Elecoglipron (development codes AZD5004 and ECC5004) is an investigational once-daily tablet that activates the glucagon-like peptide-1 (GLP-1) receptor, the target of semaglutide. It is a small synthetic molecule rather than a peptide, discovered by Eccogene and licensed to AstraZeneca, and in phase 2 trials it lowered body weight by about 11% over 36 weeks without any fasting rules around the dose.
The single most important fact: elecoglipron is not approved anywhere. AstraZeneca moved it into phase 3 in mid-2026, and the main weight-loss trial, EMBOLD, is not expected to reach its primary completion date until July 2028 (EMBOLD registry, NCT07667803). Status was checked on November 7, 2026.
This page summarizes what the published trials, trial registrations and company disclosures report, with notes on the questions anabolics.app readers tend to ask: lean mass, the liver, use alongside testosterone, and sport. It is for education only and is not medical advice.
| Property | Detail |
|---|---|
| Drug class | Non-peptide (small-molecule) GLP-1 receptor agonist |
| Developer / codes | Discovered by Eccogene (ECC5004); licensed to AstraZeneca in November 2023 (AZD5004) |
| Approval status | Investigational; not approved by the FDA, EMA or any other regulator |
| Route | Oral tablet, once daily, taken with or without food |
| Doses studied | Phase 2: 5–75 mg/day, higher doses reached by stepwise escalation; phase 3 doses not disclosed |
| Half-life | About 21 hours after a single 50 mg dose in healthy volunteers |
| Current trials | EMBOLD (weight), ELUMINATE 1–5 (type 2 diabetes), ELEVATE-HF and ELEVATE-CKD (outcomes), plus an Asian obesity trial |
| WADA status | Not named on the 2026 List; as an unapproved drug it falls under S0 (non-approved substances) |
What it is
Elecoglipron is an ordinary-looking drug molecule, not a modified hormone. That matters because peptide GLP-1 drugs such as semaglutide are broken down in the gut. Oral semaglutide needs an absorption enhancer and a strict empty-stomach routine. A small molecule can simply be swallowed.
Laboratory work published by the developers describes how it acts at the receptor (Haggag et al., Diabetes Obes Metab 2025):
- It binds the human GLP-1 receptor (IC50 2.4 nM, a measure of binding strength) and raises cAMP, the main signal the receptor sends inside the cell.
- It did this without recruiting β-arrestin-2 or causing the receptor to be pulled into the cell (internalization). Drugs that favor one signaling route over another are called “biased” agonists. Whether this changes anything for patients is not established.
- It strengthened glucose-triggered insulin release in a human beta-cell line and in monkeys.
- A 9-month oral toxicity study in monkeys showed dose-dependent weight changes.
Where it came from
Eccogene, a biotech company, developed the molecule as ECC5004. On November 9, 2023, it granted AstraZeneca exclusive rights outside China for an upfront payment of $185 million, with up to $1.825 billion more in milestones plus royalties. The two companies co-develop it in China (Eccogene license announcement). ECC5004, AZD5004 and elecoglipron all name the same molecule.
How it compares with related drugs
| Drug | Molecule | Route | Status (November 2026) | Library page |
|---|---|---|---|---|
| Semaglutide | Peptide | Weekly injection or daily tablet with fasting rules | Approved | Semaglutide |
| Orforglipron | Small molecule | Daily tablet, no food rules | FDA-approved April 2026 (Foundayo) | Orforglipron |
| Elecoglipron | Small molecule | Daily tablet, no food rules | Phase 3 | This page |
| Aleniglipron | Small molecule | Daily tablet | Phase 3 | Aleniglipron |
| HRS-7535 (safiglipron) | Small molecule | Daily tablet | Under review in China | HRS-7535 |
Orforglipron is the closest approved relative: also a daily non-peptide pill, also free of fasting rules. No trial has compared elecoglipron with orforglipron directly.
