Next-generation obesity pipeline / 2026

Retatrutide alternatives: FDA approval status and 2026 timeline

Track Retatrutide and five leading alternatives through Phase 3, application, FDA review, and approval. Confirmed milestones, sponsor-projected windows, and unknown dates remain separate, with source links for every program.

Programs tracked06
FDA approved today00
Under FDA review01
Projected decision windows01
Direct answer

When could Retatrutide or its alternatives be approved?

CagriSema is the only program in this tracker with a submitted US application. Novo Nordisk projects a fourth-quarter 2026 FDA decision window, but FDA has not published an exact action date.

Retatrutide, Zenagamtide, MariTide, standalone cagrilintide, and Survodutide have no announced FDA decision date. Phase 3 activity is not an approval, release date, pharmacy launch, or proof that a same-name product sold online is authentic.

Compare CagriSema and Retatrutide carefully →
Approval and development tracker

What happened, what comes next, and which dates do not exist yet.

Follow Retatrutide and five major alternatives from Phase 3 through FDA review. Confirmed milestones stay separate from sponsor projections and unannounced dates.

Direct status answer

CagriSema is the only program here under FDA review. Novo Nordisk projects a Q4 2026 decision window, but FDA has not published an exact action date. The other five programs have no announced FDA decision date.

01Early evidence
02Phase 3
03Application
04FDA review
05Approval
6programs shownStage position is not approval probability, evidence quality, or a clinical ranking.
01 · Novo NordiskProjected window
Cagrilintide plus semaglutide

CagriSema

Weekly fixed-dose injection

FDA application under review
Latest confirmed milestone
June 7, 2026Novo Nordisk reported additional Phase 3 results and retained its projected US decision window.
Next approval date
Q4 2026, sponsor-projected windowCagriSema is not FDA approved. It is the only program in this tracker with a submitted US application and an active review record.
Evidence to watch next
An FDA action, a revised review update, or a documented change to the projected window.
Interpretation boundary
Q4 2026 is a sponsor projection, not a published FDA action date. Review timing can change, and approval is not guaranteed.
02 · Eli Lilly and CompanyNo date announced
LY3437943

Retatrutide

Weekly injection

Phase 3 program reporting results
Latest confirmed milestone
May 21, 2026Lilly reported TRIUMPH-1 Phase 3 topline results in adults without diabetes.
Next approval date
No FDA decision date announcedRetatrutide is not FDA approved, and this evidence set contains no submitted FDA application or announced FDA decision date.
Evidence to watch next
Additional TRIUMPH results, detailed publications, and any documented regulatory filing.
Interpretation boundary
A Phase 3 result is a development milestone, not marketing authorization, a launch schedule, or a legitimate pharmacy product.
03 · Novo NordiskNo date announced
Zenagamtide, formerly Amycretin

Zenagamtide

Daily oral tablet and weekly injection under study

Phase 3 development underway
Latest confirmed milestone
June 25, 2026The AMAZE 7 Phase 3 comparison record was posted for weekly zenagamtide versus semaglutide.
Next approval date
No FDA decision date announcedZenagamtide, formerly amycretin, is not FDA approved in either oral or injectable form and has no announced FDA decision date.
Evidence to watch next
Oral and injectable Phase 3 results, tolerability data, and any documented regulatory filing.
Interpretation boundary
A posted Phase 3 protocol does not establish a trial result, final formulation, approved dose, commercial pill, launch date, or price.
04 · AmgenNo date announced
Maridebart cafraglutide, AMG 133

MariTide

Monthly lead program with lower-frequency maintenance research

MARITIME Phase 3 program active
Latest confirmed milestone
February 2026Amgen reported continued lower monthly or quarterly maintenance research after its Phase 2 program.
Next approval date
No FDA decision date announcedMariTide is not FDA approved and has no announced FDA application, decision date, commercial schedule, or pharmacy launch.
Evidence to watch next
MARITIME Phase 3 efficacy, escalation, tolerability, and maintenance results, followed by any documented filing.
Interpretation boundary
Quarterly maintenance research in selected continuing participants does not establish a quarterly starting schedule or off-treatment durability.
05 · Novo NordiskNo date announced
AM833, NNC0174-0833

