Survodutide: research

A weekly dual-hormone injection with phase 3 weight-loss data and frequent stomach side effects.

Also called: BI 456906, BI456906, Survo.

GLP-1 / glucagon dual agonists · GLP-1 and glucagon receptor dual agonist.

36 registered human protocols found, including planned and unreported studies. Secondary analyses and meta-analyses reuse participants; they are not counted again.

Studies

First doses (Jungnik 2023). rct, n=24, Healthy adult men, BMI 20 to <30. Early human results supported further dose testing. (source)
Early repeat doses (Jungnik 2023). rct, n=125, Adults with BMI 27–40. Early schedules produced weight loss and tolerability problems. (source)
Early Japanese trial. rct, n=36, Japanese men aged 20–45, BMI 23–40. Weight fell, but many could not complete dose escalation. (source)
Phase 2 diabetes. rct, n=411, Adults with type 2 diabetes on metformin. Weight or glucose improved; stomach symptoms limited tolerability. (source)
Phase 2 obesity. rct, n=386, Adults aged 18–75, BMI ≥27, without diabetes. Weight or glucose improved; stomach symptoms limited tolerability. (source)
Phase 2 MASH. rct, n=293, Adults with biopsy-confirmed MASH and F1–F3 liver scarring. Weight or glucose improved; stomach symptoms limited tolerability. (source)
Cirrhosis and drug exposure. pk-study, n=82, Adults with/without cirrhosis; Child-Pugh A–C for single dose. Exposure was similar, but clinical safety in advanced liver disease remains uncertain. (source)
SYNCHRONIZE-1. rct, n=725, Adults with obesity or overweight plus a complication, without diabetes. Weight or glucose improved; stomach symptoms limited tolerability. (source)
SYNCHRONIZE-2. rct, n=752, Adults with type 2 diabetes and BMI ≥27. Weight or glucose improved; stomach symptoms limited tolerability. (source)
SYNCHRONIZE-MASLD. rct, n=216, Adults with obesity or overweight and liver fat plus inflammation/scarring. Weight or glucose improved; stomach symptoms limited tolerability. (source)
Liver receptor imaging. rct, n=29, Obesity. A registered study; efficacy and harms cannot be inferred without results. (source)
Radiolabeled drug processing. open-label, n=6, Healthy. A registered study; efficacy and harms cannot be inferred without results. (source)
PYY agonist combination. rct, n=88, Healthy; Obesity. A registered study; efficacy and harms cannot be inferred without results. (source)
Oral contraceptive interaction. open-label, n=32, Healthy. A registered study; efficacy and harms cannot be inferred without results. (source)
SYNCHRONIZE-CVOT. rct, n=5531, Obesity. A registered study; efficacy and harms cannot be inferred without results. (source)
SYNCHRONIZE-JP. rct, n=274, Obesity. A registered study; efficacy and harms cannot be inferred without results. (source)
Heart rhythm safety. rct, n=110, Overweight; Obesity. A registered study; efficacy and harms cannot be inferred without results. (source)
SYNCHRONIZE-CN. rct, n=307, Obesity; Overweight. A registered study; efficacy and harms cannot be inferred without results. (source)
Kidney impairment and exposure. open-label, n=42, Healthy; Renal Impairment. A registered study; efficacy and harms cannot be inferred without results. (source)
Brain imaging with PYY agonist. crossover-rct, n=23, Obesity. A registered study; efficacy and harms cannot be inferred without results. (source)
Chinese dose and exposure. open-label, n=30, Overweight; Obesity. A registered study; efficacy and harms cannot be inferred without results. (source)
Oral-drug interaction probes. open-label, n=34, Overweight; Obesity. A registered study; efficacy and harms cannot be inferred without results. (source)
LIVERAGE: MASH with scarring. rct, n=1800, Metabolic Dysfunction Associated Steatohepatitis (MASH); Liver Fibrosis. A registered study; efficacy and harms cannot be inferred without results. (source)
LIVERAGE: cirrhosis. rct, n=1590, Metabolic Dysfunction Associated Steatohepatitis. A registered study; efficacy and harms cannot be inferred without results. (source)
Energy use and fat breakdown. rct, n=64, Obesity. A registered study; efficacy and harms cannot be inferred without results. (source)
Three injection formulations. crossover-rct, n=30, Healthy. A registered study; efficacy and harms cannot be inferred without results. (source)
Two injection formulations. crossover-rct, n=16, Healthy. A registered study; efficacy and harms cannot be inferred without results. (source)
Kidney disease and urine protein. rct, n=120, Chronic Kidney Disease. A registered study; efficacy and harms cannot be inferred without results. (source)
Repeat-dose formulation comparison. rct, n=100, Healthy. A registered study; efficacy and harms cannot be inferred without results. (source)
Formulation crossover. crossover-rct, n=80, Healthy; Obesity; Overweight. A registered study; efficacy and harms cannot be inferred without results. (source)
Syringe versus injector. crossover-rct, n=56, Healthy; Obesity. A registered study; efficacy and harms cannot be inferred without results. (source)
Diabetes phase 3 program. rct, n=600, Type 2 Diabetes. A registered study; efficacy and harms cannot be inferred without results. (source)
Injection bioequivalence. crossover-rct, n=44, Healthy; Obesity. A registered study; efficacy and harms cannot be inferred without results. (source)
SYNCHRONIZE-HERA: menopause. rct, n=600, Obesity. A registered study; efficacy and harms cannot be inferred without results. (source)
ELEVATE-LIVER: heart structure. rct, n=600, Obesity; Metabolic Dysfunction-associated Steatotic Liver Disease. A registered study; efficacy and harms cannot be inferred without results. (source)
SYNCHRONIZE-START: switching. open-label, n=350, Obesity. A registered study; efficacy and harms cannot be inferred without results. (source)
Survodutide meta-analysis. meta-analysis, n=1272, Participants from earlier trials. This analysis reuses earlier participants; it adds no new dose arm. (source)
Earlier weight meta-analysis. meta-analysis, n=1029, Participants from earlier trials. This analysis reuses earlier participants; it adds no new dose arm. (source)
Sex and BMI subgroup analysis. cohort, n=386, Participants from earlier trials. This analysis reuses earlier participants; it adds no new dose arm. (source)
Blood pressure secondary analysis. cohort, n=386, Participants from earlier trials. This analysis reuses earlier participants; it adds no new dose arm. (source)
Insulin and beta-cell markers. cohort, Participants from earlier trials. This analysis reuses earlier participants; it adds no new dose arm. (source)
Weight-mediated liver changes. cohort, n=170, Participants with F2–F3 fibrosis and paired baseline/end-of-treatment biopsy readings in the phase 2 MASH trial.. This analysis reuses earlier participants; it adds no new dose arm. (source)
Dual-agonist class meta-analysis. meta-analysis, Adults in 19 RCTs of four GLP-1/glucagon drugs. Class pooling cannot rank individual drugs or prove long-term safety. (source)
Discovery and mouse pharmacology. animal, Cells and mouse obesity models. Mouse findings support the mechanism, not a human dose. (source)
Receptor and biomarker profiling. animal, Preclinical receptor and animal models. Preclinical receptor balance does not establish a human stack ratio. (source)

