Retatrutide vs Ozempic: Results and Approval Status
Retatrutide is an experimental weight-loss medicine from Eli Lilly. Ozempic is a medicine that is already sold in South Africa. People often ask how they compare. This article explains how each one works, what the trials show, where retatrutide’s development stands and what its status is in South Africa. It is based on the companies’ own announcements, published studies and the South African regulator. Facts are current as of 5 October 2026.
The short answer
- Retatrutide is not approved anywhere yet. Lilly says it plans to ask the US regulator for approval in the first quarter of 2027.
- It is not registered in South Africa and cannot legally be sold here. The regulator, SAHPRA, calls it “still under clinical investigation”.
- In trials it produced larger average weight loss than the trials of semaglutide, the medicine in Ozempic. But the trials differ, so the numbers cannot be compared directly (see below).
- Ozempic is a prescription medicine registered in South Africa for type 2 diabetes.
How retatrutide and Ozempic work
Both medicines copy natural gut hormones that affect appetite, digestion and blood sugar. Ozempic (semaglutide) copies one hormone, GLP-1. Retatrutide copies three: GLP-1, GIP and glucagon. The glucagon part is what sets it apart from medicines that are approved today. It is why researchers are studying whether it can do more than medicines that act on one or two hormones.
What the trials show
All figures below are average weight change from the start of each trial, compared with placebo (a dummy injection). Individual results vary a lot.
| Medicine and trial | Who took part | Average weight change (placebo) |
|---|---|---|
| Retatrutide, phase 2 (NEJM, 2023) | 338 adults with obesity or overweight | Up to −24.2% at 48 weeks (−2.1%) |
| Retatrutide, TRIUMPH-1 (Lilly, 2026) | Adults with obesity or overweight | Up to −28.3% at 80 weeks (−2.2%) |
| Retatrutide, TRIUMPH-2 (Lilly, July 2026) | Adults with type 2 diabetes and obesity or overweight | Up to −20.8% at 80 weeks |
| Retatrutide, TRIUMPH-3 (Lilly, July 2026) | Adults with severe obesity and heart disease | Up to −22.6% at 80 weeks (−3.2%) |
| Semaglutide, STEP 1 (NEJM, 2021) | Adults with overweight or obesity | −14.9% at 68 weeks (−2.4%) |
Three things to keep in mind when you read these numbers:
- The retatrutide trials in the table compared it with placebo, not with Ozempic. So the gap between 28% and 15% is not a head-to-head result. Lilly is running a trial that compares retatrutide with semaglutide in people with type 2 diabetes (TRANSCEND-T2D-2). It finished collecting its main data in August 2026, and we have not found its results.
- The trials differ. They lasted different lengths of time and enrolled different people. The retatrutide figures are for the highest strength tested.
- Ozempic is registered in South Africa for type 2 diabetes, not for weight loss. The STEP 1 trial tested semaglutide for weight management, which in South Africa is the medicine sold as Wegovy.
Side effects and safety so far
Lilly reports that unusual skin sensations (dysesthesia) and urinary tract infections were more common with retatrutide than with placebo, and were mostly mild to moderate. More people stopped treatment because of side effects at higher strengths. In TRIUMPH-1, between 4.1% and 11.3% of people on retatrutide stopped for this reason, depending on the strength, against 4.9% on placebo. In TRIUMPH-3 the figures were 9.8% and 13.5% against 4.8% (Lilly). Long-term safety is still being studied and has not yet been reviewed by any regulator.
Where development stands
Retatrutide is in phase 3, the last stage before a company asks regulators for approval. Four phase 3 trials are now complete: TRIUMPH-1, TRIUMPH-2, TRIUMPH-3 and TRIUMPH-4. Lilly is also running further studies, including one on heart and kidney outcomes (NCT06383390) one comparing retatrutide with semaglutide in type 2 diabetes (NCT06260722) and one comparing it with tirzepatide, the medicine in Mounjaro (NCT06662383).
When could it be approved?
Lilly says it plans to submit an application to the US Food and Drug Administration in the first quarter of 2027 (Lilly, 23 July 2026). After that, regulators take many months to review the data, and Lilly has not announced a decision date. Approval in South Africa is a separate decision made by SAHPRA. We have not found any announcement from Lilly about a South African application, so it is not possible to say when, or whether, retatrutide will be sold here.
Is retatrutide legal in South Africa?
No. Retatrutide is not registered in South Africa. SAHPRA’s compliance manager, Mokgadi Fafudi, told the Mail & Guardian: “It is still under clinical investigation. It’s not even yet available in any market as approved for routine sale” (Mail & Guardian, 2 July 2026). She also said that seeing such products sold online is “a red flag” because “that is not the authorised channel”.
The regulator has warned that products sold this way have never been checked for quality, safety or effectiveness, and that buyers cannot know what is in them. SAHPRA asks anyone who bought a product marketed as retatrutide to stop using it, keep the packaging and report the seller. See the regulator’s press releases on illegal and unregistered weight-loss injections. We do not list or link to sellers of unregistered medicines.
What is registered in South Africa: Ozempic, for type 2 diabetes; Wegovy (also semaglutide), for weight management; Mounjaro (tirzepatide), for weight management; and two lower-cost semaglutide pens for type 2 diabetes, Extensior and Semagard. All of them are prescription medicines.
What this means for you
- Whether any of these medicines is right for you is a decision for you and your doctor. Read our Medical Disclaimer.
- If you have a prescription, you can see the highest legal price and compare registered pharmacies in our pharmacy ranking, for example Ozempic price at Clicks or Ozempic price at Dis-Chem.
- Learn how we compare pharmacies on How we rate.
Common questions
Is retatrutide approved?
No. It is not approved by any regulator. Lilly plans to apply to the US regulator in early 2027.
Is retatrutide the same as Ozempic?
No. They are different medicines. Ozempic acts on one hormone receptor, retatrutide on three.
How is retatrutide different from Mounjaro?
Mounjaro (tirzepatide) acts on two receptors, GIP and GLP-1, and is registered in South Africa. Retatrutide adds a third, glucagon, and is still being tested.
When will retatrutide be available in South Africa?
Nobody can say yet. It has not been approved anywhere, and we have found no South African application. Until SAHPRA registers it, any product sold as retatrutide in South Africa is unregistered.
Sources
- Eli Lilly: TRIUMPH-2 and TRIUMPH-3 results and US submission plan (23 July 2026)
- Eli Lilly: TRIUMPH-1 results (2026)
- Jastreboff et al., retatrutide phase 2 trial, New England Journal of Medicine, 2023 (PubMed)
- Wilding et al., STEP 1, once-weekly semaglutide, New England Journal of Medicine, 2021 (PubMed)
- ClinicalTrials.gov: TRIUMPH-1 (NCT05929066)
- ClinicalTrials.gov: TRIUMPH-2 (NCT05929079)
- ClinicalTrials.gov: TRIUMPH-3 (NCT05882045)
- ClinicalTrials.gov: TRIUMPH-4 (NCT05931367)
- ClinicalTrials.gov: TRANSCEND-T2D-2, retatrutide compared with semaglutide (NCT06260722)
- SAHPRA: press releases on unregistered GLP-1 medicines
- Mail & Guardian: Illegal weight loss drug floods SA (2 July 2026)
- Spotlight: which weight-loss medicines can you get in SA (2025)
- Business Insider Africa: Novo Nordisk launches Extensior (July 2026)