Human RCT
Mensch
Le Roux CW. et al. 2024
Weight reduction over 46 weeks documented in a phase-2 obesity trial
What does NOT follow: Phase-2 data; phase-3 programme SYNCHRONIZE is ongoing. Long-term data beyond 1 year pending.
Peptide entry · Metabolic
Survodutide
BI 456906 · BI-456906
Highest evidence
Human RCT
Studies recorded
4· 4 in humans
Legal status · US
UnapprovedScientific context only. Not medical advice, not a recommendation to use.
At a glance
Synthetic peptide that simultaneously activates the GLP-1 and glucagon receptors. Developed by Boehringer Ingelheim and Zealand Pharma; in phase-3 trials for obesity (SYNCHRONIZE) and MASH. No marketing approval yet.
Researched for
Weight reduction in obesity (SYNCHRONIZE programme)Glycaemic control in type 2 diabetesMetabolic dysfunction-associated steatohepatitis (MASH)
Official status
US: Unapproved
No FDA approval. Phase-3 programme SYNCHRONIZE is ongoing; an approval decision is expected no earlier than 2026.
Overview
What is it?
Synthetic peptide that simultaneously activates the GLP-1 and glucagon receptors. Developed by Boehringer Ingelheim and Zealand Pharma; in phase-3 trials for obesity (SYNCHRONIZE) and MASH. No marketing approval yet.
How is it meant to work? →
Survodutide is a dual agonist at the GLP-1 and glucagon receptors. The GLP-1 component mediates glucose-dependent insulin secretion, inhibition of glucagon secretion at high blood glucose and modulation of satiety. The glucagon …
What do studies show? →
Human RCTWeight reduction over 46 weeks documented in a phase-2 obesity trial
What do users report?
No documented community reports.
01
Mechanism of action
Survodutide is a dual agonist at the GLP-1 and glucagon receptors. The GLP-1 component mediates glucose-dependent insulin secretion, inhibition of glucagon secretion at high blood glucose and modulation of satiety. The glucagon component raises basal energy expenditure via hepatic and brown adipocyte effects. A fatty-acid side chain enables albumin binding and weekly dosing.
02
Evidence at a glance
Reading note. The distribution shows on which evidence tier each observation sits. Strong colours mark stronger evidence — weaker tiers are deliberately visible, not hidden.
03
What the studies show
Human RCT
Mensch
Sanyal AJ. et al. 2024
Histological MASH improvement reported in a phase-2 trial over 48 weeks
What does NOT follow: Phase 2 with biopsy endpoints; phase-3 confirmation with clinical endpoints (liver disease progression) pending.
Human RCT
Mensch
Le Roux CW. et al. 2024
Gastrointestinal adverse events (nausea, diarrhoea) were dose-dependently frequent across all phase-2 trials
What does NOT follow: Profile similar to other incretin-based substances; titration phase relevant.
04
Where studies disagree
Open question
Does the added glucagon action (vs. pure GLP-1 agonists) bring more benefit or more risk?
POSITION A
Glucagon agonism can raise energy expenditure and reduce liver fat — a possible advantage in obesity and MASH.
POSITION B
Glucagon potentially raises blood glucose and heart rate; the long-term balance of these effects is not yet settled in outcome trials.
CURRENT STATE · Phase 2 data are encouraging (weight, liver fat); the benefit-risk balance depends on the ongoing phase 3 trials (SYNCHRONIZE).
05
Pharmacokinetics
Theoretical concentration curve at a half-life of 168 h. Pure pharmacokinetic model — not a dosing recommendation.
Open in PK tool →Start time: t₀ = 0.0d
Repeat interval: off (single dose)
06
Routes of administration in the literature
Which routes of administration the available studies describe — neutral reporting, not a usage guide.
Subcutaneous
In all phase-1 and phase-2 trials administered subcutaneously once weekly.
06b
Amounts reported in sources
Which amounts were reported in which source — ordered by context (approval, trial, animal model, secondary literature, community).
06d
Safer use & risks
Risk notes for harm reduction — descriptive, not a usage or dosing guide.
There is no approved human use for this substance. What circulates online about amounts and frequency is self-experimentation without a safety net.
Online numbers are not a benchmark
Amounts from TikTok, YouTube and forums are mostly imitation rather than data — and are often wrongly derived from animal studies (µg/kg). Not a reliable benchmark for humans.
