Quick Answer
Zenagamtide (formerly called amycretin) is an experimental weight loss drug from Novo Nordisk — the same company that makes Ozempic and Wegovy. It targets two receptors, GLP-1 and amylin, and is being developed as both a weekly injection and a daily pill.
At ADA 2026 (June 7), Novo Nordisk presented Phase 2 results showing up to 14.6% weight loss and 1.7 percentage point HbA1c reduction with the subcutaneous version over 36 weeks in people with type 2 diabetes. Phase 3 trials are now enrolling under the AMAZE (obesity) and AMBITION (diabetes) programs.
Zenagamtide is not FDA-approved and is years away from being available.
Name Change: Amycretin Is Now Zenagamtide
Novo Nordisk has officially named this drug zenagamtide (development code NN 9487). The name "amycretin" was used in early development and press coverage, and you will still see it widely referenced online. Going forward, zenagamtide is the official name.
Drug name changes during development are normal. They typically happen as a compound advances through later-phase trials and the company prepares for potential market launch.
How Zenagamtide Works
Zenagamtide targets two receptors:
- GLP-1 receptor: Reduces appetite and slows digestion (same as Ozempic, Wegovy, Mounjaro)
- Amylin receptor: Reduces appetite through a different pathway and helps control blood sugar after meals
Amylin is a hormone that your pancreas makes along with insulin. It helps you feel full and slows down how fast food leaves your stomach. People with type 2 diabetes often have low amylin levels.
By hitting both GLP-1 and amylin, zenagamtide suppresses appetite from two different angles. This dual approach is similar in concept to how Mounjaro/Zepbound target GLP-1 + GIP — but zenagamtide uses a different second target.
Both Injection and Pill
Zenagamtide is being developed in two forms:
- Subcutaneous injection — once weekly (like Ozempic and Wegovy)
- Oral pill — once daily
Novo Nordisk's CEO has indicated the injectable version will likely launch first, with the oral version introduced later in higher-priced markets. This matters because the pill was previously the headline feature of this drug.
The oral formulation uses SNAC (salcaprozate sodium) as a permeation enhancer — the same absorption technology used in Rybelsus and Wegovy oral tablets. This means the pill may have food and water restrictions similar to oral semaglutide (take on empty stomach, wait 30 minutes before eating). Foundayo, by contrast, has no food or water rules.
Why a Pill Still Matters
All currently approved GLP-1 medications are injections (weekly for most, daily for Saxenda), except for Foundayo and oral semaglutide (Rybelsus, Wegovy pill). A new pill option would still be a big deal for people who:
- Are afraid of needles
- Travel frequently and worry about refrigeration
- Prefer the convenience of a daily pill
- Want an option that does not require injection supplies
But the landscape has changed. Foundayo (orforglipron) was approved in April 2026 and gives you a daily pill with no food restrictions today. Wegovy oral tablets launched May 2026. Zenagamtide's pill advantage is smaller now than it was a year ago — its edge would be the dual GLP-1 + amylin mechanism in pill form.
Phase 2 Results (ADA 2026, June 7)
Novo Nordisk presented Phase 2 results for subcutaneous zenagamtide at the ADA 86th Scientific Sessions on June 7, 2026. The trial tested six doses in people with type 2 diabetes over 36 weeks.
Key results:
| Dose (weekly SC) | Weight Loss (36 weeks) | HbA1c Reduction |
|---|---|---|
| 0.4 mg | ~4.3% | ~0.4%-points |
| 1.5 mg | ~7.6% | ~0.8%-points |
| 5 mg | ~8.2% | ~0.9%-points |
| 10 mg | ~12.9% | ~1.2%-points |
| 20 mg | ~13.1% | ~1.3%-points |
| 40 mg | ~14.6% | ~1.7%-points |
| Placebo | ~0% (slight gain) | ~0.1%-points |
Mean baseline: 99.2 kg body weight, 7.8% HbA1c.
The dose-response was clear. Higher doses produced more weight loss and better blood sugar control. The 40 mg dose produced the strongest results, with an estimated treatment difference vs placebo of −11.81 percentage points (p<0.0001) for weight loss.
Important context: This trial was in people with type 2 diabetes, not in people with obesity alone. Weight loss results in obesity-specific trials (expected H1 2027) may differ. The original Phase 1 oral amycretin data showed ~13% weight loss in 12 weeks in people without diabetes — a different population and formulation.