Survodutide dosage

Typical reported dose: 0.3 mg once a week

Phase 2 diabetes: 0.3 mg: 0.3 mg once weekly once weekly, under the skin. Studied in a trial. Studied in: Adults with type 2 diabetes on metformin. (source)
Phase 2 diabetes: 0.9 mg: 0.3 mg once weekly, then 0.6 mg once weekly, then 0.9 mg once weekly once weekly, under the skin. Studied in a trial. Studied in: Adults with type 2 diabetes on metformin. (source)
Phase 2 diabetes: 1.8 mg: 0.3 mg once weekly, then 0.6 mg once weekly, then 0.9 mg once weekly, then 1.2 mg once weekly once weekly, under the skin. Studied in a trial. Studied in: Adults with type 2 diabetes on metformin. (source)
Phase 2 diabetes: 2.7 mg: 0.6 mg once weekly, then 1.2 mg once weekly, then 1.8 mg once weekly, then 2.4 mg once weekly once weekly, under the skin. Studied in a trial. Studied in: Adults with type 2 diabetes on metformin. (source)
Phase 2 diabetes: 1.2 mg twice weekly: 0.3 mg twice weekly, then 0.6 mg twice weekly, then 0.9 mg twice weekly, then 1.2 mg twice weekly twice weekly, under the skin. Studied in a trial. Studied in: Adults with type 2 diabetes on metformin. (source)
Phase 2 diabetes: 1.8 mg twice weekly: 0.3 mg twice weekly, then 0.6 mg twice weekly, then 0.9 mg twice weekly, then 1.2 mg twice weekly twice weekly, under the skin. Studied in a trial. Studied in: Adults with type 2 diabetes on metformin. (source)

Highest studied: Highest published weekly SC target found: 6 mg..