Pharmacokinetics
Two published phase 1 studies describe how the body handles elecoglipron:
| Finding | Detail | Source |
|---|---|---|
| Single doses tested | 1–300 mg in healthy volunteers; 5–50 mg daily for 28 days in people with type 2 diabetes | Haggag et al. 2025 |
| Exposure | Roughly proportional to dose at 25 mg and above | Haggag et al. 2025 |
| Time to peak | Median about 8–12 hours after a single dose | Haggag et al. 2025 |
| Half-life | 20.7–21.2 hours for a 50 mg dose, fed or fasted | Xu et al., Br J Clin Pharmacol 2026 |
| Food effect | Total exposure essentially unchanged between fed and fasted states (ratio 0.95–0.96) | Xu et al. 2026 |
The first-in-human study could not pin down the half-life because blood samples were taken for only 48 hours. The later food-effect study, in 14 healthy adults, filled that gap and concluded that the drug suits once-daily dosing with or without food.
AstraZeneca has also completed or started formal drug-interaction studies. One tested whether elecoglipron changes blood levels of rosuvastatin, atorvastatin, simvastatin and repaglinide, and whether the antibiotic erythromycin changes elecoglipron levels (NCT06948747). No results had been posted when we checked. Results matter for anyone taking a statin, a common add-on for people managing cholesterol.
Regulatory status
- Not approved. No regulator has approved elecoglipron for any use. No marketing application has been announced.
- Phase 3 started in mid-2026. AstraZeneca announced the move to phase 3 on June 8, 2026, alongside the phase 2 results (AstraZeneca, June 2026).
- Prescription use. It is available only inside clinical trials. Anything sold online under this name is an unverified product, not the trial drug.
- Sport. See “Use in sport” below.
Registered phase 3 trials
| Trial | Population | Planned size | Main endpoint | Estimated primary completion |
|---|---|---|---|---|
| EMBOLD | Obesity or overweight, with or without type 2 diabetes | 4,500 | Percent weight loss at 72 weeks, vs placebo | July 2028 |
| Asian obesity trial | Asian adults with obesity or overweight | 351 | Percent weight loss at 52 weeks | April 2028 |
| ELUMINATE-1 | Type 2 diabetes; alone or with dapagliflozin vs placebo | 800 | HbA1c at 40 weeks | July 2028 |
| ELUMINATE-2 | Type 2 diabetes; open-label vs oral semaglutide | 1,200 | HbA1c at 52 weeks | May 2028 |
| ELUMINATE-3 | Type 2 diabetes on insulin; vs placebo | 600 | HbA1c at 40 weeks | May 2028 |
| ELUMINATE-4 | Type 2 diabetes with impaired kidney function, on dapagliflozin | 900 | HbA1c at 40 weeks | July 2028 |
| ELUMINATE-5 | Type 2 diabetes; elecoglipron plus dapagliflozin vs each alone | 2,000 | HbA1c at 40 weeks | July 2028 |
| ELEVATE-HF | Heart failure with preserved or mildly reduced ejection fraction | 6,950 | Cardiovascular death or heart-failure events | September 2029 |
| ELEVATE-CKD | Chronic kidney disease | 7,000 | Kidney-function decline, kidney failure or death | October 2030 |
HbA1c is the average blood sugar over about three months. EMBOLD lists two active dose arms and placebo but does not name the doses. Several of these trials pair elecoglipron with dapagliflozin, AstraZeneca’s SGLT2 inhibitor.
