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Survodutide

★ 60

Survodutide (BI 456906)

Dual GLP-1 and glucagon receptor agonist for weight loss

Fat Loss
Half-life
Optimized for once-weekly dosing via C18 fatty-acid albumin-binding tail
Route
SubQ
Cycle
Continuous use as
Status
Phase 3 SYNCHRONIZE-1 positive topline (April 2026); FDA Fast Track for MASH

About

Survodutide is a dual agonist of the GLP-1 and glucagon receptors developed by Boehringer Ingelheim and Zealand Pharma. The GLP-1 component reduces appetite while the glucagon arm raises resting energy expenditure — a two-sided approach that combines reduced intake with increased burn. A fatty-acid tail enables once-weekly subcutaneous dosing. Phase 3 SYNCHRONIZE-1 (April 2026) reported 16.6% body-weight reduction over 76 weeks, and the compound holds FDA Fast Track designation for MASH (metabolic dysfunction-associated steatohepatitis). It is not yet FDA-approved as of May 2026.

Mechanism

Dual agonism of GLP-1 receptor (suppresses appetite, slows gastric emptying) and glucagon receptor (raises resting energy expenditure and hepatic fatty-acid oxidation), driving weight loss and liver fat reduction.

Dosage

beginner

Amount
0.6 mg
Frequency
1x per week
Route
Subcutaneous (SubQ)
Duration
Weeks 1-4 (titration)

standard

Amount
2.4-3.6 mg
Frequency
1x per week
Route
SubQ
Duration
Weeks 8-46 (steady dose)

advanced

Amount
4.8 mg
Frequency
1x per week
Route
SubQ
Duration
Weeks 20-76 (top studied dose)
Timing

Same day each week, any time of day. Inject into abdomen, thigh, or upper arm; rotate sites to avoid lipodystrophy.

Cycle structure

Continuous use as studied. Slow 20-week titration (0.6 → 2.4 → 3.6 → 4.8 mg) is essential to minimize gastrointestinal side effects.

Reconstitution & Storage

10 mg + 2 mL → 5 mg/mL

Swab stopper with alcohol, draw BAC water slowly down inside wall, swirl gently (do not shake), inspect for clarity, label with date. At 5 mg/mL, 1 U on a U-100 insulin syringe = 0.05 mg.

Lyophilized long-term: -20°C, dark and dry. Lyophilized short-term: 2-8°C. Reconstituted: 2-8°C, use within BAC water shelf window. Avoid repeated freeze/thaw cycles.

Benefits

  • • Up to 16.6% body weight loss over 76 weeks (Phase 3)
  • • 85% of Phase 3 participants achieved ≥5% weight loss
  • • Dual mechanism may raise resting energy expenditure beyond GLP-1-only agents
  • • Promising MASH/liver fibrosis improvement (Phase 2)
  • • Once-weekly injection schedule
  • • Mostly fat-tissue loss with minimal lean-mass loss

Side effects

  • • Nausea (66% in MASH trial vs 23% placebo)
  • • Diarrhea, vomiting — most severe during 20-week escalation
  • • ~20-25% trial discontinuation due to GI side effects
  • • Rare: dehydration with acute kidney injury
  • • Rare: angioedema reported in one Phase 2 participant
  • • Heart rate increase (consistent with GLP-1 class)

Contraindications

  • • Personal or family history of medullary thyroid cancer or MEN 2
  • • History of pancreatitis
  • • Severe gastrointestinal disease or gastroparesis
  • • Pregnancy or breastfeeding
  • • Diabetes managed with insulin or sulfonylureas (hypoglycemia risk — requires close monitoring)
  • • Children and adolescents
  • • Known peptide allergies

Gender notes

Men

Standard dosing applies. Subgroup analyses showed similar efficacy across sexes.

Women

Standard dosing applies. Strict contraception advised — peptide effects on fetal development unknown. Loss-of-contraceptive-efficacy concern from delayed gastric emptying applies as with other GLP-1 agents.

Research

Stacks well with

CAGRILINTIDE 5-AMINO-1MQ TESAMORELIN

Track Survodutide doses in the app

Built-in reconstitution calculator, dose log, and reminders. Free on Android.

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Educational use only. Not medical advice. Many peptides shown are not FDA-approved and remain research compounds. Always consult a qualified healthcare provider.