These are doses reported in labels, trials or user reports, not a personal plan. Check the source behind each one.

Work out syringe units with the dosing calculator

Survodutide side effects and risks

Reported side effects

Nausea: SYNCHRONIZE MASLD: 56.2% at 6 mg vs 14.3% placebo., moderate (source)
Vomiting: 42.5% vs 7.1% placebo in SYNCHRONIZE MASLD., moderate (source)
Diarrhea: 29.5% vs 10.0% placebo in SYNCHRONIZE MASLD., moderate (source)
Constipation: 28.1% vs 10.0% placebo in SYNCHRONIZE MASLD., moderate (source)
Fatigue: 10.3% vs 5.7% placebo in SYNCHRONIZE MASLD., mild (source)
Gallstones or gallbladder inflammation: Each: 1/146 (0.7%) vs 0/70 placebo in SYNCHRONIZE MASLD., serious (source)
Major depression reported during treatment: 4/146 (2.7%) vs 0/70 placebo; causality is not established., serious (source)
Heart rate increase: Seen in early studies; frequency is not given as a simple patient rate., moderate (source)
Pancreatitis, severe allergy or dehydration-related kidney injury: GLP 1 class concerns; compound specific rare event rates remain uncertain., serious (source)

Stop and get help if

Severe or persistent belly pain, especially into the back: Stop dosing and get urgent medical assessment.
Trouble breathing; swelling of lips, tongue or throat: Call emergency services now.
Chest pain, fainting or a sustained racing heart: Seek emergency care.
Sudden vision loss or a major vision change: Seek urgent eye/emergency assessment.
Confusion, seizure or low blood sugar that does not resolve: Call emergency services; do not take another dose.
Repeated vomiting, inability to keep fluids down or very little urine: Get urgent care for dehydration or kidney injury.
Belly swelling with vomiting and inability to pass stool or gas: Seek urgent medical assessment.
Fever or spreading redness, heat or swelling after an injection: Get urgent medical care for possible infection.

Who should avoid it

pregnant: Excluded from trials; no established pregnancy safety.
breastfeeding: No established infant safety; avoid exposure while breastfeeding.
tryingToConceive: Plan stopping and contraception with a clinician; no verified compound-specific washout is given here.
under18: Pediatric safety and dosing remain limited.
mtcOrMen2: Personal/family medullary thyroid cancer or MEN2 was excluded. Human thyroid-cancer risk is not established.
eatingDisorderHistory: Appetite suppression may worsen restrictive eating; this is a precautionary screen.
pancreatitisHistory: Review prior pancreatitis before exposure; this is also a GLP-1 class precaution.
gallbladderDisease: Gallbladder symptoms need review during substantial weight loss.
gastroparesis: Delayed stomach emptying can worsen severe stomach-motility problems.
diabeticRetinopathy: Rapid glucose improvement can worsen existing eye disease; direct long-term risk is uncertain.
kidneyDisease: Vomiting and diarrhea can cause dehydration and kidney injury. Special-population data are incomplete.
liverDisease: Advanced liver disease needs specialist review; trial findings do not establish self-dosing.
heartCondition: Heart rate rose in early trials; review rhythm problems and symptoms.
uncontrolledBloodPressure: Review uncontrolled pressure before use; blood pressure changes and dehydration need monitoring.
surgeryPlanned: Tell the anesthesia team about use; delayed stomach emptying can raise aspiration risk.
other: Prior severe reaction to this compound or its ingredients should stop re-exposure.
testedAthlete: Investigational status brings a WADA S0 prohibition at all times.
psychiatricCondition: Major mood disorders were excluded from early trials; review symptoms and ability to eat adequately.
seizureDisorder: Seizure disorders were excluded from the phase 2 obesity trial; direct safety evidence is limited.

