| Trial results
Vanda Pharmaceuticals reported phase 3 results for tradipitant (brand name NEREUS, also known as VLY-686 and formerly LY686017), an oral anti-nausea medicine that blocks the NK-1 receptor. In Study 3601, 306 people were randomized to tradipitant (142) or placebo (164) and then given a single 1 mg dose of semaglutide (Wegovy, Ozempic) with no gradual build-up. Any vomiting occurred in 43.0% of the tradipitant group and 58.5% of the placebo group (p=0.006), a 27% relative reduction, or about 15 more people per 100 who did not vomit.
| Outcome | Tradipitant | Placebo |
|---|---|---|
| Any vomiting (main goal) | 43.0% (61 of 142) | 58.5% (96 of 164) |
| Vomiting plus severe nausea (key secondary goal) | 33.1% (47 of 142) | 50.6% (83 of 164) |
| Frequent vomiting on more than one day (post hoc) | 6.3% (9 of 142) | 15.9% (26 of 164) |
| Extreme vomiting, more than 10 episodes (post hoc) | 2.8% (4 of 142) | 14.6% (24 of 164) |
Post hoc means the analysis was done after the main results rather than planned in advance. Almost all vomiting in both groups happened by day 2, and the gap between the groups was widest on days 1 and 2. Vanda reported no new safety signals.
The design was deliberately harsh. Wegovy normally reaches 1 mg after about nine weeks of gradual increases, and 58.5% of the placebo group vomited. The trial measured vomiting over a short window. It did not measure whether people stay on a GLP-1 medicine longer, lose more weight, or respond the same way to other medicines, and only semaglutide was tested.
NEREUS has been FDA approved since December 2025, but only for preventing vomiting caused by motion. Vanda plans to discuss the results with the FDA in 2027 and then file a supplemental application. An earlier phase 2 study of 116 adults found vomiting in 29.3% on tradipitant and 58.6% on placebo after a 1 mg Wegovy dose.
Worth knowing: NEREUS is not approved for nausea or vomiting from GLP-1 medicines. These are company-reported results that have not been published in a journal. The announcement did not state the tradipitant dose used in phase 3 or give a table of side effects. If nausea is affecting your treatment, that is a conversation for your prescriber. See also nausea and fullness.
More on the compound: tradipitant on PeptideBlog.net
Source: Vanda Pharmaceuticals press release, October 27, 2026 Company announcement, not peer reviewed.
Phase 2 figures: Vanda Pharmaceuticals announcement, April 8, 2026 Company announcement, not peer reviewed. Registry: ClinicalTrials.gov NCT06804603 Trial registry.