Is amycretin approved or available?

No. As of mid-2026, amycretin, also called zenagamtide, is investigational and early-stage. Its weight-loss data come from phase 1 and phase 2 trials, and its larger phase 3 program in obesity only began in 2026. It has not been approved by the FDA and is not available to prescribe. The drugs used in practice today are the approved GLP-1 and dual-agonist medications.

Is amycretin approved or available?

No. As of mid-2026, amycretin, also called zenagamtide, is investigational and early-stage. Its weight-loss data come from phase 1 and phase 2 trials, and its larger phase 3 program in obesity only began in 2026. It has not been approved by the FDA and is not available to prescribe. The drugs used in practice today are the approved GLP-1 and dual-agonist medications.

Amycretin: Novo Nordisk's Amylin/GLP-1 Drug, in a Pill and a Shot | Philadelphia

TL;DR30-second take

Amycretin, recently given the name zenagamtide, is an investigational and early-stage weight-loss drug from Novo Nordisk. It is a single molecule that activates two receptors at once: GLP-1, the familiar appetite hormone, and amylin, a satiety hormone released with insulin. It is being developed in two forms, a weekly injection and, unusually, a daily pill. In small early trials, the injection produced about 22% weight loss at one dose and up to about 24% at the highest over 36 weeks, and the pill produced about 13% over 12 weeks. Those numbers are promising but preliminary: they come from phase 1 and phase 2 trials with about 125 and 144 people, well short of the large phase 3 trials that establish how well and how safely a drug works. Its larger phase 3 program only began in 2026, and it is not approved or available.

TL;DR: Amycretin, recently given the name zenagamtide, is an investigational drug from Novo Nordisk, and it is early. It is a single molecule that activates two receptors at once: GLP-1, the appetite hormone behind Ozempic and the rest of the class, and amylin, a different satiety hormone. Two features make it stand out. First, it is being built in both a weekly injection and a daily pill, and an effective oral version would be a meaningful convenience. Second, its early numbers are large: in a small phase 1b/2a trial the injection produced about 22% weight loss at a 20 mg dose and up to about 24% at the highest dose over 36 weeks, and in a phase 1 trial the pill produced about 13% over 12 weeks. The heavy caveat is that these come from small, short, early trials, a long way from the large phase 3 studies that settle how well and how safely a drug works. Its phase 3 program only began in 2026, and amycretin is not approved or available.

What is amycretin?

Amycretin is a once-weekly and, in a separate version, once-daily drug that mimics two of the body's appetite-regulating hormones through a single molecule. The first is GLP-1, the hormone that Ozempic, Wegovy, and the whole class act on, which quiets appetite and improves blood sugar. The second is amylin, a hormone released alongside insulin that signals fullness and slows how fast the stomach empties. Amycretin folds both actions into one molecule, so it is called a unimolecular co-agonist. Novo Nordisk, the maker, recently gave it the formal name zenagamtide, so the two names refer to the same drug.

It is helpful to place it next to a drug it resembles. CagriSema also combines amylin and GLP-1, but it does so with two separate molecules given together: cagrilintide for amylin and semaglutide for GLP-1. Amycretin builds both jobs into one molecule instead. That is not a small engineering difference, and it is part of why Novo is invested in it: a single molecule can be simpler to formulate, and it opened the door to an oral version.

As of mid-2026, amycretin is investigational, which means it is still being tested in trials and has not been approved by the FDA for any use.

How much weight did amycretin cause in early trials?

The early numbers are what drew attention, and they need to be read with their context attached.

The injectable version was tested in a phase 1b/2a trial, an early-stage study, in about 125 people at a single site.¹ Over 36 weeks, people on a 20 mg dose lost about 22% of their body weight, and those on the highest dose tested, 60 mg, lost up to about 24%, compared with little change on placebo. Those are large figures, in the range of the strongest drugs in development.

The oral version was tested in a first-in-human phase 1 trial in about 144 people.² At the highest dose, taken as a daily tablet, people lost about 13% of their body weight over 12 weeks, against about 1% on placebo. For a pill, and over only 12 weeks, that is a striking early result.

Here is the part that keeps this in proportion. Both trials are small, short, and early, phase 1 and phase 2 rather than phase 3. Early trials like these are designed mainly to check safety and find a dose rather than to establish how much weight a drug reliably produces, and their numbers often move once a drug reaches the large phase 3 trials that enroll thousands of people over a year or more. So the fair way to hold amycretin's figures is as promising early signals rather than settled efficacy. The drug that eventually reaches the market, if it does, may land higher or lower.

Why is an oral version a big deal?

