Foundayo vs Zepbound

The short answer

Zepbound produced more weight loss on average in its trial, and it is also approved for obstructive sleep apnea with obesity ^{[2] [3]}. Foundayo is a pill with no injections, no food rules and a lower self-pay price at most doses ^{[1] [4]}. The trials were separate, so the numbers are not a direct contest. Single-drug guides: Foundayo and Zepbound.

Foundayo vs Zepbound side by side

Foundayo vs Zepbound, label and price facts as of Oct 24 2026

	Foundayo	Zepbound
Active ingredient	Orforglipron, a GLP-1 receptor agonist [1]	Tirzepatide, a GIP and GLP-1 receptor agonist [2]
Maker	Eli Lilly [1]	Eli Lilly [2]
Approved for	Weight reduction and long-term maintenance in adults with obesity, or overweight with a related condition [1]	Same, plus moderate to severe sleep apnea in adults with obesity [2]
How taken	Once daily, with or without food; swallow whole [1]	Once weekly injection, any time of day, with or without meals [2]
Dose steps	0.8 mg, then 2.5 mg and 5.5 mg after at least 30 days each; then 9, 14.5 or 17.2 mg [1]	2.5 mg for 4 weeks, then 2.5 mg steps after at least 4 weeks; maintenance 5, 10 or 15 mg [2]
Missed dose	Take as soon as possible; do not double. After 7 or more missed doses, restart at a lower dose [1]	Take within 4 days; otherwise skip and resume [2]
Average weight loss, 72 weeks	7.4% (5.5 mg), 8.3% (9 mg), 11.1% (17.2 mg) vs 2.1% placebo [1]	15.0% (5 mg), 19.5% (10 mg), 20.9% (15 mg) vs 3.1% placebo [3]
Stopped for side effects	8% overall (10% at 17.2 mg) vs 3% placebo [1]	4.8% to 6.7% by dose vs 3.4% placebo [2]
Nausea	26% to 35% vs 10% placebo [1]	25% to 29% vs 8% placebo [2]
Birth control pills	Switch or add a barrier method for 30 days after starting and each dose increase [1]	Same advice for 4 weeks after starting and each dose increase [2]
Storage	Room temperature, 68 to 77 F [1]	See tirzepatide storage
LillyDirect self-pay	$149 (0.8, 2.5 mg), $199 (5.5 mg), $299 (9, 14.5, 17.2 mg) [4]	$299 (2.5 mg), $399 (5 mg), $449 (7.5 to 15 mg) [5]
Savings card, plan covers it	As little as $25; $1,000 a year cap; 10 fills [6]	As little as $25; $1,300 a year cap; 13 fills (pen) [7]
Medicare GLP-1 Bridge	Covered, $50 copay if eligible [8]	KwikPen only, $50 copay if eligible [8]

Which works better for weight loss?

No trial has compared them directly. In Foundayo's label trial of adults without diabetes, average loss at 72 weeks was 11.1% on 17.2 mg, 9.0 points more than placebo ^[1]. In SURMOUNT-1, Zepbound 15 mg averaged 20.9% at 72 weeks against 3.1% on placebo ^[3]. The trials enrolled different people, so treat the gap as a rough guide only. These are averages; individual results vary. More on Zepbound results and Foundayo vs Wegovy pill.

Cost over a year

At the top dose on self-pay with on-time refills, Foundayo is $299 a month and Zepbound $449 ^{[4] [5]}. Lilly counts a Foundayo month as 30 days and a Zepbound month as 28 days, so a year is about 12 Foundayo fills and 13 Zepbound fills ^{[4] [5]}. That is roughly $3,600 a year for Foundayo and $5,840 for Zepbound at those prices. Full details: Foundayo savings card, Zepbound savings card and Zepbound cost.

Side effects and warnings

Both mostly cause stomach side effects: nausea, diarrhea, vomiting and constipation ^{[1] [2]}. Both carry a boxed warning about thyroid C-cell tumors. Zepbound's is based on rodent tumors; Foundayo's notes that other GLP-1 drugs caused them in rodents, while orforglipron is not active in rodents, so the human relevance is not known ^{[1] [2]}. Neither is for people with a personal or family history of medullary thyroid carcinoma or MEN 2. Foundayo is not recommended in severe liver impairment ^[1]. See GLP-1 side effects.

Switching between them

Neither label gives a conversion from one to the other. Foundayo's label starts everyone at 0.8 mg, and says using it with another GLP-1 receptor agonist is not recommended ^[1]. Zepbound's label starts at 2.5 mg ^[2]. Your prescriber sets the plan; see switching GLP-1s.

Clean-rated programs that prescribe both

1. LifeMD

   Clean

   Good fit for: brand Wegovy or Zepbound with insurance help

   PriceProgram fee $39 first month, then $149/mo; Zepbound vial from $299; Foundayo price not posted (checked Oct 24 2026) ^[10]

   What you get

   Brand GLP-1s with a pharmacy benefit check

   FDA record

   No warning letter on our tracker

   BBB

   Not yet confirmed

   Note

   See our LifeMD review.

   Visit LifeMDon the LifeMD website

2. Ro (Ro Body Program)

   Clean

   Good fit for: brand drugs with prior authorization help

   PriceFoundayo $149 to $299/mo; Zepbound KwikPen $299 to $449/mo; membership $39 first month, then $74 to $149/mo (checked Oct 24 2026) ^[9]

   What you get

   FDA-approved brand GLP-1s only

   FDA record

   No warning letter on our tracker

   BBB

   Not yet confirmed

   Note

   See our Ro review.

   Visit Ro (Ro Body Program)on the Ro website

See Ro priceson the Ro website