What the research shows
Weight loss in obesity (VISTA, phase 2)
VISTA randomized 310 adults without diabetes who had obesity, or overweight with a weight-related condition, at sites in seven countries (Davies et al., Lancet 2026). Mean weight at entry was 106.9 kg, mean BMI 38.2, and 73% were women. Five dosing arms were tested: fixed 5 mg and 15 mg, 50 mg reached by steps every 4 weeks, and 75 mg reached by steps every 2 weeks or every week.
| Outcome | Placebo | Elecoglipron range | Best arm (75 mg, weekly steps) |
|---|---|---|---|
| Weight change at week 26 (primary) | −0.6% | −2.6% (5 mg) to −10.5% | −10.5% |
| Lost at least 5% at week 26 | 15.6% | 40.4% to 88.8% | 88.8% |
| Weight change at week 36 | −0.3% | — | −11.8% |
The week 36 figures come from AstraZeneca’s release (AstraZeneca, June 2026). Two caveats apply:
- Dose drives everything. The lowest dose barely beat placebo. The 10–12% headline belongs to the top dose.
- Adherence was incomplete. 93% finished the study, but only 75% finished their assigned treatment. Results are estimates assuming people took the drug as planned.
Type 2 diabetes (SOLSTICE, phase 2b)
SOLSTICE treated 404 adults with type 2 diabetes (mean HbA1c 7.9%, mean weight 99.8 kg) for 26 weeks. It compared several elecoglipron regimens with placebo and included an open-label oral semaglutide arm for reference (Aroda et al., Lancet 2026).
| Outcome at 26 weeks | Placebo | Elecoglipron | Oral semaglutide 14 mg (open label) |
|---|---|---|---|
| HbA1c change | −0.15 points | −0.91 (5 mg) to −1.88 (75 mg) | −1.3 |
| Weight change | −1.7% | −7.7% (75 mg) | −5.1% |
| HbA1c under 7% (75 mg) | 25% | 90% | — |
The semaglutide figures and the target-attainment rates come from AstraZeneca’s release (AstraZeneca, June 2026). The semaglutide arm was not blinded and was not part of a formal comparison, so the numbers cannot rank the two drugs. ELUMINATE-2 is the head-to-head test.
As with every GLP-1 drug, weight loss was smaller in people with diabetes than in people without it.
Lean mass and body composition
This is the question most relevant to lifters, and there are no published data. Neither Lancet paper reports body composition, and AstraZeneca’s results release does not mention lean mass. No registered elecoglipron trial lists lean mass or DXA scans (dual-energy X-ray absorptiometry, a body-composition scan) as an endpoint.
Data from approved drugs in the same class give a rough expectation. A 2026 meta-analysis of 20 randomized semaglutide trials estimated that lean mass made up about 35% of the weight lost, a share not statistically different from lifestyle-only weight loss, with diet plus resistance training giving the best ratio (Eisa and Barood, Diabetes Obes Metab 2026). “Lean mass” on a DXA scan includes water, organs and connective tissue, not only skeletal muscle. Whether elecoglipron behaves the same way has not been measured.
Use alongside testosterone or anabolic steroids
No trial has tested elecoglipron in people on testosterone replacement therapy (TRT) or anabolic-androgenic steroids (AAS). What exists is indirect:
- Testosterone levels. A 2026 systematic review of 10 studies (639 men) found that peptide GLP-1 drugs such as liraglutide and semaglutide raised total testosterone in men with obesity, diabetes or functional hypogonadism, while LH and FSH were preserved (Deameh et al., J Sex Med 2026). That effect is tied to weight loss in men with low testosterone. It has not been shown for elecoglipron, and it has no clear meaning for someone whose testosterone comes from injections.
- Testosterone to protect muscle during GLP-1 weight loss. A 2026 paper proposed combining incretin drugs with testosterone therapy in men with obesity and low testosterone. Its authors stated that the only direct human data are from a small non-randomized pilot and that randomized trials are needed (Zitzmann et al., Diabetes Obes Metab 2026). See the testosterone cypionate page for TRT itself.
