Zenagamtide is the new name for amycretin, Novo Nordisk’s experimental drug for weight management and type 2 diabetes. It copies GLP-1, a gut hormone involved in appetite and blood sugar. It also copies amylin, a pancreas hormone that helps signal fullness, within the same molecule.
Researchers are testing weekly injections and daily tablets. It remains investigational, meaning it is still being tested in clinical trials. The weight-loss headlines describe results in particular study groups, not what any one person can expect.
What zenagamtide’s new name means
Zenagamtide appears in the WHO’s Recommended INN List 95. INN means international nonproprietary name: a standard drug name rather than a brand. Amycretin and zenagamtide refer to the same compound.
WHO also explains that assigning a name does not recommend using the substance as medicine. The name change does not establish a treatment result.
The drug activates receptors, cell switches that respond to hormone signals. Semaglutide acts at the GLP-1 receptor; zenagamtide also engages the amylin pathway.
CagriSema combines two molecules, semaglutide and cagrilintide; zenagamtide puts the GLP-1 and amylin actions into one molecule. The cagrilintide explainer covers that separate combination.
The early studies enrolled people with overweight or obesity, while the newer diabetes studies enrolled a different group. Keeping those groups apart matters when reading the numbers.
Semaglutide is already a prescribing option. Through Promise, semaglutide and tirzepatide are dispensed as compounded medications, prepared by a pharmacy for a prescription. They are different from FDA-approved products: the formulations offered here are not FDA-approved.
As of September 30, 2026, the day this article was written, the FDA’s compounding explanation states that the agency does not review these preparations’ safety, effectiveness or quality before marketing. Its page carries “Content current as of: 06/22/2026.” A licensed provider may still prescribe a compounded formulation; that decision is between you and your doctor.
Zenagamtide weight loss in the early injection study
The largest early headline was about one-quarter of starting body weight: 24.3% at 36 weeks in the highest-dose group.
That came from Dahl and colleagues’ phase 1b/2a study, The Lancet, 2025. Phase 1b/2a means early testing of how people handle the drug and its treatment effects. The study enrolled 125 adults aged 18–55 with overweight or obesity, divided across several parts.
Subcutaneous means injected under the skin. These were weekly injections, with doses increased during treatment. Placebo means an inactive comparison treatment. The paper reported these estimated average changes:
| Dose reached | Total treatment time | Weight change on zenagamtide | Weight change on placebo |
|---|---|---|---|
| 1.25 mg | 20 weeks | −9.7% | +2.0% |
| 5 mg | 28 weeks | −16.2% | +2.3% |
| 20 mg | 36 weeks | −22.0% | +1.9% |
| 60 mg | 36 weeks | −24.3% | −1.1% |
Minus means weight loss; plus means weight gain. The groups had different treatment lengths, so the table isn’t a simple dose ranking.
The authors reported many withdrawals, often for reasons unrelated to side effects. That matters when interpreting estimates from a small early trial.
What did the amycretin pill study find?
The swallowed form was tested separately. Gasiorek and colleagues’ phase 1 trial, The Lancet, 2025, enrolled 144 people across several parts. Only 60 entered the 12-week treatment portion.
In its June 20, 2025 summary, Novo reported average weight loss of 13.1% with 100 mg daily versus 1.2% with placebo at 12 weeks.
Weight change was exploratory, an early signal rather than the main question the trial was designed to answer. The main question was safety. These are study doses, and tablet milligrams do not convert directly into injection milligrams.
Is zenagamtide better than tirzepatide?
The trials above cannot answer that: they compared zenagamtide with placebo, rather than tirzepatide.
Tirzepatide acts at GLP-1 and GIP, another gut hormone involved in blood-sugar control. It uses a different second signal from zenagamtide. Different participants, treatment lengths and analysis methods make a ranking from separate trials unreliable.
The tirzepatide-versus-semaglutide comparison covers their direct comparisons. Zenagamtide’s early numbers do not establish results for either compounded preparation offered through Promise.
What the newer diabetes papers add
As of September 30, 2026, the day this article was written, full phase 2 diabetes results are available in two Lancet papers published online July 30, 2026. These studied blood-sugar control over 36 weeks.
The injection paper by Mora and colleagues enrolled 262 adults. At 40 mg weekly, average HbA1c fell 1.7 percentage points. HbA1c measures average blood sugar over roughly three months. The tablet paper enrolled 186 adults; at 50 mg daily, the average fall was 1.4 points.
Novo’s June 6, 2026 report also gave injection weight results: 14.6% loss at 40 mg versus 2.1% with placebo at 36 weeks. Those figures used time on treatment without extra diabetes medication to rescue blood-sugar control.
These participants had type 2 diabetes. Their results do not replace the earlier obesity figures or establish a direct pill-versus-shot comparison.
What side effects have the trials reported?
Stomach and bowel symptoms were the most common side effects. In the 2026 tablet study, nearly half of the 50 mg group reported them: 24 of 51 people, or 47%. That compared with 7 of 30 people on placebo, or 23%.
The injection studies also reported mainly mild or moderate stomach and bowel symptoms. That doesn’t mean everyone tolerated treatment. Small studies and short follow-up cannot settle uncommon or longer-term risks.
Zenagamtide phase 3: what is underway?
Phase 3 means larger studies testing treatment effects and collecting more safety information. The clinical-trial phases guide explains the stages.
As of September 30, 2026, the day this article was written, ClinicalTrials.gov lists the following phase 3 studies as recruiting. AMAZE 1’s record was updated September 24, 2026; the other two were updated September 28, 2026.
| Study | Planned participants | Main weight measurement |
|---|---|---|
| AMAZE 1: weekly injection versus placebo | 1,150 | Week 84 |
| AMAZE 9: daily tablets versus placebo | 950 | Week 76 |
| AMAZE 7: weekly injection versus semaglutide | 650 | Week 84 |
AMAZE 7’s record gives an actual start of September 22, 2026, and an estimated main completion date of October 10, 2028. That comparison can address a question the early studies couldn’t. A start date is not a result, and an estimated completion date is not a pharmacy launch date.
The diabetes program is underway too. AMBITION 7 compares zenagamtide with insulin glargine, a long-acting version of the hormone that helps regulate blood sugar. Its record, updated September 1, 2026, lists recruiting status.
Semaglutide remains a separate medicine a provider can consider today while these comparisons run.
Where this leaves a prescription visit
Promise does not offer zenagamtide. Someone considering treatment now can discuss existing options against their medical history, current medicines and previous side effects.
A useful visit also covers how side effects will be followed and who handles a problem between visits. The answer should name the medication being considered and the provider responsible for its care. A headline percentage gives none of that detail.
At Promise, a licensed U.S. provider reviews every request, and not everyone qualifies. If a medication is prescribed, the provider sets the actual dose and follow-up plan.
