Survodutide
Also known as: BI 456906
Dual GLP-1/Glucagon Receptor Agonist | Weight Loss & Diabetes
Overview
Investigational dual receptor agonist targeting metabolic disease through balanced GLP-1R and GCGR activation. Phase 2/3 clinical trials demonstrate superior weight loss and MASH treatment efficacy.
Key benefits
- Superior weight loss vs monotherapy (14.9% at 46 weeks)
- Once-weekly convenient dosing
- Proven efficacy in obesity, MASH, and Type 2 diabetes
- 62% MASH improvement in clinical trials
Mechanism of action
Dual agonism: GLP-1R reduces appetite and slows gastric emptying; GCGR increases energy expenditure and hepatic fat oxidation. EC50 0.52nM GCGR, 0.33nM GLP-1R.
Molecular data
- Type
- Peptide with fatty acid acylation
- Half-life
- Approximately 6 days (109-115 hours)
Sequence
29-amino acid peptide
Indications
What the research community uses this compound for, with self-reported effectiveness.
Weight Loss
Obesity Without Diabetes
Most effective14.9% mean weight loss at 46 weeks (4.8mg); 55% achieved ≥15% reduction.
Obesity With Type 2 Diabetes
Most effectiveSuperior to semaglutide: -8.7% vs -5.3% at 16 weeks.
Sustained Weight Management
Most effectiveDual mechanism addresses both energy intake and expenditure.
Metabolic
MASH Treatment
Most effective62% achieved MASH improvement without fibrosis worsening at 4.8mg.
Liver Fat Reduction
Most effective63-67% achieved ≥30% liver fat reduction.
Type 2 Diabetes Control
EffectiveHbA1c reduction up to -1.6% at highest doses.
Dosing protocols
Common protocols by delivery method. Adjust the curve below to model accumulation in your own cycle.
Injectable
Subcutaneous injection to abdomen (2+ inches from navel), upper thigh, or upper arm. Any time of day, with or without food.
| Protocol | Dose | Frequency | Route / duration |
|---|---|---|---|
| Obesity - Conservative Start | 0.6mg titrated over 24 weeks | Once weekly with 4-week intervals | SubQ |
| Obesity - Standard Protocol | 3.6-6.0mg | Once weekly | SubQ |
| MASH Treatment | 2.4-4.8mg | Once weekly | SubQ |
| Type 2 Diabetes | 0.3-2.7mg | Once weekly | SubQ |
Preparation
You will need
- Survodutide lyophilized powder vial
- Bacteriostatic water (1-2mL)
- Insulin syringe (29-31 gauge)
- Alcohol swabs
Steps
- Remove vial from refrigerator; allow 15-30 minutes to reach room temperature
- Clean rubber stoppers with alcohol swabs
- Draw prescribed amount of bacteriostatic water
- Insert needle at 45-degree angle into vial
- Inject BAC water down vial side slowly to minimize foaming
- Gently swirl (do not shake vigorously)
- Allow 2-3 minutes for complete dissolution
- Solution should be clear to slightly opalescent without particles
- Store reconstituted solution in refrigerator immediately
Work out the water volume and syringe units in the reconstitution calculator →
Interactions
Pairwise interactions with other compounds you might be cycling — the same data behind the cycle builder's safety check.
Other Glucagon Agonists
AvoidRisk of excessive glucagon receptor activation.
Semaglutide/Tirzepatide
MonitorBoth GLP-1 agonists; combining risks excessive activation and GI side effects.
Sulfonylureas
MonitorHypoglycemia risk; consider dose reduction.
Insulin
MonitorMay require insulin dose reduction due to improved glycemic control.
Oral Contraceptives
MonitorTake 1+ hour before survodutide due to delayed gastric emptying.
Metformin
CompatibleDemonstrated together in Phase 2 diabetes trials.
SGLT2 Inhibitors
CompatibleNo known interactions; allowed in Phase 3 with monitoring.
Timeline
Typical week-by-week effects reported in clinical and observational data.
- Weeks 1-4
Possible nausea, reduced appetite (most common during escalation)
- Weeks 4-8
Initial weight loss begins; improved satiety between meals
- Weeks 8-16
Progressive weight loss; potential energy level improvements
- Weeks 16-24
Approaching steady-state; more consistent effects
- Weeks 24+
Sustained weight loss; average 15-19% by week 46
Safety
Reported adverse effects, contraindications, and what to monitor on cycle.
Common side effects
- Nausea (40-66%)
- Diarrhea (25-49%)
- Vomiting (15-41%)
- Slight heart rate increase (mean 2-5 bpm)
Stop signs — stop and seek advice
- Severe persistent nausea/vomiting preventing oral intake
- Signs of pancreatitis (severe abdominal pain radiating to back)
- Allergic reactions (rash, itching, difficulty breathing)
- Severe hypoglycemia with insulin/sulfonylureas
- Gallbladder symptoms (right upper quadrant pain)
- Significant tachycardia or arrhythmias
Contraindications
- Not recommended in pregnancy or breastfeeding
- Use contraception during treatment
Monitoring
- Monitor blood glucose if on diabetes medications
- No dose adjustment needed for hepatic impairment (including cirrhosis)
- Monitor heart rate in patients with cardiac conditions
Quality checks
What a legitimate product looks like, what should give pause, and what should make you stop.
Good signs
- Clear to slightly opalescent solution without visible particles
- Sealed vial with intact rubber stopper
- Within expiration date
Warning signs
- Slight foam after reconstitution is normal if disappears within minutes
Stop signs — don't use
- Cloudy solution or visible particles indicates contamination
- Discoloration of powder or solution
References
Primary literature and clinical-trial data informing this entry.
Phase 2 Obesity Trial Without Diabetes
2024
387 participants; BMI ≥27 kg/m²; 46 weeks. 14.9% mean weight loss at 4.8mg; 83% achieved ≥5%, 69% achieved ≥10%, 55% achieved ≥15%.
Phase 2 MASH and Fibrosis Trial
2024
293 participants with biopsy-confirmed MASH; 48 weeks. MASH improvement: 62% (4.8mg) vs 14% placebo; 63-67% achieved ≥30% liver fat reduction.
Phase 2 Type 2 Diabetes Trial
2023
Head-to-head vs semaglutide 1.0mg; 16 weeks. Survodutide -8.7% weight loss vs semaglutide -5.3%; HbA1c reduction up to -1.6%.
Last updated . How this page was sourced is described in the methodology.