The approved maximum is 17.2 mg once daily. The 36 mg figure in most coverage comes from the trials, which used a different formulation, and the label says so itself.
Foundayo tablets come in six strengths: 0.8, 2.5, 5.5, 9, 14.5 and 17.2 mg. The starting dose is 0.8 mg once daily, and each step requires at least 30 days at the previous one, so reaching the top takes about five months.1
The dose, in short:1
- Starting dose 0.8 mg once daily, for at least 30 days
- Six strengths, maximum 17.2 mg once daily
- One tablet a day, swallowed whole, with or without food
- About five months from first tablet to maximum dose
- Trial doses of 6, 12 and 36 mg were an investigational capsule, not this tablet
Why does the Foundayo pill say 17.2 mg when the trial said 36 mg?
Because they are different formulations. The ATTAIN trials used an investigational capsule at 6, 12 and 36 mg; the approved pill is a tablet at different strengths. Section 14 of the label states that it presents the trial results as equivalent dosages of the marketed tablet, and gives the mapping.1
| Trial capsule | Equivalent approved tablet |
|---|---|
| 6 mg | 5.5 mg |
| 12 mg | 9 mg |
| 36 mg | 17.2 mg |
So when a study abstract says participants took 36 mg and achieved 12.4% weight loss, the equivalent prescription is 17.2 mg. Both numbers are correct in their own context, and quoting the first as a dose you could be prescribed is not.
This also explains the vials and capsules sold online labelled 6 mg. That is the trial capsule strength, and it does not correspond to any tablet you can be given.
What is the Foundayo dose schedule?
Six steps, each at least 30 days, from 0.8 mg to 17.2 mg.1
| Step | Dose | Minimum before the next step |
|---|---|---|
| 1 | 0.8 mg daily | 30 days |
| 2 | 2.5 mg daily | 30 days |
| 3 | 5.5 mg daily | 30 days |
| 4 | 9 mg daily | 30 days |
| 5 | 14.5 mg daily | 30 days |
| 6 | 17.2 mg daily | maximum dose |
Doses from 5.5 mg upward are maintenance doses, so not everyone climbs to the top. The label frames each increase as conditional on response and tolerability rather than automatic.
Escalation exists because gut side effects cluster at dose increases. In the trials, adverse events caused 5.3% to 10.3% of participants to stop, against 2.7% on placebo, and both figures rose with dose.2
How do you take Foundayo?
Three instructions from the label, and the third is the one that distinguishes this drug.1
One tablet a day, and not more. Swallowed whole, not broken, crushed or chewed. With or without food, at any time of day, with no water restriction.
That last point is the practical difference from oral semaglutide, which has to be taken on an empty stomach with a small amount of water, followed by a wait before eating or drinking anything else.
What if you miss a dose of Foundayo?
The label's guidance is thinner than people expect, and saying that plainly beats filling the gap with invention.
What is clear is the ceiling: one tablet per day, never two to catch up. Doubling after a missed day is the error this instruction exists to prevent.
For a longer gap, the question is whether to restart lower, and that is a prescriber decision. Anyone quoting a specific reinitiation rule for this drug is going beyond what the label states.
How much weight do you lose on each dose?
Weight loss rose with dose across all three arms, and the figure you will see quoted is one of two.2
| Trial dose, 72 weeks | Equivalent tablet | If you stayed on it | Everyone randomised |
|---|---|---|---|
| 6 mg | 5.5 mg | 7.8% | 7.5% |
| 12 mg | 9 mg | 9.3% | 8.4% |
| 36 mg | 17.2 mg | 12.4% | 11.2% |
| Placebo | 0.9% | 2.1% |
From ATTAIN-1, 3,127 adults with obesity and without diabetes, published in the New England Journal of Medicine.2
The two columns are not a rounding difference. The first is the efficacy estimand, which estimates what would have happened if everyone had stayed on the drug as directed. The second is the treatment-regimen estimand, which counts everyone who was randomised, including those who stopped.
The number you see quoted is almost always 12.4%, the higher one. The more conservative figure is 11.2%. Both are in the same paper and neither is wrong, which our glossary entry on estimands covers.
Look at the placebo row. On the efficacy estimand placebo lost 0.9%; on the treatment-regimen estimand it lost 2.1%. The placebo arm does better when dropouts are counted, which tells you something about who left and why.
Among people on the top dose, 54.6% lost at least 10% of their body weight, 36.0% lost at least 15% and 18.4% lost at least 20%, against 12.9%, 5.9% and 2.8% on placebo.
