Amycretin (Zenagamtide): What It Is, What Early Trials Showed and Where It Stands

As of October 5, 2026, amycretin is an investigational drug from Novo Nordisk that activates the receptors for two hormones, GLP-1 and amylin, with a single molecule^[3,5]. It is being studied in two forms: a once-weekly injection and a once-daily tablet^[12]. Its official name is now zenagamtide, the nonproprietary name proposed by the World Health Organization^[6]. It is not approved in any country: it does not appear among the FDA’s novel drug approvals for 2026 or in Drugs@FDA, and as of September 4 it was not on the European Medicines Agency’s list of applications under review^[30,31,32]. So far there are only phase 1 and 2 data, from small groups. Phase 3 began in 2026, and the earliest estimated completion dates for those trials are in mid-2028^[16,24,26].

This is general information, not treatment guidance. If you are considering this or any other medication, talk to your doctor.

What amycretin is, and why it is now called zenagamtide

Amycretin is the name Novo Nordisk used while developing this molecule, also known by its code NNC0487-0111^[13,14]. In 2025, the WHO published its proposed International Nonproprietary Name: zenagamtide^[6]. The 2026 papers and the newest trial records already use that name, and Novo Nordisk now describes it as “zenagamtide, formerly known as amycretin”^[3,12]. It is the same drug. How these names are built is explained in GLP-1 generic and brand names.

It is a peptide, a chain of amino acids. According to the WHO description, one part is a modified version of human GLP-1 and the other is an artificial peptide that activates the amylin receptor, joined by a short linker. It also carries a fatty-acid side chain^[6]. That chain lets it bind to albumin in the blood and keeps it in the body longer^[5].

How it works: GLP-1 and amylin in one molecule

GLP-1 is the hormone behind semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound): it curbs appetite and helps control blood sugar. Amylin is a different hormone. According to the FDA label for pramlintide, an amylin analog approved for diabetes, amylin is released by the pancreas together with insulin after eating, slows gastric emptying, suppresses glucagon secretion and regulates food intake through the brain^[34]. Amylin receptors are built on the calcitonin receptor, which is why the 2026 papers describe amycretin as an agonist of GLP-1, amylin and calcitonin receptors^[3,5].Dotted underline: a drug-label fact; hover over it to see the date it was checked.

How it differs from CagriSema. CagriSema, also from Novo Nordisk, aims for the same two pathways with two molecules in one injection: cagrilintide, which mimics amylin, and semaglutide^[35]. Amycretin does it with one. According to the Novo Nordisk team that designed it, simply attaching cagrilintide’s sequence to semaglutide’s cost a lot of potency at the amylin receptor, so they used a different sequence for that part^[5]. Whether one molecule works better or worse than two has not been shown: no trial compares amycretin with CagriSema.

How each molecule fits into the family is covered in what GLP-1 medications are.

Phase 1: the first results (The Lancet, 2025)

In June 2025, The Lancet published the first two trials in people. Both ran at a single site in San Antonio, Texas, and were funded by Novo Nordisk^[1,2]. Their main goal was safety, not weight loss.

Injection figures: the paper’s abstract^[2]. Tablet figures: Novo Nordisk’s press release^[7]; the paper’s abstract does not report weight^[1].

These numbers need a lot of caution:

• Very small groups. Each dose was tested in a few dozen people or fewer^[1,2].
• Many dropouts. The injection paper itself says a large number of participants withdrew, many of them for reasons unrelated to side effects^[2].
• A favorable analysis. Novo Nordisk states that the injection figures assume everyone followed the planned dosing schedule with no discontinuations (the efficacy estimand)^[7]. Phase 3 trials usually report smaller numbers because they also count people who stop treatment.

Phase 2 in type 2 diabetes (The Lancet, 2026)

This was a single trial with two parts, one for the weekly injection and one for the daily tablet. It enrolled 448 adults with type 2 diabetes not controlled on metformin, with or without an SGLT2 inhibitor, at 83 sites in 11 countries, including the United States^[3,4,15]. It lasted 36 weeks, and the main goal was HbA1c (glycated hemoglobin, a measure of average blood sugar over the past few months)^[3,4].

Both papers use the efficacy estimand as their main analysis, based only on data from people still on treatment and without rescue medication^[3,4]. The weight figures are not in the papers’ abstracts: they come from Novo Nordisk’s press releases^[8,9]. For the injection, Novo Nordisk reported −14.6% versus −2.1% in its June 2026 release, and −14.5% versus −2.6% in its November 2025 announcement^[8,9].

Two important caveats. The highest doses were held only briefly: 8 weeks at 20 mg and just 4 weeks at 40 mg, because people reached them by stepping up gradually^[9]. And weight loss in type 2 diabetes tends to be smaller than without diabetes, as with every drug in this family (see how much weight people lose on GLP-1s).

There is no dedicated phase 2 trial in obesity without diabetes. Apart from the phase 1b/2a study, I have not found one on ClinicalTrials.gov. Based on the phase 1 results, Novo Nordisk announced in June 2025 that it would move both the injection and the tablet into phase 3 for weight management^[7].