Cagrilintide

Weekly standalone amylin injection under study

Standalone RENEW Phase 3 program
Latest confirmed milestone
July 20, 2026 record checkRENEW 1 and RENEW 2 remained the active standalone Phase 3 records, with no posted results.
Next approval date
No FDA decision date announcedStandalone cagrilintide is not FDA approved, has no announced FDA decision date, and must not inherit CagriSema's application or combination result.
Evidence to watch next
Standalone RENEW results, longer-term safety and tolerability, and any documented regulatory filing.
Interpretation boundary
CagriSema combines cagrilintide with semaglutide. The combination's FDA application and 22.7% result do not transfer to cagrilintide alone.
06 · Boehringer Ingelheim + Zealand PharmaNo date announced
BI 456906

Survodutide

Weekly injection under study

Phase 3 program active and reporting
Latest confirmed milestone
June 7, 2026Peer-reviewed SYNCHRONIZE-1 Phase 3 obesity results were published alongside liver-focused evidence.
Next approval date
No FDA decision date announcedSurvodutide is not approved for marketing and this evidence set contains no announced FDA submission or decision date.
Evidence to watch next
Regulatory filing evidence, cardiovascular outcomes, additional liver results, and longer-term benefit-risk data.
Interpretation boundary
Completed Phase 3 trials and regulatory designations do not establish a submission date, review outcome, final label, launch, or retail supply.
Important 2026 update

Foundayo is approved, oral, and not a peptide.

Orforglipron now provides a real US comparator for convenience and access. It is a non-peptide small-molecule GLP-1 agonist, so we track it separately from these five investigational peptide and peptide-combination programs.

Understand the molecular difference →
Five program profiles

One program name. One evidence ledger.

Each program card separates the attention-grabbing result from the limitation that should travel with it.

01Novo Nordisk
Formerly Amycretin

Zenagamtide

Route
Daily oral tablet and weekly injection under study
Status
Phase 3 weight-management development underway
Evidence signal
13.1% at 12 weeks in an early oral cohort
Reality check

The oral Phase 1 group had 16 active participants. It is a promising signal, not proof that zenagamtide is the strongest pill or faster than drugs tested in larger, longer trials.

Watch nextOral and subcutaneous Phase 3 results, tolerability, final formulation, and regulatory filings

Open the full Zenagamtide profile
02Amgen
Maridebart cafraglutide

MariTide

Route
Monthly injection in the lead program
Status
MARITIME Phase 3 program active
Evidence signal
Up to 19.9% at week 52 in Phase 2
Reality check

Quarterly evidence concerns continued maintenance treatment in selected participants who had already lost at least 15% and stayed on study drug. It is not a proven quarterly starting schedule or off-treatment result.

Watch nextPhase 3 efficacy, dose escalation, gastrointestinal tolerability, and lower-frequency maintenance

Open the full MariTide profile
03Novo Nordisk
Cagrilintide plus semaglutide

CagriSema

Route
Weekly fixed-dose injection
Status
Submitted to the FDA, not yet approved
Evidence signal
22.7% at week 68 under the trial-product estimand
Reality check

A REDEFINE 1 DXA subset showed most weight reduction came from fat mass, but lean soft-tissue mass also declined. That is not evidence that CagriSema preserves muscle.

Watch nextFDA action, final label, safety review, long-term maintenance, and body-composition evidence

Open the full CagriSema profile
04Novo Nordisk
AM833 / NNC0174-0833

Cagrilintide

Route
Weekly injection under study
Status
Standalone RENEW Phase 3 program active
Evidence signal
11.8% at week 68 in the REDEFINE 1 monotherapy arm
Reality check

Cagrilintide alone is not CagriSema. The combination's 22.7% result and FDA application cannot be transferred to standalone cagrilintide.

Watch nextRENEW 1 and RENEW 2 results, side effects, approval path, and comparison with semaglutide

Open the full Cagrilintide profile
05Boehringer Ingelheim and Zealand Pharma
BI 456906

Survodutide

Route
Weekly injection under study
Status
Phase 3 program active and reporting
Evidence signal
Up to 16.6% at week 76 in SYNCHRONIZE-1
Reality check

Two different 63-related liver-fat results circulate online. One is a relative reduction from an MRI substudy. Another is the proportion of a Phase 2 group reaching a 30% threshold. They are not the same endpoint.

