Peptide Graded

All peptides / Gut and weight

Amycretin

Amylin + GLP-1 co-agonist

Also Zenagamtide, NN9487, NNC0487-0111

Evidence
BSome human evidence
FDA status
In clinical trialsas of 2026-10-26
Route
Several routes
Studies cited
3 human0 animal or cell

A pill or weekly shot from Novo Nordisk, tried for weight loss and type 2 diabetes. It has early human trials, and they show large weight loss.

Sold for

Amycretin is talked about as Novo Nordisk's next step after semaglutide and CagriSema: one molecule that hits both the GLP-1 and amylin receptors, available as a pill or a weekly injection.

Studies say

Early randomized trials show large, dose-dependent weight loss over up to 36 weeks with the usual gastrointestinal side effects, but the trials were small and many participants dropped out, so the evidence is grade B pending phase 3.

Why grade B. The published human data are a first-in-human phase 1 trial of the oral tablet in 144 people, a 125-participant phase 1b/2a trial of the weekly injection, and a 186-participant phase 2 trial of the oral form in type 2 diabetes published in 2026, all randomized and placebo-controlled. In the obesity trials weight change was a secondary or exploratory endpoint and dropout was high, so the weight-loss use is grade B until the phase 3 programme reports. 135

FDA. Amycretin (international nonproprietary name zenagamtide) is an investigational drug from Novo Nordisk and is not approved by the FDA or any other regulator. It entered phase 3 trials for weight management in 2026. 14

Written from 5 cited sources. Fact-checked 2026-10-27: 16 claims checked, 3 corrected. Last refreshed 2026-10-27. Not physician reviewed.

What this means for you

What people take it for
Weight loss and blood sugar
Can a US doctor prescribe it?
Not yet; it is still in trials.
Properly tested in people?
Partly: early trials of 125 to 186 people, with many dropouts.

Evidence checklist

  • Randomised controlled trial Phase 1b/2a placebo-controlled, n=125yes
  • Human study over 100 people 125 in the largest published trialyes
  • More than one research group Single sponsor, Novo Nordiskno information
  • Clinical outcomes, not surrogate markers Weight change in early-phase trialsno
  • Human safety data beyond case reports Short trials, mostly GI effectsno

Drawn from the cited studies below. A dash means the sources give no information.

What it is

Amycretin is a lab-made peptide that activates two receptors at once. One is the GLP-1 receptor, the target of semaglutide. The other is the amylin receptor, the target of cagrilintide. Novo Nordisk designed it so one molecule could do what the two-drug combination CagriSema does with two injections. Its generic name is zenagamtide. 123

Two forms are in development. One is a tablet taken daily. The other is an injection under the skin, given once a week. Both have been tested in randomized placebo-controlled trials in people with overweight or obesity. 35

How it works

GLP-1 is a gut hormone. It increases insulin release when blood sugar is high and slows stomach emptying. It also reduces appetite through receptors in the brainstem and hypothalamus. Amylin is a hormone from the pancreas that is released along with insulin. It makes you feel full after meals, slows stomach emptying and suppresses glucagon. It works through its own receptor, which is built from the calcitonin receptor plus an accessory protein. In trials of the separate drugs, hitting both pathways produced more weight loss than either alone. Amycretin aims to do the same with one molecule. 23

What human research shows

The injection was tested in a phase 1b/2a randomized placebo-controlled study at a single site in San Antonio. In five parts, 125 adults with overweight or obesity were assigned to amycretin or placebo. Treatment lasted up to 36 weeks. Weight loss was significantly greater than placebo in every dose-escalation group, and the effect grew with the dose. The authors noted many people dropped out, mostly for reasons unrelated to side effects. 3

The tablet went through a first-in-human randomized phase 1 trial in 144 people with overweight or obesity. It was also published in The Lancet in 2025. Weight change over 12 weeks was tracked as an exploratory outcome. In 2026 The Lancet published a 36-week phase 2 trial of the tablet, under the name zenagamtide, in 186 adults with type 2 diabetes. HbA1c fell by 0.9 to 1.4 percentage points across the three trial doses, significantly more than with placebo. Stomach and gut effects were the most common adverse events. 15

Novo Nordisk started a phase 3 trial of amycretin in February 2026 (AMAZE 1, NCT07339423). No phase 3 results have been published. 4

StudyModelFinding
Subcutaneous amycretin phase 1b/2a, Lancet 2025Humans, n=125 with overweight or obesity, randomized placebo-controlled, up to 36 weeksDose-dependent weight loss significantly greater than placebo in all multiple-dose groups, with mainly gastrointestinal side effects and many withdrawals. 3
Oral amycretin phase 1, Lancet 2025Humans, n=144 with overweight or obesity, randomized placebo-controlled first-in-human, single doses and multiple doses up to 12 weeksThe daily tablet was safe and tolerable, with dose-dependent and mostly gastrointestinal adverse events; weight change was an exploratory endpoint. 5
Oral zenagamtide phase 2, Lancet 2026Humans, n=186 with type 2 diabetes, randomized double-blind placebo-controlled, 36 weeksHbA1c fell 0.9 to 1.4 percentage points across three trial doses, each significantly more than placebo. 1
AMAZE 1 phase 3 (NCT07339423)Humans, phase 3, recruiting since February 2026First large trial of amycretin for weight management; no results yet. 4

Safety

The most common adverse events in the 36-week injection study were in the gut: nausea, vomiting and reduced appetite. Most were mild to moderate and had resolved by the end of the study. That pattern matches GLP-1 and amylin drugs tested separately. 3

The trials so far are small and short. So nothing is known about effects over years. Nor is it known whether rare events such as pancreatitis or gallbladder disease will appear, as they do in large GLP-1 trials. Nobody knows what happens to weight after stopping. The high dropout rate in the phase 1b/2a study also makes the estimates of whether it works less certain than the headline numbers suggest. 3

Questions for your clinician

  • Is amycretin available to me only through a clinical trial?
  • How do approved weight-loss drugs compare while amycretin is still in phase 3?
  • What is known about its safety beyond 36 weeks?

Questions people ask

Is amycretin FDA-approved?

No. It is in phase 3 trials and has not been submitted for approval anywhere. Any product sold online under this name is unregulated. 14

How is amycretin different from CagriSema?

CagriSema is two separate peptides, cagrilintide and semaglutide, injected together. Amycretin is one peptide designed to activate both the amylin and GLP-1 receptors on its own. It also comes as a tablet. 23

How much weight did people lose in the trials?

In the 36-week injection study, weight loss rose with dose. It was significantly greater than placebo in every multiple-dose group. The groups were small and many people dropped out. So read the exact figures as preliminary until phase 3 data arrive. 3

Is amycretin a pill or an injection?

Both forms are being developed. The tablet has completed a phase 1 trial in obesity and a phase 2 trial in type 2 diabetes. The once-weekly injection has completed a phase 1b/2a trial. 135

Citations

  1. Mora 2026, Lancet: oral zenagamtide (amycretin) phase 2 trial in type 2 diabetes doi.org
  2. StatPearls: Glucagon-like peptide-1 receptor agonists ncbi.nlm.nih.gov
  3. Lancet 2025: subcutaneous amycretin phase 1b/2a randomised controlled study doi.org
  4. ClinicalTrials.gov: AMAZE 1 phase 3 trial of amycretin clinicaltrials.gov
  5. Gasiorek 2025, Lancet: first-in-human phase 1 trial of oral amycretin doi.org

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