GLP-1 & Incretin Medications Compared
5 of the major incretin medications are FDA-approved; the newest triple- and dual-agonists are still investigational. Here is the honest comparison — by class, approval, and what each is approved for.
Medically reviewed by Charles Kamen, MD, board-certified neurologist ·
Semaglutide, tirzepatide, liraglutide, dulaglutide, and exenatide are FDA-approved incretin medications; retatrutide, survodutide, and CagriSema remain investigational as of June 2026. They differ by how many incretin pathways they activate — semaglutide, liraglutide, dulaglutide, and exenatide are single GLP-1 receptor agonists, tirzepatide is a dual GIP/GLP-1 agonist, and retatrutide is a triple GIP/GLP-1/glucagon agonist. Tirzepatide (Zepbound) is also the only one FDA-approved for obstructive sleep apnea. The table below compares them. No doses are published here.
The comparison
Class, FDA approval status, what each is approved or studied for (with year), and administration form.
| Medication | Brand(s) | Class | FDA status | Approved / studied for | Form |
|---|---|---|---|---|---|
| Semaglutide | Ozempic, Wegovy, Rybelsus | GLP-1 receptor agonist | FDA-approved | Type 2 diabetes (2017); chronic weight management (Wegovy, 2021); cardiovascular event risk reduction (Wegovy, 2024); MACE risk reduction in type 2 diabetes (Ozempic; oral Rybelsus, 2025). | Injection (Ozempic, Wegovy); oral tablet (Rybelsus) |
| Tirzepatide | Mounjaro, Zepbound | Dual GIP / GLP-1 receptor agonist | FDA-approved | Type 2 diabetes (2022); chronic weight management (2023); obstructive sleep apnea in adults with obesity (2024) — the first medication ever FDA-approved for OSA. | Injection |
| Liraglutide | Victoza, Saxenda | GLP-1 receptor agonist | FDA-approved | Type 2 diabetes (Victoza, 2010); chronic weight management (Saxenda, 2014); cardiovascular risk reduction in type 2 diabetes. | Injection |
| Dulaglutide | Trulicity | GLP-1 receptor agonist | FDA-approved | Type 2 diabetes (2014); cardiovascular event risk reduction in adults with type 2 diabetes. | Injection |
| Exenatide | Byetta, Bydureon | GLP-1 receptor agonist (first in class) | FDA-approved | Type 2 diabetes (Byetta, 2005; extended-release Bydureon, 2012). The first FDA-approved GLP-1 receptor agonist. | Injection |
| Retatrutide | — (investigational) | Triple GIP / GLP-1 / glucagon receptor agonist | Investigational | Studied for obesity and type 2 diabetes in the Phase 3 TRIUMPH program. Not FDA-approved as of June 2026; not available outside clinical trials. | Injection (in trials) |
| Survodutide | — (investigational) | Dual glucagon / GLP-1 receptor agonist | Investigational | Studied for weight management and metabolic dysfunction-associated steatohepatitis (MASH). Not FDA-approved. | Injection (in trials) |
| CagriSema | — (investigational) | Amylin analog (cagrilintide) + GLP-1 receptor agonist (semaglutide) | Investigational | Studied for weight management. An FDA application was submitted in December 2025; not yet approved as of June 2026. | Injection (in trials) |
How this comparison is maintained: compiled and reviewed by Charles Kamen, MD from FDA approval records and manufacturer labeling. Approval years reflect the first FDA approval for the listed indication; some products carry additional later indications. Investigational-agent timelines reflect publicly announced filings and are not FDA approvals — verify current status at the time of care.
Educational reference, not medical advice. This page does not recommend a medication or state that any drug treats, cures, or prevents a disease, and it publishes no doses or titration schedules. Whether any GLP-1 medication is appropriate is a decision for you and a licensed clinician.
GLP-1 Medication FAQ
Is retatrutide FDA-approved?
No. As of June 2026 retatrutide remains investigational — a triple GIP/GLP-1/glucagon receptor agonist studied in the Phase 3 TRIUMPH program. It is not FDA-approved and is not available outside clinical trials.
What is the difference between tirzepatide and semaglutide?
Semaglutide is a single-pathway GLP-1 receptor agonist. Tirzepatide is a dual agonist that activates both the GIP and GLP-1 receptors. Tirzepatide (as Zepbound) is also the only one of the two FDA-approved for obstructive sleep apnea in adults with obesity.
Which GLP-1 medication is FDA-approved for sleep apnea?
Only tirzepatide (Zepbound), approved in 2024 for moderate-to-severe obstructive sleep apnea in adults with obesity — the first medication ever FDA-approved for OSA.
Is semaglutide a peptide?
Yes. Semaglutide is a peptide — a GLP-1 receptor agonist closely modeled on the body’s own GLP-1 hormone. So are tirzepatide, liraglutide, dulaglutide, and exenatide.
Which GLP-1 medications reduce cardiovascular risk?
Several carry FDA-approved cardiovascular indications: Wegovy (semaglutide) for cardiovascular event risk reduction in adults with overweight or obesity and established cardiovascular disease, and Ozempic, Victoza, and Trulicity for major adverse cardiovascular event reduction in type 2 diabetes.
Which is the oldest GLP-1 drug?
Exenatide (Byetta), the first-in-class GLP-1 receptor agonist, FDA-approved in 2005.
Related reading: Which peptides are FDA-approved? · Peptide drug-class taxonomy · Peptide evidence-grade index
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