Comparison With Approved Drugs
| Drug | Weight Loss | Duration | Population |
|---|---|---|---|
| Zenagamtide 40 mg SC | ~14.6% | 36 weeks | T2D |
| Ozempic 1.0 mg | ~15% | 68 weeks | T2D |
| Wegovy 2.4 mg | ~15% | 68 weeks | Obesity |
| Wegovy HD 7.2 mg | ~20.7% | 72 weeks | Obesity |
| Zepbound | ~20% | 72 weeks | Obesity |
| CagriSema | ~20.4% | 68 weeks | Obesity |
| Foundayo | ~11% | 72 weeks | Obesity |
These are cross-trial comparisons and cannot be directly compared. Different populations, durations, and trial designs. But the Phase 2 signal is encouraging — zenagamtide appears competitive at 36 weeks with room to grow at longer durations.
Safety Profile
Zenagamtide appeared to have a safe and well-tolerated profile consistent with incretin and amylin-based therapies. Common side effects at the 40 mg dose:
- Nausea: 37% (vs 14% placebo)
- Vomiting: 29% (vs 6% placebo)
- Diarrhea: 37% (vs 6% placebo)
- Adverse events leading to withdrawal: 34% at 40 mg (vs 6% placebo)
- Dysesthesia (tingling/burning sensation): 21% at 40 mg (vs 0% placebo)
The discontinuation rate at higher doses is notable — 34% stopped treatment due to side effects at the 40 mg dose. This is higher than what is typically seen with Ozempic or Wegovy (around 10-15% in their trials). Most GI side effects were mild to moderate and diminished over time.
Dysesthesia is the same side effect reported with retatrutide (~21% at the highest dose in TRIUMPH-1). It is mostly mild but worth knowing about.
Zenagamtide vs Ozempic: Key Differences
| Feature | Zenagamtide | Ozempic | Foundayo | CagriSema |
|---|---|---|---|---|
| Mechanism | GLP-1 + amylin | GLP-1 only | GLP-1 only | GLP-1 + amylin |
| Form | Weekly injection + daily pill | Weekly injection | Daily pill | Weekly injection |
| Manufacturer | Novo Nordisk | Novo Nordisk | Eli Lilly | Novo Nordisk |
| FDA approved | No | Yes | Yes (Apr 2026) | No (under review) |
| Available | No | Yes | Yes | No |
| Best weight loss data | ~14.6% (36 weeks, T2D) | ~15% (68 weeks) | ~11% (72 weeks) | ~20.4% (68 weeks) |
| Food restrictions (oral) | Likely (uses SNAC) | N/A | None | N/A |
Potential Advantages of Zenagamtide
- Dual mechanism. Targeting amylin alongside GLP-1 may produce better weight loss than GLP-1 alone. CagriSema's 20.4% result supports this — it uses the same amylin + GLP-1 combo.
- Both injection and pill options. Novo Nordisk is developing both forms, giving patients more choice.
- Same company as Ozempic. Novo Nordisk has deep experience with GLP-1 drugs and the manufacturing capacity to scale.
- Head-to-head trials coming. AMBITION 3 and 4 will test zenagamtide directly against semaglutide in type 2 diabetes.
Potential Disadvantages
- High discontinuation rate. 34% stopped the 40 mg dose due to side effects. This is a real concern.
- Daily pill with likely food restrictions. The oral formulation uses SNAC, which typically requires taking on an empty stomach with a 30-minute wait before eating. Foundayo has no such restrictions.
- Less proven. Only Phase 2 T2D data so far. Long-term safety and effectiveness in obesity are unknown.
- Years away. Not available until at least 2029, probably later.
- Injection first, pill later. The pill format that made amycretin famous may not be the first version to launch.