Phase 3: the AMAZE and AMBITION programs

Novo Nordisk calls its obesity program AMAZE and its type 2 diabetes program AMBITION^[12]. The first trial, AMAZE 1, started in February 2026, and Novo Nordisk announced six more in May^[10,16]. As of October 5, 2026, these are the trials registered on ClinicalTrials.gov:

All are double-blind and use the weekly injection, except AMAZE 9, which tests the tablet^{[16,17,22,24,28,29]}. The date shown is the estimated primary completion date; results usually come months later. Novo Nordisk expects AMAZE 8 to read out in the first half of 2029 and HF-POLARIS in the second half^[11]. One detail: Novo Nordisk reported in August that AMAZE 8 had started, but its registry record, last updated in March, still listed it as “not yet recruiting” on October 5^[11,23].

US sites. Every trial in the table except AMAZE 10 and AMAZE 13 lists sites in the United States, and AMAZE 7 and AMAZE 9 are US-only^{[16,17,18,19,20,21,22,23,24,25,26,27,28,29]}. Each record on ClinicalTrials.gov lists its locations and contacts.

Amycretin vs. semaglutide, CagriSema, retatrutide, survodutide and orforglipron

Which one works best? There is no way to know. Amycretin has only phase 1 and 2 data: groups of a few dozen people, 12 to 36 weeks long, using the most favorable analysis^[1,2,3]. The others have phase 3 trials with hundreds or thousands of participants lasting more than a year^{[35,36,37,38]}. Putting the numbers side by side would be misleading. Phase 3 results for the other drugs are charted in the trial results chart. Another drug in development, maridebart cafraglutide (MariTide), has its own guide.

The only head-to-head comparisons under way are against semaglutide: AMAZE 7 in obesity and AMAZE 8 in type 2 diabetes, both double-blind^[22,23]. I have not found any trial on ClinicalTrials.gov comparing it with tirzepatide, CagriSema, retatrutide, survodutide or orforglipron.

What does set it apart is having two forms in development: the weekly injection and a daily tablet, which is already in phase 3 in AMAZE 9^[24]. The pills available today are covered in GLP-1 pills.

Side effects in the trials

There is no FDA label, so there is no official list of side effects, contraindications or warnings. This is what the papers report:

• Digestive. The most common in every trial, mostly mild to moderate^[1,2,3]. In the phase 2 tablet trial they affected 26%, 41% and 47% on 6, 25 and 50 mg, versus 23% on placebo^[4].
• Phase 1 tablet trial. 62% of participants, including those on placebo, had at least one side effect, all mild or moderate and more frequent at higher doses^[1].
• Serious events. In the phase 2 injection trial, 8% had a serious adverse event (21 of 261 people, 3 of them on placebo), with no clear link to dose; in the tablet trial, 4% on amycretin and no one on placebo^[3,4]. There were no deaths^[3,4].

With so few participants, rare side effects cannot be known yet. For digestive symptoms on approved GLP-1 drugs, see what to eat with nausea.

Is it FDA approved? Regulatory status

The FDA does not publish the applications it is reviewing, but in this case there is no reason to think one exists: the phase 3 trials are still enrolling, and Novo Nordisk does not list any amycretin submission among its expected 2026 milestones^[11].

Can you buy it? Unapproved products

Not legally. Outside clinical trials, amycretin cannot be prescribed anywhere. The FDA warns that illegal versions of drugs in this family are sold online falsely labeled “for research purposes” or “not for human consumption,” and urges people not to buy them because their quality is unknown and they may be harmful^[33]. That page does not name amycretin, and I have not found an FDA warning letter about products sold under that name. The trial results come from a product made by Novo Nordisk and say nothing about a vial bought online. If you have already used one, tell your doctor. For other products sold as alternatives, see natural Ozempic and supplements.

What is still unknown

• How much weight people lose in a large trial. AMAZE 1 and AMAZE 2, both 84 weeks long, will answer that around 2028 to 2029^[16,17].
• Whether the tablet works long term. AMAZE 9 is the first phase 3 trial of the oral form^[24].
• How it compares with semaglutide. AMAZE 7 and AMAZE 8 will measure that directly^[22,23].
• What it does to the heart. HF-POLARIS studies heart failure; I have not found a registered general cardiovascular safety trial^[29].
• What happens after stopping it, and how often rare side effects occur: current data cannot say.

Frequently asked questions

What is amycretin and what is it used for?

It is an investigational drug from Novo Nordisk that activates both the GLP-1 and amylin receptors with a single molecule^[3]. Its official name is zenagamtide^[6]. It is being studied for obesity and type 2 diabetes, as a weekly injection and a daily tablet^[12]. It is not approved for either.

Are amycretin and zenagamtide the same thing?

Yes. Amycretin was the development name; zenagamtide is the International Nonproprietary Name the WHO proposed in 2025^[6]. The 2026 papers refer to “zenagamtide (formerly amycretin)”^[3,4].

When will amycretin be available?

There is no date. The phase 3 trials have estimated completion dates in 2028 and 2029, and Novo Nordisk has not announced when it will apply for approval^[11,16,24]. A US launch would then depend on the FDA’s review.

Is amycretin better than Wegovy or Zepbound?

There is no way to know. No trial has compared it with tirzepatide (Zepbound), and the two trials comparing it with semaglutide (Wegovy) will not have results until late 2028 or 2029^[11,22,23]. The phase 1 and 2 numbers come from small, short studies and cannot be set beside phase 3 results^[1,2].