Watch nextRegulatory filings, liver outcomes, cardiovascular outcomes, and gastrointestinal discontinuation

Open the full Survodutide profile
Comparison matrix

Compare the program, not just the percentage.

Results below come from different studies unless the source explicitly says otherwise. They do not form a head-to-head ranking.

ProgramPrimary strategyEvidence anchorCurrent milestone
Zenagamtide / AmycretinGLP-1 plus amylin in oral and injected forms13.1% at 12 weeks in a 16-person active oral Phase 1 cohortPhase 3 weight-management development underway
MariTideLong-acting GLP-1 agonism plus GIP antagonismUp to 19.9% at week 52 under an efficacy estimandMonthly Phase 3 program and lower-frequency maintenance research
CagriSemaCagrilintide plus semaglutide fixed-dose combination22.7% at week 68 under a trial-product estimandFDA application under review
CagrilintideStandalone long-acting amylin analogue11.8% at week 68 in a REDEFINE 1 monotherapy armRENEW 1 and RENEW 2 Phase 3 trials
SurvodutideGLP-1 plus glucagon dual agonismUp to 16.6% at week 76 in SYNCHRONIZE-1Phase 3 obesity, liver, and cardiovascular program
Approval and evidence answers

Dates, routes, results, and claims checked.

Each answer resolves a practical reader question without turning a trial milestone into an approval forecast. Every status remains tied to the July 21, 2026 evidence check.

01

When could CagriSema be approved by the FDA?

Novo Nordisk projects a US decision window in the fourth quarter of 2026. That is a sponsor projection, not an exact FDA action date. CagriSema remains investigational while the submitted application is under review, and the review timing or outcome can change.

02

When could Retatrutide be approved or released?

No FDA approval date or US release date has been announced for Retatrutide. Lilly reported Phase 3 TRIUMPH-1 topline results in May 2026, but this evidence set contains no submitted FDA application or published decision date. A Phase 3 result should not be converted into a launch forecast.

03

What weight-loss drugs are coming after retatrutide?

The most visible late-stage or fast-advancing programs include zenagamtide, formerly amycretin; MariTide; CagriSema; standalone cagrilintide; and survodutide. They are not one class or one development stage. CagriSema is under FDA review, while the others remain in active clinical development. None should be ranked from headline percentages taken from separate trials.

04

Is Amycretin now called Zenagamtide?

Yes. Zenagamtide is Novo Nordisk's current name for the molecule previously called amycretin. It is a single peptide designed to activate GLP-1 and amylin receptors, with separate oral and subcutaneous development programs. Older papers, trial records, and references still use amycretin, so both names belong on the same canonical profile.

05

Is Amycretin really a once-daily pill?

An oral once-daily formulation is under study, but zenagamtide is not only a pill. Novo Nordisk is also developing a once-weekly injection. The widely repeated 13.1% result came from a 12-week Phase 1 oral cohort with 16 active participants. It cannot establish a commercial pill, approved dose, launch date, or superiority over another program.

06

Will MariTide be monthly or quarterly?

Monthly dosing is the clearest efficacy program. Amgen's Phase 2 Part 1 used monthly and one eight-week arm, while Part 2 studied lower monthly or quarterly maintenance in selected participants who had already lost at least 15% after one year and remained on treatment. That supports a lower-frequency maintenance hypothesis, not a quarterly starting schedule for everyone.

07

Does CagriSema preserve muscle?

That claim is not established. In a REDEFINE 1 DXA subset, Novo Nordisk reported that 67% of total weight reduction was attributed to total body fat mass and 33% to lean soft-tissue mass. The sponsor also cautioned that lean soft-tissue mass is not synonymous with total fat-free mass. This can inform body-composition research, but it does not prove muscle preservation.

08

Did survodutide reduce liver fat by 63%?

