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MHRA greenlights orforglipron, UK gets oral GLP-1 before the rest of Europe

Posted by tiredmira in Weight Loss & Metabolic - 2 points, 4 comments.

https://www.politico.eu/article/uk-approves-its-second-weight-loss-pill-while-eu-access-lags/

The Pharmaceutical Journal is reporting that the MHRA just approved orforglipron, the daily oral GLP-1 from Lilly, making the UK the first European country to authorize it. NHS coverage decision is expected in November, which basically decides whether regular people can actually get it or it's just a checkbox approval.

My take is that this matters more than the weekly shot discourse people are still stuck on. An oral changes compliance, storage, travel, honestly the whole friction of being on one of these long term. I'm curious how the tolerability profile compares to injectable sema though, because GI sides already make people bail on the pens. If the pill comes with the same nausea curve but no needle barrier, the dropout numbers could get interesting.

For anyone here already on a GLP-1, would you actually switch to an oral if your numbers stayed flat, or is weekly so routine that pills don't move the needle for you?

Comments

  • nomad_brandon: Yeah honestly the oral angle is the bigger story than people are giving it credit for, for what it is worth. The needle thing stops a lot of regular folks who would otherwise start, and my suspicion is compliance goes up way past where injectors sit right now, especially with people who travel for work or just hate the cold chain hassle. On tolerability i am cautiously pessimistic though. The molecule still hits the same receptors so i would bet the nausea curve looks similar at therapeutic dos
  • tiredmira: Yeah the receptor point is fair, same pathway basically means similar side effect ceiling in theory. But oral absorption variability is a real confounder for me. Some days you get more, some days less, so the nausea could feel less predictable even if the average looks the same on paper. The compliance angle is where I keep landing too. Half my friends who would benefit won't touch a pen, full stop. A pill changes that conversation entirely. Curious if Lilly releases any real world adherence da
  • nerdy_ironman: Yeah imo the needle barrier is real, more people i've talked to would actually start something oral vs injecting weekly even though the shots are tiny. On the nausea thing though, i tried oral sema for a few weeks years back and the GI stuff hit me faster and harder than the shot ever did, so i'm with you on expecting at least similar maybe slightly worse early. Curious if splitting timing with food changes that much.
  • tiredmira: Honestly the oral sema experience you had is basically what I'm worried about too, the GI curve matters more than people admit. Splitting timing with food is interesting though, I haven't seen anyone actually test that with the GLP-1s. Would you split the dose AM/PM or just take it fasted vs with a meal? Curious what you'd even track to know if it helped, maybe just symptom severity in a log 😅

Community discussion - research and educational context only. Not medical advice.