Sterility & infection risk
Injection solutions prepared or stored non-sterile carry an infection and abscess risk. Contamination is common with grey-market product.
Unknown product quality
Research-/grey-market product is not quality-tested: identity, purity and actual content are often unknown, and counterfeits occur.
Mind interactions
Combinations with medications or pre-existing conditions can carry risks (see the Interactions section). Clarify with a doctor beforehand.
Warning signs — seek medical help
With persistent pain, redness/swelling at the injection site, fever, shortness of breath, racing heart, chest pain or allergic reactions, seek medical help immediately.
A doctor, not a forum
Concrete questions about use and amount belong in a conversation with a doctor — not in a comment thread.
07
Known adverse events from studies
Factual reporting of what studies observed. Not a safety statement for individual use.
Human RCT
Nausea / vomiting
Most frequent events documented in phase 2; often transient during titration.
häufig, dosisabhängig
Human RCT
Transient glucose increase
Consequence of the glucagon component; clinically not significant in the obesity studies, to be monitored carefully in diabetes settings.
in einigen Phase-2-Subgruppen beobachtet
07b
Interactions & combinations
Documented interactions and contraindications from studies, prescribing information and guidelines. Where no data exists, this is stated.
Reporting of risks, NOT a combination guide. The absence of an entry does not mean „safe to combine“ but „not sufficiently studied“.
No documented interactions recorded
We have not yet found robustly documented interactions for this peptide. This does NOT mean none exist — the data is limited.
11
Legal status by country
12
Reconstitution calculator
Pure mg/mL maths — works like a calculator. Not a usage recommendation.
Peptides ship as a dry powder. Once dissolved in a liquid (reconstitution), this calculator answers a single question: how much substance is in one millilitre of solution afterwards?
- 1Enter the vial's substance amount (printed on the label).
- 2Enter how much solvent you add.
- 3Result = concentration in mg per mL.
Printed on the label
/
Liquid you add
=
2.50
mg / mL
5 mg in 2 mL gives 2.50 mg/mL — each millilitre contains 2.50 mg of substance.
Cofactors
These cofactors relate to the peptide class, not to a specific use. No recommendation, no dosing.
14
Study register
Human RCTRandomised controlled trialn = 387
Le Roux CW. et al. · 2024
Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial
Concrete results
Mean weight reduction (highest dose arm)
−18.7%
vs Placebo (−2.0%) · 46 Wochen
Human RCTRandomised controlled trialn = 293
Sanyal AJ. et al. · 2024
A phase 2 randomized trial of survodutide in MASH and fibrosis
Concrete results
Histological MASH improvement (responder rate highest arm)
83%
vs Placebo (18%) · 48 Wochen
Human RCTRandomised controlled trialn = 293
· 2024
A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis
SampleAdults with MASH (metabolic steatohepatitis) and liver fibrosis; NCT04771273.
EndpointImprovement in MASH with no worsening of fibrosis at 48 weeks.
MethodOnce-weekly subcutaneous dosing (2.4 / 4.8 / 6.0 mg groups) vs. placebo over 48 weeks, with titration.
Concrete results
MASH improvement without fibrosis worsening (higher dose)
62% vs 14%
vs Placebo · 48 Wochen
Findings:MASH improvement occurred in 47–62% depending on dose vs. 14% on placebo; fibrosis improvement by at least one stage in 34–36% vs. 22%.
Limitations:Phase 2, 48 weeks, histological surrogate endpoints; long-term clinical outcomes and phase 3 confirmation pending (SYNCHRONIZE program).
Human RCTRandomised controlled trial
· 2024
Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial
SampleAdults (18–75 y) with BMI ≥27 without diabetes; 43 centres in 12 countries.
EndpointPercentage change in body weight at 46 weeks.
MethodOnce-weekly subcutaneous dosing (0.6 / 2.4 / 3.6 / 4.8 mg groups) vs. placebo over 46 weeks, with titration.
Concrete results
Proportion with ≥15% weight loss (highest dose)
55%
46 Wochen
Findings:Dose-dependent weight reduction of up to about 12% versus placebo; in the highest-dose group 55% of participants achieved at least 15% weight loss. Gastrointestinal effects were most common.
Limitations:Phase 2, dose-finding, 46 weeks; non-diabetic; cardiovascular/long-term outcomes pending in phase 3 (SYNCHRONIZE).
15
Sources & method
Reviewed by
editor-placeholder
Last reviewed
2026-05-22
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