Because the drugs that work best in this class are almost all injections, and many people would prefer a pill. GLP-1 and amylin are peptides, which the gut tends to break down, so making them work by mouth is difficult. Semaglutide has an oral form, Rybelsus, but it needs careful timing on an empty stomach and delivers less than the shot. Orforglipron is a true oral pill but works through GLP-1 alone and produces more modest weight loss.

An oral amycretin that delivers anywhere near its injectable numbers would be different, because it would pair a pill's convenience with two-hormone power. That is the prize Novo is chasing, and it is why the 13% over 12 weeks in the oral trial drew notice despite the trial's small size. It is worth stressing that the oral figure is very early, from a 12-week phase 1 study, so it is a proof of concept rather than a finished answer.

How is amycretin different from CagriSema, and why does that matter?

The two share the amylin-plus-GLP-1 idea, but they arrive at it differently, and the timing is part of the story.

CagriSema uses two molecules together and reached about 22.7% weight loss in its main phase 3 trial, a strong result that nonetheless came in below Novo's own target, and in a head-to-head it did not prove as good as tirzepatide. Those results were a disappointment for the company. Amycretin is widely seen as Novo's next major effort in obesity, built on the single-molecule design and the oral prospect. That framing, that amycretin is the bigger bet after CagriSema fell short of expectations, is how the industry reads it, though it is an expectation rather than anything the trials have proven. What amycretin has shown so far is early-phase promise rather than a phase 3 result, let alone a head-to-head win.

What are the limits and unknowns?

Several, and they are the heart of an honest read.

The biggest is stage. Everything known about amycretin's weight effect comes from phase 1 and phase 2 trials. Its large phase 3 program in obesity began only in 2026, and no phase 3 results exist yet. Until those read out, its effectiveness in practice and its safety at scale are not established. A drug can look strong in a 125-person study and shift when tested in thousands.

The side effects so far are the class's usual ones, centered on the gut: nausea, vomiting, and reduced appetite, mostly mild to moderate and concentrated during the weeks when the dose is raised. The early trials did not report an unexpected or organ-specific safety problem, which is reassuring as far as it goes, but these studies are too small and too short to call the drug safe in the settled way a large trial can. The right statement is that nothing alarming has appeared yet, with the caveat that the decisive safety test is still ahead.

Two more points of precision. Amycretin is also being studied separately for type 2 diabetes, and that program reported its own early data in 2026; the diabetes and obesity numbers should not be blended, since they come from different trials in different people. And none of amycretin's figures come from head-to-head trials against tirzepatide, retatrutide, or CagriSema, so any comparison to those drugs is across separate studies and should be read as a rough guide rather than a contest.

Guidance from the Clinic

"Amycretin is the drug patients bring up when they have read that a pill might one day match the shots, and the early data are interesting. What I make sure to say is how early it is. These are phase 1 and phase 2 numbers from a hundred-odd people, a long way from the large trials we rely on to know what a drug does, so I treat the 22% and the 13% as encouraging signals rather than promises. The two ideas worth holding onto are the single-molecule amylin and GLP-1 design, and the oral form, because a pill with that kind of power would change who can and will take these drugs. For now, none of it is approved or available, so I build plans around the drugs we have and keep an eye on this as its phase 3 trials, which started in 2026, begin to report. When they do, we will know a great deal more."

Key Takeaways

Amycretin, recently named zenagamtide, is an investigational and early-stage Novo Nordisk drug that activates the GLP-1 and amylin receptors through a single molecule, and it is not approved or available.
It is being developed in two forms, a weekly injection and a daily pill; an effective oral version would be unusual in a class dominated by injections.
In early trials, the injection produced about 22% weight loss at a 20 mg dose and up to about 24% at the highest dose over 36 weeks, and the pill about 13% over 12 weeks, but these come from small, short phase 1 and phase 2 studies and are preliminary.
It differs from CagriSema, which combines amylin and GLP-1 using two separate molecules; amycretin uses one, and is seen as Novo's next major bet after CagriSema fell short of expectations.
Its phase 3 program began only in 2026, with no phase 3 results yet, and its side effects so far are mainly gastrointestinal; its effectiveness and safety at scale are not yet established.