Side effects and risks
Gastrointestinal effects
Stomach and gut effects were the main side effects, as with all GLP-1 drugs. AstraZeneca reported these rates for the 75 mg arms (AstraZeneca, June 2026):
| Adverse event | VISTA: 75 mg | VISTA: placebo | SOLSTICE: 75 mg | SOLSTICE: placebo |
|---|---|---|---|---|
| Nausea | 55% | 20% | 37% | 3% |
| Constipation | 41% | 6% | 29% | 4% |
| Diarrhea | 35% | 25% | 21% | 15% |
| Vomiting | 29% | 5% | 18% | 1% |
In VISTA, adverse events of any kind were reported by 84–98% of people on elecoglipron vs 84% on placebo. In SOLSTICE the range was 63–87% vs 63% (Davies et al. 2026; Aroda et al. 2026). AstraZeneca described discontinuations for adverse events as infrequent but did not give numbers in its release. In SOLSTICE, low blood sugar was uncommon and caused no serious events.
The liver
Small-molecule GLP-1 drugs are mostly cleared through the liver, so liver safety gets close attention in this class. Pfizer stopped developing its own oral GLP-1 pill, danuglipron, in 2025 after one trial participant had possible drug-induced liver injury that resolved when the drug was stopped (Pfizer, 2025).
For elecoglipron, AstraZeneca reported no liver safety signal in VISTA or SOLSTICE (AstraZeneca, June 2026). The phase 2 trials were short (26–36 weeks) and enrolled about 700 people in total, which is too few to rule out rare liver injury.
Anabolic steroids are a recognized cause of liver injury, including a specific form of cholestasis (impaired bile flow), peliosis hepatis (blood-filled cysts) and liver tumors (Petrovic et al., World J Gastroenterol 2022). A Latin American registry of 18 young men with liver injury from oral stanozolol (Winstrol) found jaundice and itching with very high bilirubin (Nunes et al., J Clin Exp Hepatol 2025). No study has looked at elecoglipron in people taking these drugs, so the combined effect on the liver is unknown.
Gaps in the safety data
- Phase 2 lasted at most 36 weeks. Phase 3 will be the first look at 72 weeks and beyond.
- Class risks seen with approved GLP-1 drugs, including gallbladder disease, pancreatitis and the thyroid C-cell tumor warning on approved GLP-1 labels, cannot yet be confirmed or excluded for elecoglipron.
- Effects in pregnancy, adolescents and lean or athletic people have not been studied.
Use in sport
Elecoglipron is not named on the WADA Prohibited List. The S0 class prohibits at all times any pharmacological substance that is not covered elsewhere on the List and has no current approval by any government health authority for human therapeutic use, including drugs “under pre-clinical or clinical development” (WADA 2026 Prohibited List). As an unapproved investigational drug, elecoglipron falls into that class. This could change if a regulator approves it.
Approved GLP-1 drugs are treated differently: they are not prohibited, but WADA has placed markers of semaglutide and tirzepatide on its 2026 Monitoring Program to watch for misuse (WADA 2026 Monitoring Program).
Key takeaways
- A GLP-1 pill that is not a peptide. Elecoglipron is a small molecule taken once daily with or without food, with a half-life of about 21 hours.
- Not approved anywhere. Phase 3 began in mid-2026; the main weight trial, EMBOLD, has an estimated primary completion of July 2028 (checked November 7, 2026).
- About 11–12% weight loss at the top phase 2 dose. VISTA showed 10.5% at 26 weeks and 11.8% at 36 weeks on 75 mg, vs under 1% on placebo. Low doses did little.
- Gastrointestinal effects are common. At 75 mg in VISTA, 55% had nausea and 29% vomited.
- No lean-mass data. No published or registered trial measures body composition, so its effect on muscle is unknown.
- Prohibited in sport under S0. As an unapproved drug it falls under WADA’s catch-all class for non-approved substances.
Sources
- Haggag AZ, Xu J, Butcher L, et al. Non-clinical and first-in-human characterization of ECC5004/AZD5004, a novel once-daily, oral small-molecule GLP-1 receptor agonist. Diabetes Obes Metab. 2025;27(2):551–562. PubMed.
