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Survodutide

Last reviewed: April 18, 2026 by The Peptide Catalog Team

A dual GLP-1/glucagon agonist for weight loss, liver fat reduction, and metabolic health. Survodutide is a dual GLP-1/glucagon receptor agonist being investigated for obesity, type 2 diabetes, and metabolic dysfunction-associated steatohepatitis (MASH). By activating both GLP-1 and glucagon receptors, it promotes appetite suppression, fat oxidation, and improved hepatic lipid metabolism. In Phase III clinical trials showing significant weight loss and liver fat reduction.

CategoryWeight Loss & Metabolic Peptides
ClassGLP-1 agonist
GoalFat Loss
Overview

Core Benefits

Key Advantages
Dual-receptor fat loss
Hits GLP-1 and glucagon for appetite plus calorie burn.
~18.7% weight loss
Phase 2 completers lost 18.7% body weight at 46 weeks.
Liver fat clearance
62% MASH resolution in Phase 2 — strong liver data.
Glucagon edge over GLP-1
Glucagon arm raises resting metabolic rate.
FDA Breakthrough for MASH
Granted Breakthrough Therapy designation for MASH in 2024.
Weekly dosing
Once-weekly injection with slow titration for GI tolerance.

These are educational summaries of commonly discussed effects in wellness/regenerative contexts, not guarantees.

Survodutide Results Timeline

Progression
1
Week 1–4
Physical Changes
Initial weight loss (2-5 lbs) as dose titration begins
Performance & Recovery
Reduced appetite from GLP-1 action, early satiety signals
Other Benefits
GI side effects common (nausea, diarrhea) during dose escalation; slow titration helps
2
Month 2–3
Physical Changes
Accelerating weight loss (6-10%), visible fat reduction
Performance & Recovery
Glucagon-driven energy expenditure increases — more calories burned at rest
Other Benefits
Liver fat begins clearing, blood sugar and lipid improvements measurable
3
Month 4–6
Physical Changes
Significant weight loss (12-15%), reduced waist circumference
Performance & Recovery
Sustained appetite suppression + elevated metabolic rate from dual mechanism
Other Benefits
Liver fat reduction of 30%+ in MASH studies; metabolic markers improve
4
6+ Months
Physical Changes
Up to 18.7%+ weight loss (Phase 2 completers at 46 weeks — no plateau observed)
Performance & Recovery
Continued fat loss from both reduced intake and increased expenditure
Other Benefits
Phase 3 trials (76 weeks) may show further weight loss beyond Phase 2 results

Timeline is illustrative and non-guaranteed. Outcomes vary and are commonly discussed alongside training, nutrition, sleep, and cycling practices.

Evidence at a glance

Two parallel grades per outcome — clinical RCT depth and real-world community adoption. See the Research Overview below for citations and detail.

OutcomeClinical EvidenceCommunity Evidence
Body weight reduction (obesity)StrongPreliminary
MASH histology resolutionStrongPreliminary
HbA1c reduction in T2DModeratePreliminary
How It WorksDual Agonist — GLP-1/Glucagon Receptor

Receptor → Metabolic Cascade → Weight & Glucose → Outcomes

1
Target

GLP-1 + Glucagon Receptors — Dual Activation

Survodutide (BI 456906) is a dual agonist derived from glucagon, engineered to activate both GLP-1 receptors (appetite suppression, insulin secretion) and glucagon receptors (energy expenditure, liver fat oxidation). Unlike tirzepatide's GIP/GLP-1 approach, survodutide pairs GLP-1 with glucagon — adding a "burn more" signal alongside "eat less."

2
Cellular Signal

cAMP Activation → Satiety + Thermogenesis + Hepatic Fat Oxidation

GLP-1 receptor activation suppresses appetite, slows gastric emptying, and stimulates glucose-dependent insulin release. Glucagon receptor activation in the liver promotes fatty acid oxidation and ketogenesis, while increasing whole-body energy expenditure through thermogenesis — without activating the sympathetic nervous system.

3
Systemic Effect

Reduced Intake + Increased Expenditure + Liver Fat Clearance

The dual mechanism produces weight loss from both sides of the energy equation. Phase 2 completers achieved 18.7% weight loss at 46 weeks with no plateau observed. Uniquely, 62% of MASH patients achieved histologic improvement (NEJM 2024) — the glucagon component directly clears hepatic fat.

4
What You Notice

Strong Appetite Reduction + Steady Weight Loss + Liver Improvement

Appetite reduction begins within weeks of starting. Weight loss accelerates through months 2-4 as the glucagon-driven metabolic boost compounds with reduced intake. GI side effects (nausea, diarrhea) are common during titration but improve. Liver fat markers improve significantly — particularly relevant for fatty liver disease.

