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Survodutide

Studied for body-weight reduction in obesity, liver fat reduction and mASH improvement without worse fibrosis. A dual agonist of the glucagon and GLP-1 receptors, licensed by Boehringer Ingelheim from Zealand Pharma and first dosed in humans in 2017.

categoryweight loss
clinical evidencephase 3
community adoptionniche
uses graded4
sources12
last reviewed24 Aug 2026
compound file

The answer, first. A dual agonist of the glucagon and GLP-1 receptors, licensed by Boehringer Ingelheim from Zealand Pharma and first dosed in humans in 2017. The strongest evidence is for body-weight reduction in obesity, graded A — approval or replicated trials.

Minus 12.2% at 3.6 mg and minus 13.0% at 6.0 mg against minus 5.4% on placebo at week 76, n=725 1. Phase 2 reached minus 14.9% by week 46, n=387 2. Approved nowhere.

What it is used for

Every use graded on its own evidence, not the compound as a whole. 4 outcomes, ranked by what the human record supports.

#outcome · human · animal · gradewhat the best evidence actually shows
01Body-weight reduction in obesity2 phase 3, 1 phase 2 · mouse, beat semaglutidegrade AMinus 12.2% at 3.6 mg and minus 13.0% at 6.0 mg against minus 5.4% on placebo at week 76, n=725 1. Phase 2 reached minus 14.9% by week 46, n=387 2. Approved nowhere.
02Liver fat reduction1 phase 3 co-primary · rodent hepatic fat oxidationgrade B84.2% on survodutide reached a 30% or larger cut in MRI-measured liver fat against 24.3% on placebo at week 48, n=216 3. The phase 2 agreed on a secondary endpoint 4.
03MASH improvement without worse fibrosis1 biopsy-read phase 2 · none publishedgrade BHistologic improvement in 47% at 2.4 mg, 62% at 4.8 mg and 43% at 6.0 mg, against 14% on placebo 4. Week 48, n=293, all biopsy-read 4. One trial.
04HbA1c reduction in type 2 diabetes1 phase 2, 16 weeks · glucose tolerance in micegrade CHbA1c fell 1.46 to 1.71 percentage points across dose groups over 16 weeks, n=413, against placebo and open-label semaglutide 5. One dose-finding trial. The phase 3 in diabetes has not reported 6.
gradewhat it means
ARegulatory approval, or multiple adequately-powered trials agreeing with each other
BAt least one well-powered human randomised trial, with the direction replicated
CSmall or open-label human trials only
DAnimal or mechanism data only, with no controlled human outcome
EA claim the human trials have already killed

How it works

The proposed mechanism, in three steps. A mechanism is a reason to run a trial, never a substitute for one.

1targetA single 29-amino-acid peptide agonising both the GLP-1 receptor and the glucagon receptor. A C18 fatty acid stretches dosing to once weekly.
2signalThe GLP-1 arm cuts food intake and slows gastric emptying. The glucagon arm raises energy expenditure and drives hepatic fat oxidation.
3effectHuman dosing lowered plasma amino acids and glucagon, the readouts of glucagon-receptor engagement, alongside weight loss.

What it does not do

Claims the current record does not support. Worth knowing before you set expectations.

not supported by the evidence

How it is used

What published protocols administered, and what the community reports doing. Descriptive on both counts, and never a recommendation.

routeSubcutaneous injection, once weekly, in every published trial. Dose escalated over 16 to 24 weeks before a maintenance phase 14.
formatTrial supply was manufactured solution. Grey-market survodutide is sold as lyophilised powder.
published dosesPhase 3 escalated to 3.6 mg or 6.0 mg once weekly across 76 weeks, n=725 1. Phase 2 tested 0.6, 2.4, 3.6 and 4.8 mg over 46 weeks, n=387 2. The MASH trial used 2.4, 4.8 and 6.0 mg 4. Descriptive of protocols.
human pharmacokineticsPhase 1 characterised exposure in 149 people 8. Cirrhosis did not change AUC or Cmax 10. No terminal half-life published.
reported conventionsAs reported on Reddit r/Peptides and vendor comment threads, 2024 to 2026: once-weekly subcutaneous injection, reconstituted in bacteriostatic water. Escalated from a fraction of a milligram over months. Report volume is thin and no forum ladder is consistent. Convention, not guidance.

This site does not publish protocols to follow. The doses above are what studies administered or what users report, stated as facts about the literature and the market. How protocols are structured, mixing and storage and the reconstitution calculator cover the arithmetic.

What to expect

Where a trial measured it, the trial. Where only the community reports it, that is said out loud.

onsetPhase 3 read body weight at week 76 after a long escalation, n=725 1. The phase 2 curve was still falling at week 46, n=387 2. Liver fat was read at week 48 3. No trial published a first-week weight signal.
most common reportReduced appetite. It was the most frequent drug-related event in phase 1, in 50.0% of single-dose and 66.7% of Japanese multiple-dose participants 811.
adverse effectsGastrointestinal events in 80.9% at 3.6 mg and 89.7% at 6.0 mg against 47.9% on placebo, week 76, n=725, no deaths 1. Phase 2 MASH: nausea 66% against 23%, vomiting 41% against 4% 4.
the stop signalTrial record: escalation was slowed or halted for gastrointestinal events, and 12.5% to 17.8% of phase 1 participants discontinued 8. Only 60.4% finished the 46-week phase 2 2.

