Survodutide

Survodutide

Survodutide (BI 456906)

Dual GLP-1 and glucagon receptor agonist for weight loss

Fat Loss ★ 60
Half-life
Optimized for once-weekly dosing via C18 fatty-acid albumin-binding tail
Cycle
Continuous use as studied. Slow 20-week titration (0.6 → 2.4 → 3.6 → 4.8 mg) is essential to minimize gastrointestinal side effects.
Storage
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.
Research
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

0.6 mg
1x per week
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Draw to 12 units on a U-100 insulin syringe

10 mg · 2 mL BAC

Route
Subcutaneous (SubQ)
Duration
Weeks 1-4 (titration)

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

Reconstitution

Vial size (mg): 10 mg · BAC water (mL): 2 mL · Concentration: 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.

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)

Gender notes

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

Cautions

  • 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

Research

Stacks well with

Cagrilintide5-Amino-1MQTesamorelin
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