So the dose producing the number people quote is also the one with the most side effects, which is the trade every drug in this class presents.
Does Foundayo interact with other medicines?
One interaction is on the label. With a strong CYP3A4 inhibitor, the maximum dose drops to 9 mg instead of 17.2 mg.1 The label also says to avoid Foundayo entirely with drugs that strongly inhibit CYP3A4 and also inhibit OATP1B, rather than using the 9 mg adjustment.
That class includes some common prescriptions, and it is the kind of thing a pharmacy catches and a self-directed protocol does not.
Common questions
What is the maximum dose of Foundayo?
17.2 mg once daily. The 36 mg in trial coverage refers to an investigational capsule, which the label maps to the 17.2 mg tablet.
What is the starting dose of orforglipron?
0.8 mg once daily, for at least 30 days before the first increase.
How long does it take to reach the full dose?
About five months, since each of the five increases requires at least 30 days at the current dose.
Can I take Foundayo with food?
Yes. It can be taken at any time of day, with or without food, and with no water restriction. That is the main practical difference from oral semaglutide.
Why do some sources say 6 mg, 12 mg or 36 mg?
Those are the doses of the investigational capsule used in the ATTAIN trials. The marketed tablet uses different strengths and the label provides the mapping: 6 to 5.5 mg, 12 to 9 mg, 36 to 17.2 mg.
Do I have to go all the way to 17.2 mg?
No. Doses from 5.5 mg upward are maintenance doses, and the label frames each increase as conditional on response and tolerability.
What if I miss a dose?
Do not take two tablets to catch up; the label sets a ceiling of one per day. For a longer gap, restarting is a prescriber decision, and no specific rule for it appears in the label.
Does any medication change the maximum dose?
Yes. With a strong CYP3A4 inhibitor the maximum is 9 mg daily instead of 17.2 mg. Drugs that strongly inhibit CYP3A4 and also inhibit OATP1B should be avoided altogether, per the label.
Is the Foundayo pill the same as the trial capsule?
No. The trials used an investigational capsule at 6, 12 and 36 mg. The approved product is a tablet at 0.8 to 17.2 mg, and the label states which trial dose each tablet strength corresponds to.
Why do I see 12.4% and 11.2% for the same dose?
Both come from ATTAIN-1 and both are correct. 12.4% is the efficacy estimand, which estimates what would have happened if everyone had stayed on the drug. 11.2% is the treatment-regimen estimand, which counts everyone randomised including those who stopped. The higher figure is the one usually quoted.
Sources
- Foundayo (orforglipron) prescribing information, NDA 220934, sections 2.1, 3, 7 and 14. accessdata.fda.gov. The approved label. Tablets of 0.8, 2.5, 5.5, 9, 14.5 and 17.2 mg; starting dosage 0.8 mg once daily with at least 30 days before each increase; maximum 17.2 mg, reduced to 9 mg with a strong CYP3A4 inhibitor; one tablet daily, swallowed whole, with or without food. Section 14 states that the trials used an investigational formulation and presents efficacy as equivalent dosages of the marketed tablet, which is the source of the 6 to 5.5, 12 to 9 and 36 to 17.2 mg mapping.
- Wharton S, et al. Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment (ATTAIN-1). New England Journal of Medicine 2025;393:1796-1806. doi:10.1056/NEJMoa2511774. NCT05869903. Phase 3, multinational, randomised, double-blind, placebo-controlled trial. 3,127 adults with obesity, or overweight with at least one weight-related condition, without diabetes, randomised 3:3:3:4 to orforglipron 6 mg, 12 mg, 36 mg or placebo once daily for 72 weeks, all starting at 1 mg and escalating stepwise. Mean weight change on the efficacy estimand: 7.8%, 9.3% and 12.4% against 0.9% on placebo. On the treatment-regimen estimand: 7.5%, 8.4% and 11.2% against 2.1%. Among the 36 mg group on the treatment-regimen estimand, 54.6% had a reduction of 10% or more, 36.0% of 15% or more and 18.4% of 20% or more, against 12.9%, 5.9% and 2.8% on placebo. Overall treatment discontinuation 21.9%, 22.5% and 24.4% against 29.9% on placebo. The most common adverse events were gastrointestinal and mostly mild to moderate.
Citing this page. Peptide Decoding. Foundayo (Orforglipron) Dose: Why 36 mg Is Not an Approved Dose. Label figures from NDA 220934. https://peptidedecoding.com/guides/orforglipron-dose