The New Weight-Loss Drugs, Compared - where amycretin sits in the whole field
CagriSema (Cagrilintide + Semaglutide) - the other amylin/GLP-1 drug, using two molecules
Orforglipron (Foundayo) - the oral GLP-1 pill already approved
Retatrutide: The Triple Agonist - the highest emerging weight loss
Survodutide (GLP-1/Glucagon) - the glucagon dual agonist built for the liver
Tirzepatide (Zepbound, Mounjaro) - the strongest approved drug in depth

Scientific References

Dahl K, Toubro S, Dey S, et al. "Amycretin, a Novel, Unimolecular GLP-1 and Amylin Receptor Agonist Administered Subcutaneously: Results from a Phase 1b/2a Randomised Controlled Study." The Lancet. 2025. DOI: 10.1016/S0140-6736(25)01185-7.
Gasiorek A, Heydorn A, Gabery S, et al. "Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of the First-in-Class GLP-1 and Amylin Receptor Agonist, Amycretin: A First-in-Human, Phase 1, Double-Blind, Randomised, Placebo-Controlled Trial." The Lancet. 2025. DOI: 10.1016/S0140-6736(25)01176-6.

Fishtown Medicine | Metabolism

2418 E York St, Philadelphia, PA 19125(267) 360-7927 hello@fishtownmedicine.comHSA/FSA Eligible

Start your intake

Frequently Asked Questions

Common Questions

In early trials, the injectable version produced about 22% weight loss at a 20 mg dose and up to about 24% at the highest dose over 36 weeks, in a study of about 125 people. The oral pill produced about 13% over 12 weeks, in a study of about 144 people. These are promising numbers, but they come from small, short, early-stage trials, so they are preliminary and may change when the drug is tested in large phase 3 trials.

Two things. First, it is a single molecule that activates both the GLP-1 and the amylin receptors, where a drug like CagriSema uses two separate molecules to hit those same two targets. Second, it is being developed as both a weekly injection and a daily pill. An oral version that works nearly as well as the injection would be unusual, because most drugs in this class are injections, and it is one of the main reasons amycretin is being watched.

Both combine amylin and GLP-1, but CagriSema does it with two molecules given together, cagrilintide and semaglutide, while amycretin does it with one. CagriSema is further along, with phase 3 results of about 22.7%, while amycretin is still in early trials. Amycretin is often described as Novo Nordisk's next major bet in obesity after CagriSema came in below expectations, though that is an industry expectation rather than something amycretin's trials have proven.

It is too early to say. In its first human trial, the pill produced about 13% weight loss over 12 weeks, while the injection produced more, about 22 to 24%, over a longer 36 weeks. The two were tested in different trials over different lengths of time, so they cannot be compared directly, and both are early. The pill is a promising proof of concept rather than a finished answer, and how it compares to the shot will only be clear once larger trials run.

Deep-Dive Questions

Because the active parts of these drugs are peptides, which are small chains of amino acids, and the gut is built to break peptides down into their pieces for digestion. A peptide swallowed as a pill mostly gets destroyed by stomach acid and enzymes before it can be absorbed, which is why nearly all of these drugs are injected, bypassing the gut altogether. Making an oral version work takes special formulation, often an absorption enhancer and careful dosing, and even then much of the dose is lost, which is why oral semaglutide, Rybelsus, needs an empty stomach and delivers less than the shot. An oral amycretin that keeps most of its power would be a notable piece of drug engineering, which is part of why its early oral data drew attention.

Amylin is a hormone released from the pancreas alongside insulin after a meal, and it signals fullness to the brain, slows stomach emptying, and helps limit how much is eaten. It works through partly different brain pathways than GLP-1, so adding amylin to GLP-1 is a way to push on satiety from two directions at once, which is the logic behind both amycretin and CagriSema. The hope is that two complementary satiety signals produce more weight loss, and possibly with a different side-effect balance, than pushing GLP-1 alone as hard as it will go. Whether the amylin route ends up better tolerated or simply additive is one of the questions the larger trials will answer.

Treat it as a promising signal rather than a settled figure. Early trials, phase 1 and phase 2, are built mainly to test safety and to find a workable dose, and they enroll small numbers of people, here about 125 for the injection, at one or a few sites, over relatively short periods. Numbers from such trials are valid measurements, but they carry wide uncertainty and often move once a drug is tested in a large phase 3 trial with thousands of people, a longer follow-up, and a more varied population. Sometimes the effect holds, sometimes it shrinks, and the safety picture can change too. So the disciplined way to read amycretin's early numbers is as encouraging evidence that the approach works, with the true magnitude still to be pinned down.

When its phase 3 trials report. Novo Nordisk advanced amycretin into a large phase 3 obesity program in 2026, and those trials are the ones designed to measure, in thousands of people over a year or more, how much weight the drug reliably produces and how safe it is over time. Until then, the honest answer to "how good is it" is that it looks promising early and is not yet proven. Phase 3 results, when they arrive, will show whether the injectable and oral versions hold their early numbers, and how they fit among the drugs already available and the others in development.

Ready when you are