What Makes This Peptide Different

Survodutide occupies a unique position between semaglutide and retatrutide. Unlike pure GLP-1 agonists, its glucagon component increases energy expenditure and directly oxidizes liver fat. Unlike retatrutide (triple agonist), it skips GIP — focusing the dual mechanism on the two pathways most relevant to obesity and liver disease. FDA Breakthrough Therapy designation for MASH (Sept 2024) reflects its strong liver data.

Research overview

Outcome-by-outcome look at what the evidence actually supports for Survodutide, including human vs. animal study counts and our editorial take on each.

Body weight reduction in obesity

Clinical:StrongCommunity:Preliminary

Le Roux 2024 (Lancet D&E, Phase 2 dose-finding) showed mean body weight reductions of 6.2% (0.6 mg), 12.5% (2.4 mg), 13.2% (3.6 mg), and 14.9% (4.8 mg) vs 2.8% placebo over 46 weeks in adults with overweight/obesity. The dose-response curve had not plateaued at 4.8 mg — Phase 3 SYNCHRONIZE will define the asymptote.

2 human studies · 4 animal studies

Key findings & citations
  • 14.9% mean weight loss at 4.8 mg over 46 weeks.
  • Dose-response had not plateaued — higher doses tested in Phase 3.
  • Glucagon-receptor agonism contributes to fat oxidation beyond GLP-1 effect.

Our take

Among the most active second-generation GLP-1/glucagon dual agonists. Phase 3 readouts will determine its rank among retatrutide, tirzepatide, and semaglutide.

MASH / fibrosis

Clinical:StrongCommunity:Preliminary

Sanyal 2024 (NEJM Phase 2, n=293) showed survodutide produced MASH resolution without fibrosis worsening in 47-62% of patients across dose arms vs 14% placebo over 48 weeks. Fibrosis improvement also separated from placebo at higher doses — a cleaner fibrosis signal than semaglutide.

1 human study · 4 animal studies

Key findings & citations
  • MASH resolution: 47% (2.4 mg), 62% (4.8 mg), 43% (6.0 mg) vs 14% placebo.
  • Fibrosis stage improvement separated from placebo in higher-dose arms.
  • Glucagon agonism likely contributes via direct hepatic FFA oxidation.

Our take

Most promising MASH peptide signal to date. Glucagon agonism appears to add real fibrosis benefit beyond what pure GLP-1 produces.

What Survodutide doesn't do

Claims that current evidence does not support. Worth knowing before you set expectations.

Survodutide Vendors

10% OFF
COA
EZ Peptides

EZ Peptides

Score
10/10
Price
$70.20
$78.00
Amount
10mg
Cost/mg
$7.80/mg
Save 10% with code thepeptidecatalog at checkout.
View at EZ Peptides
Dosing ProtocolWeight Loss / Metabolic Health

Educational reference only. Individual responses vary. Consult healthcare provider before use.

Vial Size
5 mg or 10 mg
Reconstitution
1-2 mL BAC water
Dose
0.3 mg → 4.8 mg (titrated over 20 weeks)
Timing
Same day each week
Frequency
Once per week
Duration
46 weeks (Phase 2 trial duration)
Protocol Notes
Dual GLP-1/glucagon receptor agonist. Investigational — not FDA-approved. Requires slow 7-step titration to minimize GI side effects. Glucagon component adds energy expenditure and liver fat reduction.

Why This Dosing Protocol

Why slow titration? Dual receptor activation produces dose-dependent GI side effects. Phase 2 trials used a 20-week escalation from 0.3mg to 4.8mg — allowing adaptation at each step dramatically improves tolerability.

Why weekly? Extended half-life supports once-weekly subcutaneous injection. Phase 3 trials test 3.6mg and 6.0mg as maintenance doses with flexible escalation schedules.

Why higher doses in Phase 3?Phase 2 weight loss hadn't plateaued at 46 weeks, and the 6.0mg dose (not tested in Phase 2) may provide additional efficacy in the 76-week SYNCHRONIZE trials.
Full Dosing GuideReconstitution CalculatorCycle Cost Calculator

Reconstitution Calculator

Dilution math and unit conversions. Prefilled using a common vial size for this peptide.

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Storage & Handling

Storage at a glance

Proper storage temperatures, shelf life, reconstitution best practices, and travel tips for lyophilized and reconstituted peptides.

Powder: Freezer
1+ year at -20°C
Reconstituted: Fridge
4 weeks max at 2-8°C
View Complete Storage Guide

Handling specifics

Educational overview on storage, labeling, and traceability considerations for lab environments. Consult primary literature and vendor documentation for specifics.