A SYNCHRONIZE-1 MRI substudy reported up to a 63.1% relative liver-fat reduction from baseline among measured participants who remained on treatment. Separately, an earlier Phase 2 MASH trial reported that 63% of participants in the 2.4 mg group achieved at least a 30% reduction. The newer Phase 3 SYNCHRONIZE-MASLD trial reported 84.2% reaching that 30% threshold versus 24.3% with placebo under the efficacy estimand.

09

Which upcoming weight-loss drug has the fewest side effects?

The current evidence cannot name a reliable winner. Trials differ in population, duration, dose escalation, event collection, estimand, and discontinuation handling. Gastrointestinal events remain important across these programs. A fair safety comparison needs matched definitions and preferably a randomized head-to-head trial, not separate sponsor summaries.

10

Can you buy any of these drugs now?

Not as the investigational products described here. CagriSema has been submitted to the FDA but is not approved at this evidence check. Zenagamtide, MariTide, cagrilintide, and survodutide also remain investigational. An online vial using a development name is not proof that it contains the sponsor's clinical-trial material, and a seller price is not a commercial drug price.

11

What about Foundayo and orforglipron?

FOUNDAYO is no longer an upcoming program in the United States. FDA approved it on April 1, 2026. Its active ingredient, orforglipron, is a non-peptide small-molecule GLP-1 receptor agonist, not a peptide. It belongs in comparisons with the next generation because it creates an approved oral benchmark, but it should not be added to a list of investigational peptides or described as the Amycretin pill.

Critical boundary

Upcoming does not mean available.

Clinical-trial names do not authenticate online products. None of these program names creates an approved dose, pharmacy route, commercial price, or legitimate affiliate offer before the relevant regulator authorizes a specific product.

This guide reports clinical and regulatory evidence. It does not recommend a drug, reproduce unapproved dosing instructions, or compare same-name research vials with sponsor trial material.

Primary referencesTRIUMPH-1 Retatrutide Phase 3 topline resultsMay 2026 Phase 3 milestone, topline weight results, trial context, and continued investigational statusEli Lilly and CompanyResearch and early development presentationOral amycretin Phase 1 cohort size and the 13.1% result at 12 weeksNovo NordiskZenagamtide Phase 2 data at ADA 2026Current name, mechanism, formulations, 36-week subcutaneous results, and Phase 3 planNovo NordiskNovo Nordisk Annual Report 2025Zenagamtide rename, oral and subcutaneous formulations, and Phase 3 weight-management statusNovo NordiskMonthly MariTide Phase 2 resultsPhase 2 population, monthly schedules, week-52 estimands, tolerability, and maintenance-study designAmgenMariTide lower-frequency maintenance updateSelected-participant maintenance on lower monthly or quarterly treatment and Phase 3 program statusAmgenREDEFINE 1 peer-reviewed publicationCagriSema, cagrilintide, semaglutide, and placebo randomized trial design and resultsNational Library of Medicine, PubMedREDEFINE 1 body-composition analysisDXA subset, total body fat mass, lean soft-tissue mass, and the sponsor's interpretation boundaryNovo Nordisk Science HubCagriSema FDA submission announcementNew Drug Application submission, submitted regimen, pivotal result, and investigational statusNovo NordiskCagriSema REIMAGINE 1-3 Phase 3 resultsJune 2026 type 2 diabetes Phase 3 results, gastrointestinal adverse-event context, and projected Q4 2026 FDA decision windowNovo NordiskSurvodutide once weekly for adults with obesityPeer-reviewed SYNCHRONIZE-1 Phase 3 design, weight results, and safety interpretationNational Library of Medicine, PubMedSYNCHRONIZE-MASLD Phase 3 results216-participant design, 30% liver-fat threshold, weight results, estimands, and limitationsNational Library of Medicine, PubMedPhase 2 survodutide trial in MASH and fibrosisMASH improvement, liver-fat threshold proportions, fibrosis findings, and adverse eventsNational Library of Medicine, PubMedFDA concerns with unapproved GLP-1 drugsCagrilintide approval and federal compounding status plus the consumer warning for same-name productsU.S. Food and Drug AdministrationFDA approves FoundayoApril 1, 2026 US approval, approved population, and separation from the remaining investigational programsU.S. Food and Drug Administration