A
Class-leading
Oral division · GLP-1 mono
Oral semaglutide 25 mg
Novo Nordisk · once daily
Approved
Division standing
#1 of 2
the oral frontier
← Tolerability cost (bands)% body weight lost →
Clean011% vs placebo
Tolerability: the cost
Clean6.9% vs 5.9% placebo
AE-discontinuation +1 point, at the 25 mg daily. From OASIS-4.
Efficacy: the frontier
11%25 mg · placebo-adjusted · 64 wk
OASIS-4: 13.6% vs 2.2% placebo, an 11-point gap on the treatment policy estimand.
A higher 50 mg dose, not approved, reached 12.7% in OASIS-1; the extra loss brings a little more GI dropout, enough to move it from Clean to Mild. The board scores the approved 25 mg.
The strongest and gentlest pill. Its only real ask is an empty stomach.
The fasting requirement is a property of the oral peptide formulation, not the brand.
Convenience profile: you weigh it, not us
Route
Oral pill
Frequency
Once daily
Food / water rule
Must take fasting: empty stomach, limited water, wait before eating
Titration
Stepwise dose escalation
Storage
Room temperature
Provenance: every number traces back
TrialOASIS-4 · NCT05564117
Estimandtreatment policy estimand
Populationnon-diabetic obesity
Dose25 mg daily
SourceOASIS-4, NEJM 2026; FDA approval (Wegovy oral 25 mg), 22 Dec 2025
Verdict confirmed6 Jul 2026
Compare Oral semaglutide 25 mg against:RetatrutideTirzepatideCagriSemaSemaglutideSurvodutideOrforglipron