The Medicines and Healthcare products Regulatory Agency (MHRA) has approved two prescription weight loss tablets for use in the UK - Wegovy and Foundayo. Both can aid weight loss, but they differ in how they are taken.
Wegovy: approval and eligibility
Wegovy has been available as an injection for some time, but the semaglutide tablet only received approval for use in June. According to the MHRA, the tablet may now be prescribed to adults in the UK with obesity, who have a Body Mass Index (BMI) of 30 or above, or who are overweight with a BMI between 27 and 30 and at least one weight-related comorbidity. This must be alongside a reduced-calorie diet and increased physical activity.
The starting dose is 1.5 mg once daily, increasing to 4 mg, 9 mg and 25 mg, with a minimum duration of one month at each dose level. Patients currently treated privately with a 2.4 mg semaglutide injection once weekly can be transitioned straight to semaglutide 25 mg tablets once daily.
How to take Wegovy and side effects
The tablet should be swallowed whole on an empty stomach following a fast of at least 8 hours, taken with a small sip of water. Nothing should be eaten or drunk for at least thirty minutes afterwards, as consuming food or drink within 30 minutes of taking the tablet significantly reduces its absorption. The MHRA confirmed that the most frequently reported side effects are gastrointestinal complaints, including nausea, diarrhoea, constipation and vomiting.
Like all GLP-1 receptor agonists, this is a prescription-only medicine. It is not yet available on the NHS, as it still requires an assessment and recommendation from the National Institute for Health and Care Excellence (NICE) before it can be funded and made widely available.
Foundayo: approval and eligibility
In August, the MHRA granted authorisation for orforglipron, Foundayo, making the UK the first country in Europe to approve this GLP-1 tablet for both weight management and type 2 diabetes. When used alongside a reduced-calorie diet and increased physical activity, orforglipron is authorised for weight loss and weight maintenance in adults in the UK with a BMI of 30 or above, or a BMI of between 27 and 30 with at least one weight-related comorbidity. It is also authorised to help improve glycaemic control in patients whose type 2 diabetes is insufficiently managed.
How to take Foundayo and side effects
There is one notable distinction between Wegovy and Foundayo in terms of how each medication is administered. While Wegovy comes with strict usage guidelines, the orforglipron tablet is taken once daily and can be consumed at any time of day, with no restrictions on food or water intake. Treatment commences at 0.8 mg, increasing through 2.5 mg, 5.5 mg, 9 mg, 14.5 mg, and 17.2 mg, with a minimum of one month spent at each dose level.
According to the MHRA, the most common side effects reported by those taking orforglipron include nausea, constipation, diarrhoea, vomiting, dyspepsia (indigestion), and abdominal pain. Much like Wegovy, orforglipron is a GLP-1 receptor agonist and is therefore only available via prescription. It has not yet been made available on the NHS, as it is still undergoing evaluation by NICE, though a decision is anticipated on November 18.