Interactions

Insulin: Additive low-glucose risk; insulin doses may need clinician adjustment.
Sulfonylureas: Additive low-glucose risk; review dose and glucose checks.
Other GLP-1 or related appetite injections: Overlapping actions may worsen stomach symptoms and dehydration. No verified home stack has a tested dose.
Narrow-window oral medicines: Slower stomach emptying or vomiting may alter exposure. Monitoring needs are medicine-specific.
Oral contraception: Vomiting may reduce pill reliability. A tirzepatide-specific backup rule cannot be assumed for this drug.
Oral anticoagulants: Illness and poor intake may change anticoagulation. No direct interaction magnitude is established here.

Product quality risks

No independent published assay series of online survodutide products was found.
Indirect evidence: online semaglutide samples had 7%–14% purity and 29%–39% excess content; one had elevated endotoxin.
FDA names this compound in warnings about unapproved research-labeled GLP-1 products of unknown quality.
Wrong identity, wrong amount, contamination and counterfeit packaging are separate risks.

How Survodutide works

The GLP-1 signal helps reduce appetite and control blood sugar. The glucagon signal changes how the liver uses fuel. Animal work suggests higher energy use; its added effect in people is still being measured.

GLP-1 receptor: Supports fullness and glucose-dependent insulin release; can slow stomach emptying.
Glucagon receptor: Changes liver fuel handling; may add energy use beyond appetite reduction.

Half-life: 112 hours in the SYNCHRONIZE-MASLD protocol; individual estimates can vary.

Gaps: Complete early phase 1 and cirrhosis escalation tables were not recovered; no missing dose is guessed. Cardiovascular and long-term liver outcomes were not found; trial completion alone is not a safety result. No validated home mixing, storage or product-quality series; community reports cannot establish prevalence. Some phase 3 regional studies have design papers only; registry and paper enrollment counts sometimes differ. A MASLD correction exists (PMID 42642663); its full text was inaccessible. The currently available primary article was used. No published clinician dosing standard outside trials was located.

Related to Survodutide

Mazdutide: A weekly dual-hormone injection approved in China, with phase 3 weight-loss results.
Tirzepatide: A weekly GIP/GLP-1 injection with strong diabetes and weight-loss evidence and common stomach side effects.
Retatrutide: An experimental weekly injection with phase 3 weight-loss results.

Survodutide: the short version

Sources

21 CFR 216.23 — Bulk drug substances that can be used to compound drug products in accordance with section 503A of the Federal Food, Drug, and Cosmetic Act., Office of the Federal Register · eCFR · 2026
503B Bulk Drug Substances List, FDA · FDA · 2026
Bulk Drug Substances Nominated for Use in Compounding Under Section 503A of the Federal Food, Drug, and Cosmetic Act, FDA · FDA · 2026
Bulk Drug Substances Used in Compounding Under Section 503A of the FD&C Act, FDA · FDA · 2026
FDA’s Concerns with Unapproved GLP-1 Drugs Used for Weight Loss, FDA · FDA · 2026
Find product information about medicines, Medicines and Healthcare products Regulatory Agency · MHRA · 2026
Medicines, European Medicines Agency · European Medicines Agency · 2026
The 2026 Prohibited List, World Anti-Doping Agency · WADA · 2026
The Prohibited List, World Anti-Doping Agency · World Anti-Doping Agency · 2026
Understanding your responsibilities when importing, compounding and supplying unapproved peptide products, Therapeutic Goods Administration · Therapeutic Goods Administration · 2026
WEGOVY- semaglutide injection, solution WEGOVY- semaglutide tablet, DailyMed · DailyMed · 2026
Bulk Drug Substances Nominated for Use in Compounding Under Section 503B of the Federal Food, Drug, and Cosmetic Act, FDA · FDA · 2025
Nutritional priorities to support GLP-1 therapy for obesity: a joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society., Mozaffarian D et al. · The American journal of clinical nutrition · 2025
Australian Register of Therapeutic Goods (ARTG), Therapeutic Goods Administration · TGA
Drug Product Database: Access the database, Health Canada · Health Canada

Sources checked: 2026-10-18.

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