Phase 3 Programs: AMAZE and AMBITION
Novo Nordisk has launched two Phase 3 programs for zenagamtide:
AMAZE (Obesity Program)
| Trial | Focus | Duration | Primary Endpoint |
|---|---|---|---|
| AMAZE 1 | Weight loss in obesity | 84 weeks (+ 52-week extension) | Weight loss |
| AMAZE 2 | Weight loss in T2D | 84 weeks | Weight loss |
| AMAZE 3 | Obstructive sleep apnea | 80 weeks | AHI / weight loss |
| AMAZE 4 | Obesity + sleep apnea | — | — |
| AMAZE 5 | Knee osteoarthritis | 80 weeks | WOMAC / weight loss |
| AMAZE 6 | Obesity + knee OA | — | — |
| AMAZE 9 | Oral zenagamtide | 76 weeks | Weight loss |
AMAZE 9 is especially notable — it is the Phase 3 trial for the oral pill form of zenagamtide. This is the trial that will determine whether the daily pill version works.
AMBITION (Diabetes Program)
| Trial | Focus | Duration | Primary Endpoint |
|---|---|---|---|
| AMBITION 1 | Monotherapy in T2D | 44 weeks | HbA1c |
| AMBITION 2 | Add-on to insulin | 52 weeks | HbA1c |
| AMBITION 3 | Head-to-head vs semaglutide 1.0 mg (high dose) | 60 weeks | HbA1c |
| AMBITION 4 | Head-to-head vs semaglutide 0.5/1.0 mg (low dose) | 52 weeks | HbA1c |
AMBITION 3 and 4 will give us the first direct comparison of zenagamtide vs semaglutide (the drug in Ozempic and Wegovy).
When Could Zenagamtide Be Available?
Zenagamtide has moved into Phase 3 trials as of June 2026. Estimated timeline:
- Phase 2 T2D results: Presented June 2026 at ADA
- Phase 2 obesity results: Expected H1 2027
- Phase 3 trials: 2026-2028 (currently enrolling)
- Phase 3 data readouts: 2027-2028
- FDA submission (if successful): 2029 or later
- Earliest possible approval: 2029-2030
This is an optimistic estimate. Most drugs that enter Phase 1 never make it to market. Zenagamtide could fail, be delayed, or turn out to be less effective than expected. The high discontinuation rate at the 40 mg dose is a real concern that Phase 3 will need to address.
Other Pipeline Drugs to Watch
Zenagamtide is not the only experimental GLP-1 drug. Also in development:
- CagriSema (Novo Nordisk) — Same GLP-1 + amylin combo as zenagamtide, but in injectable form. Phase 3 complete, FDA decision expected late 2026/early 2027. Showed 20.4% weight loss. This is the strongest signal for what zenagamtide might eventually achieve.
- Retatrutide (Eli Lilly) — GLP-1 + GIP + glucagon triple agonist. TRIUMPH-1 Phase 3 results showed up to 28.3% weight loss at 80 weeks. Not yet submitted to FDA.
- Survodutide (Boehringer Ingelheim) — GLP-1 + glucagon. Phase 3 SYNCHRONIZE results (June 2026) showed 34% visceral fat reduction and 63% liver fat reduction.
Should You Wait?
No. If you need help with weight loss now, the medications available today work well. Ozempic, Wegovy, Wegovy HD, Mounjaro, Zepbound, and Foundayo are all proven options.
Zenagamtide is years away from approval and there is no guarantee it will be better than what is already available. The dual mechanism is promising, but CagriSema already delivers that same dual mechanism in injectable form and is much closer to market.
The pill format is appealing, but Foundayo already gives you a daily pill with no food restrictions today, and Wegovy oral tablets are now available. You should not delay treatment for a drug that might not even reach the market.
Bottom Line
Zenagamtide (formerly amycretin) has real Phase 2 data now — 14.6% weight loss at 36 weeks in T2D, and Phase 3 trials are enrolling. The name change and the shift to "injection first, pill later" are important developments.
If you are choosing a GLP-1 medication today, focus on what is available now. Keep zenagamtide on your radar — especially if you want a pill that targets both GLP-1 and amylin — but do not wait for it.
Supplies If You Use an Injected GLP-1 Today
Since zenagamtide is not yet available, most people reading this will use an injectable GLP-1 like Ozempic or Wegovy. A few supplies make weekly injections easier:
- Alcohol prep pads — for cleaning the injection site before each dose
- A sharps container — for safe pen needle disposal
- An insulated travel cooler — for keeping your pen cold when you travel
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This article is for informational purposes only and does not constitute medical advice. Zenagamtide (amycretin) is not FDA-approved. Always talk to your healthcare provider before starting any medication.