- Xu J, Haggag A, Butcher L, et al. Phase 1, open-label, randomized study of the elecoglipron pharmacokinetic profile in healthy participants under fed and fasted conditions. Br J Clin Pharmacol. Published online October 19, 2026. PubMed.
- Davies MJ, Aroda VR, Rosenstock J, et al. Elecoglipron, an oral small molecule GLP-1 receptor agonist in adults with obesity or overweight (VISTA): a multicentre, phase 2, randomised, placebo-controlled clinical trial. Lancet. 2026;407(10547):2503–2514. PubMed.
- Aroda VR, Davies MJ, Maaske J, et al. Elecoglipron, an oral small molecule GLP-1 receptor agonist in adults with type 2 diabetes (SOLSTICE): a multicentre, phase 2b, randomised, placebo-controlled trial. Lancet. 2026;407(10547):2515–2527. PubMed.
- AstraZeneca. Elecoglipron, an oral small molecule GLP-1 RA, moves to Phase III programme. Press release, June 8, 2026. AstraZeneca.
- Eccogene. Eccogene enters exclusive license agreement with AstraZeneca to develop and commercialize small molecule GLP-1 receptor agonist ECC5004 for cardiometabolic diseases. Press release, November 9, 2023. PR Newswire.
- ClinicalTrials.gov. A master protocol to investigate efficacy and safety of elecoglipron in participants with obesity or overweight (EMBOLD). NCT07667803. ClinicalTrials.gov.
- ClinicalTrials.gov. A study to investigate the efficacy and safety of elecoglipron in Asian participants with obesity or overweight with or without type 2 diabetes mellitus. NCT07775404. ClinicalTrials.gov.
- ClinicalTrials.gov. ELUMINATE-1 to ELUMINATE-5 phase III trials of elecoglipron in type 2 diabetes. NCT07662044, NCT07662213, NCT07664553, NCT07662135, NCT07662109. ELUMINATE-1; ELUMINATE-2; ELUMINATE-3; ELUMINATE-4; ELUMINATE-5.
- ClinicalTrials.gov. ELEVATE-HF and ELEVATE-CKD outcome trials of elecoglipron. NCT07761117, NCT07753993. ELEVATE-HF; ELEVATE-CKD.
- ClinicalTrials.gov. A study to investigate the effect of AZD5004 on rosuvastatin, atorvastatin, simvastatin, repaglinide and the effect of erythromycin on AZD5004 in healthy participants. NCT06948747. ClinicalTrials.gov.
- Eisa N, Barood O. Lean mass changes with incretin therapy versus lifestyle intervention: a systematic review and meta-analysis of randomised controlled trials. Diabetes Obes Metab. 2026;28(6):4818–4827. PubMed.
- Deameh MG, Ramez M, Rowaiee R, et al. Effects of glucagon-like peptide-1 receptor agonists on male reproductive hormones, semen parameters, and metabolic outcomes: a systematic review. J Sex Med. 2026;23(2):qdaf381. PubMed.
- Zitzmann M, Bosnyak Z, Jones R, et al. Weight regain after incretin treatment: the lean mass deficit hypothesis and a role for testosterone combination therapy in men. Diabetes Obes Metab. Published online October 19, 2026. PubMed.
- Petrovic A, Vukadin S, Sikora R, et al. Anabolic androgenic steroid-induced liver injury: an update. World J Gastroenterol. 2022;28(26):3071–3080. PubMed.
- Nunes V, Schinoni MI, Bessone F, et al. Stanozolol-induced liver injury: a distinctive cholestatic clinical and biochemical phenotype at presentation. J Clin Exp Hepatol. 2025;15(3):102506. PubMed.
- Pfizer. Pfizer provides update on oral GLP-1 receptor agonist danuglipron. Press release, 2025. Pfizer.
- World Anti-Doping Agency. World Anti-Doping Code International Standard: Prohibited List 2026. WADA 2026 Prohibited List.
- World Anti-Doping Agency. The 2026 Monitoring Program. WADA.