Powder storage (very stable)
  • Freezer (-20°C): 1+ year
  • Refrigerator (2-8°C): 1-3 months
  • Room temperature: 2-3 weeks (emergency only)
Reconstituted storage (fragile)
  • MUST refrigerate at 2-8°C
  • 4-week maximum shelf life
  • NEVER freeze after reconstitution
  • Use bacteriostatic water for multi-dose
Molecular Structure
  • Length: 29 amino acids
    (Glucagon-derived backbone.)
  • Half-life: ~7 days
    (Allows weekly dosing.)
  • Mechanism: Dual agonist
    (GLP-1 + Glucagon.)
  • Primary Use: Weight loss + MASH
    (18.7% loss at 46 weeks.)
Key modifications
Glucagon backbone with GLP-1 receptor cross-reactivity + acylation for extended half-life
The glucagon receptor component directly promotes hepatic fat oxidation, giving survodutide unique efficacy for metabolic liver disease — earning FDA Breakthrough Therapy designation for MASH.
Key takeaway: Survodutide bridges GLP-1 mono-agonists and triple agonists. Phase 2 showed 18.7% weight loss (no plateau) and 62% MASH resolution. Phase 3 SYNCHRONIZE results expected H1 2026.

FAQ

What is survodutide and how does it work?

Survodutide (BI 456906) is a dual glucagon/GLP-1 receptor agonist developed by Boehringer Ingelheim. It combines appetite suppression from GLP-1 receptor activation with increased energy expenditure and liver fat oxidation from glucagon receptor activation. This dual mechanism targets weight loss from both sides of the energy equation.

Is survodutide FDA-approved?

No. Survodutide is currently in Phase 3 clinical trials (SYNCHRONIZE-1 and SYNCHRONIZE-2). It is not approved for any indication. All dosing and efficacy data comes from published Phase 1 and Phase 2 clinical trials.

How does survodutide compare to semaglutide and tirzepatide?

Survodutide is a dual GLP-1/glucagon agonist, while semaglutide targets only GLP-1 and tirzepatide targets GLP-1/GIP. The glucagon component gives survodutide unique benefits for energy expenditure and liver fat clearance. Phase 2 weight loss (~18.7%) falls between semaglutide (~15-17%) and retatrutide (~24%).

What are the main side effects of survodutide?

Gastrointestinal effects dominate: nausea, vomiting, diarrhea, and decreased appetite, occurring in about 75% of participants in Phase 2. These are consistent with the GLP-1 agonist class and typically improve with dose titration. No unexpected safety signals were identified.

How much weight can I lose on survodutide?

In the Phase 2 trial, participants on the highest dose (4.8mg weekly) lost up to 18.7% of body weight over 46 weeks (actual doses received analysis). The intention-to-treat analysis showed 14.9%. Over half of participants at 4.8mg achieved at least 15% weight loss.

Does survodutide help with liver disease?

Yes. In a dedicated Phase 2 MASH trial, 83% of participants on the highest dose achieved histologic improvement with no worsening of fibrosis. The glucagon receptor component directly promotes hepatic fat oxidation, making survodutide particularly effective for metabolic liver disease.

How long does reconstituted peptide last?

Once mixed with bacteriostatic water, peptides remain stable for up to 4 weeks when refrigerated at 2-8°C (36-46°F). Unopened powder can last 1+ year in the freezer. Get our complete Storage & Travel Guide.

Is this peptide legal to purchase?

Peptides sold "for research purposes only" are legal to purchase in the US, but are not FDA-approved for human use outside of specific medical applications. Always consult a healthcare provider before use.

New to peptides?

Take our Peptide Match tool to find the best peptide for your goals. You can also read our Complete Guide to Peptides to learn the basics.

Survodutide Research Articles

guides

Survodutide Dosage: 4.8mg/Week Titration Protocol

The titration schedule matters more than the final dose. Covers weekly escalation, injection timing, and dual-agonist safety monitoring.

results

Survodutide Results: Week-by-Week Timeline

Appetite drops in week 1, but the 18.7% weight-loss figure took 46 weeks of titration. Full trial-reported timeline by phase and use case.

guides

Survodutide Reconstitution: 5mg + 2mL Chart

4.8mg = 96 units with standard dilution. Titration demands precise syringe math. Dilution chart, storage, and common mistakes.

bloodwork

Survodutide Bloodwork: 8 Labs to Track

Liver enzymes are the one most skip — and shouldn't with a glucagon agonist. 8 essential labs with optimal ranges and testing schedule.

Compare Survodutide to alternatives

Side-by-side mechanism, dose, half-life, and vendor pricing.

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Disclosure: we may earn affiliate commission from qualifying purchases. Educational information only — not medical advice.