Survodutide is the other GLP-1 and glucagon dual agonist in late development, and it shares mazdutide's logic: reduce intake through GLP-1, raise energy expenditure through glucagon.
What distinguishes it is where the glucagon side has been taken. Glucagon receptor activation drives fat breakdown in the liver specifically, and survodutide has been studied in metabolic dysfunction-associated steatohepatitis, the inflammatory form of fatty liver disease, where treatment options are genuinely scarce. That is a different proposition from a weight-loss drug that happens to help the liver.
It is not approved anywhere. It is in phase 3 for both obesity and liver disease, which makes it one of the more advanced compounds on this site without an approval. Material sold as survodutide today is still a research chemical, with none of the manufacturing controls a future approval would rest on.
How it works
Survodutide activates the GLP-1 receptor and the glucagon receptor — the same pair as mazdutide — from a different molecule.
The GLP-1 activity produces the familiar effects: glucose-dependent insulin release, slowed gastric emptying, reduced appetite.
The glucagon activity increases energy expenditure and drives hepatic fat oxidation. The liver effect is direct, not a consequence of weight loss, which is the mechanistic argument for studying it in steatohepatitis specifically.
As with every dual agonist, the balance between the two receptor activities is the design problem: too much glucagon raises blood glucose, too little wastes the second mechanism.
Regulatory status — United States
Not approved in any jurisdiction. In phase 3 development for obesity and for metabolic dysfunction-associated steatohepatitis. Anything sold as survodutide today is a research chemical.
Last reviewed 18 Aug 2026. Regulatory positions in this category change frequently; we date this line so you can see how current it is.
What it is studied for
Each entry states the evidence behind it. We do not rank indications by effectiveness — for most compounds here, that would be a claim nobody can support.
Weight management
Clinical trialIn phase 3.
EvidencePhase 2 reported substantial weight loss, and phase 3 is under way. Not approved.
Metabolic dysfunction-associated steatohepatitis
Clinical trialThe indication that makes it distinct from the rest of the class.
EvidencePhase 2 reported improvement in liver inflammation and fibrosis measures. Phase 3 is under way; nothing is approved.
Identity and clearance
Molecule
- Class
- GLP-1 and glucagon dual receptor agonist, acylated peptide
Pharmacokinetics
Clinical trialWeekly dosing.
Dose protocols reported in sources
Displayed for reference only. Every row says where it came from, and a trial protocol and a community convention are not the same kind of information. None of this is fed into the calculator, and none of it is a recommendation.
| Goal | Dose | Frequency | Route | Units, 5 mg vial | Source | Start this protocol |
|---|---|---|---|---|---|---|
| Phase 2 escalation | 1.2 mg – 6 mg | Once weekly, escalating over several months | SubcutaneousEscalated to a maximum of about 6 mg weekly. Gastrointestinal tolerability drove the escalation schedule, as it does across the class. | from 24 u | Clinical trial | Start this |
Start this copies a row into a protocol of your own, which you can then edit. Where a source gave a dose range or an ambiguous frequency, those fields arrive empty — we will not pick a number on your behalf.
Calculator
Work out what to draw
Pre-filled with a 10 mg vial as a worked example. These are not recommended values — change them to match the vial in front of you.
Draw to 60 units on a 1 mL U-100 syringe. That is 0.6 mL, containing 6 mg of Survodutide.
60 units sits exactly on a printed line.
Bioalmanac performs arithmetic on values you enter. It does not recommend doses, schedules or compounds, and nothing here is medical advice. Confirm every calculation against your vial and syringe before drawing, and speak with a licensed healthcare provider.
Open this calculation in the full calculator
Units, concentration, bacteriostatic water — the glossary defines the vocabulary, and a unit is not a fixed volume.
Safety
Reported effects
- Nausea, vomiting and diarrhoeaClinical trial
Very common in trials
Dose-related and most pronounced during escalation.
- Increased heart rateClinical trial
Reported in trials
Consistent with glucagon receptor activity, as with the other dual agonist in this class.
- Injection site reactionsClinical trial
Common
- Long-term safetyClinical trial
Not established
Phase 3 is ongoing. Nothing has completed the programme that an approval would require.
When to stop
- Severe, persistent abdominal pain, particularly radiating to the back.
- Vomiting severe enough that you cannot keep fluids down.
- A resting heart rate persistently higher than usual, or palpitations.
- Yellowing of the skin or eyes, or pain in the upper right abdomen.
