Duration on the current dose
• Date of the last dose
• Any treatment interruptions
• Previous side effects and tolerability
• Current weight and weight trajectory
• Weight-loss or maintenance goals
• Medical history
• Other medicines

Our approach remains focused on finding the lowest effective and well-tolerated dose that supports the patient's individual weight-management needs.

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

One of our prescribing clinicians will be happy to review your treatment history, explain the available options and help determine the most appropriate next step for you.

Key Takeaways

• Some patients established on Wegovy tablets may be suitable for switching to Foundayo.
• Wegovy tablets and Foundayo are different medicines despite both acting on GLP-1 receptors.
• There is no manufacturer-approved mg-for-mg conversion guide between them.
• The Pharmulous proposed switching pathway is:
  Wegovy 1.5 mg → Foundayo 0.8 mg
  Wegovy 4 mg → Foundayo 2.5 mg
  Wegovy 9 mg → Foundayo 5.5 mg
  Wegovy 25 mg → Foundayo 9 mg
• Foundayo's licensed starting dose remains 0.8 mg once daily.
• Starting Foundayo above 0.8 mg requires an individual prescribing decision.
• The proposed dose pathway is based on previous GLP-1 exposure and clinical extrapolation rather than direct dose-equivalence studies.
• Pharmulous applies a 7-day interval after the final Wegovy tablet before starting Foundayo as a conservative clinical switching policy.
• The 7-day interval has not been established as a required washout period in a Wegovy-tablet-to-Foundayo clinical trial.
• Patients with an existing treatment interruption or poor tolerability should not automatically follow the switching table.
• The exact starting dose and timing should always be confirmed by a qualified prescribing clinician.

References

• Novo Nordisk Limited. Wegovy 1.5 mg, 4 mg, 9 mg and 25 mg tablets — Summary of Product Characteristics. Electronic Medicines Compendium. 2026.
• Eli Lilly and Company Limited. Foundayo (orforglipron) — Summary of Product Characteristics. Electronic Medicines Compendium. 2026.
• Rosenstock J, Yabe D, et al. Efficacy and safety of once-daily oral orforglipron compared with oral semaglutide in adults with type 2 diabetes (ACHIEVE-3): a multinational, multicentre, non-inferiority, open-label, randomised, phase 3 trial. The Lancet. 2026.
• Aronne LJ, Horn DB, le Roux CW, et al. Orforglipron for maintenance of body weight reduction: the double-blind, randomised Phase 3b ATTAIN-MAINTAIN trial. Nature Medicine. 2026.
• Medicines and Healthcare products Regulatory Agency (MHRA). GLP-1 medicines for weight loss and diabetes: information for patients and healthcare professionals.