Also known as: BI 456906, BI-456906
Half-life: ~80-90 hours (once-weekly dosing)
Last reviewed: · Published:
Survodutide is an investigational, once-weekly subcutaneous peptide developed by Boehringer Ingelheim in partnership with Zealand Pharma. It is a co-agonist of the GLP-1 receptor and the glucagon receptor — combining the appetite-suppressing and insulin-sensitizing effects of GLP-1 with the energy-expenditure and lipolytic effects of glucagon. The dual mechanism aims to drive larger weight loss than single-agonist GLP-1 drugs like semaglutide while also providing meaningful improvements in liver fat and metabolic markers.
In the phase 2 obesity trial published in 2024 (NEJM), survodutide produced mean weight loss of approximately 19% over 46 weeks at the highest dose, with most participants still losing weight at week 46 — suggesting headroom for further losses with longer treatment. Phase 3 obesity (SYNCHRONIZE) and MASH/NASH (LIVERAGE) programs are ongoing as of 2026.
Because survodutide engages the glucagon receptor in addition to GLP-1, it has shown notable improvements in MASH/NASH endpoints in mid-stage trials — driving liver fat reduction beyond what pure GLP-1 agonists achieve. The same dual action can produce a transient rise in heart rate and modest increases in fasting glucose at lower doses before the GLP-1 effect dominates, which is why titration schedules are slow and methodical.
Survodutide was developed through the Boehringer Ingelheim / Zealand Pharma collaboration announced in 2011, which focused on next-generation incretin co-agonists. It entered human trials in the late 2010s, with phase 1 PK/PD work showing a half-life suitable for weekly dosing and clean target engagement.
The 2024 phase 2 obesity readout drew significant attention because the placebo-adjusted weight loss figures (~19%) were competitive with tirzepatide and ahead of semaglutide at comparable timepoints. In parallel, phase 2 results in MASH/NASH demonstrated histological improvement in fibrosis — a notoriously difficult endpoint. Both the obesity (SYNCHRONIZE-1, SYNCHRONIZE-2) and MASH (LIVERAGE-1) phase 3 programs are reading out in 2026-2027.
Tolerability follows the typical incretin pattern: GI side effects dominate, peak during dose escalation, and ease as the body adapts. The glucagon component adds two unique signals — a modest heart rate bump and a small transient increase in fasting glucose at sub-therapeutic doses — both of which resolve as the GLP-1 effect dominates at higher doses. Slow, methodical titration over 12-16 weeks substantially reduces discontinuation. No serious safety signals have emerged in phase 2; phase 3 will provide definitive cardiovascular and pancreatitis data.
Dose Range
0.3-6.0 mg
Frequency
Once weekly SubQ (titrated)
Duration
Long-term (chronic dosing)
Dose Range
1.2-6.0 mg
Frequency
Once weekly SubQ (titrated)
Duration
48 weeks minimum
Dose Range
0.3-4.8 mg
Frequency
Once weekly SubQ
Duration
Long-term
Dosing information is for educational purposes only. Consult a healthcare professional before using any peptide.
Typical Vial Size
10 mg
Water Type
Bacteriostatic water (BAC water)
Mixing Volume
2 mL
Half-Life
~80-90 hours (once-weekly dosing)
Molecular Weight
~4700 Da
Reconstitute a 10mg vial with 2mL of BAC water. Store refrigerated at 2-8°C and use within 28 days. Avoid freezing or shaking. Inject slowly down the side of the vial — do not spray directly onto the powder.
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FDA Status
Not FDA approved. Investigational compound in phase 3 clinical trials for obesity and MASH/NASH.
Legal Status
Unregulated research chemical. Not approved as a drug or dietary supplement in any jurisdiction.
USA
Not approvedPhase 3 trials ongoing (SYNCHRONIZE for obesity, LIVERAGE for MASH)
EU
Not approvedEMA evaluation pending phase 3 readout
UK
Not approvedMHRA evaluation pending phase 3 readout
Australia
Not approvedTGA has not evaluated
Canada
Not approvedHealth Canada has not authorized
le Roux CW, Steen O, Lucas KJ, Startseva E, Unseld A, Hennige AM
The Lancet Diabetes & Endocrinology (2024)
Phase 2 trial demonstrating ~19% mean weight loss at 46 weeks at the highest dose (4.8 mg weekly), with continued weight reduction at trial end — suggesting further losses possible with longer treatment.
View Study →Sanyal AJ, Bedossa P, Fraessdorf M, Neff GW, Lawitz E, Bugianesi E
New England Journal of Medicine (2024)
Phase 2 MASH trial showing histological improvement without worsening of fibrosis in 83% of participants at the highest dose, with significant reductions in liver fat content on MRI-PDFF.
View Study →Bossart M, Wagner M, Elvert R, Evers A, Hennig D, Kannt A
Cell Metabolism (2022)
Preclinical pharmacology paper characterizing survodutide’s dual-receptor binding profile, demonstrating balanced agonism at both receptors and superior weight loss versus single-agonist comparators in obese rodent models.
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Fat-metabolizing fragment of human growth hormone without growth-promoting effects.
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