Approval and status

What regulators and sport bodies have actually said, separately from what the evidence shows.

approvalInvestigational. Approved by no regulator as of August 2026.
FDANo FDA approval. Phase 3 obesity results published 2026. The cardiovascular outcome trial and the diabetes phase 3 are still running 169.
sport [WADA]Not named. S0 covers unapproved drugs in development 12.
sold asresearch chemical

Check the vial

The grade above describes a molecule studied under controlled conditions. It says nothing about the powder in a particular vial.

That gap is the one part of this market a reader can actually close. How to read a certificate of analysis covers the five measures in five minutes, and the 2026 audit grades vendors on the documents they publish against a rubric printed in full.

Questions we get

What is Survodutide used for?

In trials, obesity and fatty liver disease. A 725-person phase 3 cut body weight 12.2% to 13.0% against 5.4% on placebo over 76 weeks. A 216-person phase 3 in fatty liver disease met both endpoints at week 48.

A phase 2 lowered HbA1c in type 2 diabetes over 16 weeks. None of that is an approval. No regulator has cleared survodutide for any use.

How is Survodutide used?

Descriptively, from the published protocols: one subcutaneous injection a week, escalated over 16 to 24 weeks before a maintenance dose. Phase 3 escalated to 3.6 mg or 6.0 mg.

Phase 2 tested 0.6 through 4.8 mg. The MASH trial went to 6.0 mg. Research-vial material is not the manufactured drug those protocols used, and no published analysis has compared the two.

How long does Survodutide take to work?

The trials do not answer that in weeks. Phase 3 read body weight at week 76, after a long escalation, and the phase 2 curve was still falling at week 46. Liver fat was read at week 48.

Phase 1 logged falling appetite inside the first dosing weeks, recorded as an adverse event rather than a benefit. No trial published a first-week weight signal.

Is Survodutide an approved drug?

No. It is investigational everywhere. Both 2026 phase 3 papers describe it that way. The cardiovascular outcome trial is still enrolling, and the phase 3 in type 2 diabetes has not reported.

On our index it is graded phase 3 on clinical evidence and niche on community adoption, and those two are rated separately on purpose.

References

  1. le Roux CW, et al. Survodutide Once Weekly for the Treatment of Adults with Obesity. N Engl J Med. 2026. PMID 42253238
  2. le Roux CW, et al. Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial. Lancet Diabetes Endocrinol. 2024. PMID 38330987
  3. Kaplan LM, et al. Survodutide in adults with obesity and metabolic dysfunction-associated steatotic liver disease: SYNCHRONIZE-MASLD, a randomized, double-blind, placebo-controlled phase 3 trial. Nat Med. 2026. PMID 42252333
  4. Sanyal AJ, et al. A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis. N Engl J Med. 2024. PMID 38847460
  5. Blueher M, et al. Dose-response effects on HbA1c and bodyweight reduction of survodutide, a dual glucagon/GLP-1 receptor agonist, compared with placebo and open-label semaglutide in people with type 2 diabetes: a randomised clinical trial. Diabetologia. 2024. PMID 38095657
  6. Wharton S, et al. Baseline characteristics in the SYNCHRONIZE-2 randomized phase 3 trial of survodutide for obesity in people with type 2 diabetes. Diabetes Obes Metab. 2026. PMID 41216778
  7. Zimmermann T, et al. BI 456906: Discovery and preclinical pharmacology of a novel GCGR/GLP-1R dual agonist with robust anti-obesity efficacy. Mol Metab. 2022. PMID 36356832
  8. Jungnik A, et al. Phase I studies of the safety, tolerability, pharmacokinetics and pharmacodynamics of the dual glucagon receptor/glucagon-like peptide-1 receptor agonist BI 456906. Diabetes Obes Metab. 2023. PMID 36527386
  9. Kosiborod MN, et al. Survodutide for the Treatment of Obesity: Rationale and Design of the SYNCHRONIZE Cardiovascular Outcomes Trial. JACC Heart Fail. 2024. PMID 39453356
  10. Lawitz EJ, et al. Efficacy, tolerability and pharmacokinetics of survodutide, a glucagon/glucagon-like peptide-1 receptor dual agonist, in cirrhosis. J Hepatol. 2024. PMID 38857788
  11. Yazawa R, et al. A randomized Phase I study of the safety, tolerability, pharmacokinetics and pharmacodynamics of BI 456906 in healthy Japanese men with overweight/obesity. Diabetes Obes Metab. 2023. PMID 36974349
  12. World Anti-Doping Agency. Prohibited List 2026, International Standard, in force 1 January 2026. wada-ama.org

Inside Your Peptides is published by the owners of the next lab, a vendor graded elsewhere on this site. We sell nothing here, and this page carries no vendor link. Grades follow the published criteria in our editorial policy — never referral terms. Research and education only. Not medical advice.