- Any allergic response: rash, hives, facial swelling or difficulty breathing. Seek urgent care.
Interactions and situations that need care
- Personal or family history of medullary thyroid carcinoma, or MEN 2Avoid
The GLP-1 class carries a boxed warning about thyroid C-cell tumours in rodents, and this includes full GLP-1 activity.
- Existing cardiovascular diseaseUse caution
Glucagon receptor activation raises heart rate, and no cardiovascular outcomes trial has been completed for this compound.
- Self-treating liver diseaseAvoid
Steatohepatitis is diagnosed by imaging or biopsy and monitored with liver function tests. Treating a suspected liver condition with an unapproved research chemical — without any of that — risks letting a progressive disease advance unmeasured.
- Pregnancy and breastfeedingAvoid
No safety data, and weight loss in pregnancy is contraindicated.
What to expect
- Phase 2 results are substantial and phase 3 is not finished. That is a meaningful distinction. Phase 2 results routinely shrink in phase 3.
- The liver indication is the genuinely interesting part, and it is also the one where self-treating makes least sense, because the disease is invisible without tests.
- It is not approved anywhere.
- Glucagon is the second receptor, so the heart rate effect is somewhat larger than a pure GLP-1 produces.
Storage and handling
- Freeze-dried powder
- Refrigerated at 2–8 °C, protected from light.
- After mixing
- Refrigerated at 2–8 °C. Do not freeze once mixed.
- Long-term, frozen
- Unopened powder is stable at −20 °C or colder.
With other peptides
- Mazdutideincompatible
Both are GLP-1 and glucagon dual agonists. These are alternatives to one another, not a stack.
- Semaglutideincompatible
Overlapping GLP-1 agonism. Running them together stacks one mechanism and its side effects.
Checking your vial
Research chemicals carry no manufacturing standard, so what the vial looks like is often the only quality signal available before you use it. More on assessing quality and COAs.
White cake, clear solution after gentle mixing
Standard for a lyophilised acylated peptide.
Cloudy solution or collapsed cake
Degradation or heat damage. Do not use it.
Questions
- How is it different from mazdutide?
- Same two receptors, different molecule and different development path. Survodutide has been taken further into fatty liver disease specifically, which mazdutide has not.
- Is it approved?
- No, nowhere. It is in phase 3 for obesity and for steatohepatitis.
References
Survodutide in adults with overweight or obesity: phase 2 trial
New England Journal of Medicine and Boehringer Ingelheim programme, 2024 · Randomised, double-blind, placebo-controlled phase 2 trial
Adults with overweight or obesity without diabetes · Up to 6 mg subcutaneous, once weekly · 46 weeks
Substantial dose-dependent weight loss against placebo. Gastrointestinal effects were the most common adverse events, with a modest heart rate increase consistent with glucagon receptor activity.
Survodutide in metabolic dysfunction-associated steatohepatitis: phase 2 trial
New England Journal of Medicine, 2024 · Randomised, double-blind, placebo-controlled phase 2 trial
Adults with biopsy-confirmed steatohepatitis and fibrosis · 48 weeks
Improvement in steatohepatitis without worsening of fibrosis in a significantly greater proportion than placebo. Phase 3 is under way; nothing is approved.
Survodutide compared with
Related compounds
Mazdutide
A GLP-1 and glucagon dual agonist approved in China in 2026. Not approved in the United States, and the US pathway is undecided.
Semaglutide
A long-acting GLP-1 receptor agonist approved for type 2 diabetes and for weight management, dosed once weekly.
Tirzepatide
A once-weekly dual agonist that activates both the GIP and GLP-1 receptors, approved for type 2 diabetes and for weight management.
Retatrutide
An investigational once-weekly triple agonist acting on the GLP-1, GIP and glucagon receptors. Not approved anywhere.
Next
What to do with Survodutide
- Keep a record of itTurn a dose and a schedule into a protocol, then log what you actually take. Survodutide is filled in for you.
- See what it costsPer-milligram prices read from vendor sites and confirmed by a person, so vial sizes compare.
- Check a combinationWhat our profiles record about Survodutide alongside each other compound — including the pairs where nothing is recorded.
Keep this page honest
If something here is wrong, out of date, or missing a source, tell us and we will fix it and say that we did.
This page is educational. It describes what published research reports, not what you should do. Peptides discussed here are largely not approved for human use, and nothing on Bioalmanac is medical advice. No clinician reviews these pages.
Page last updated 18 Aug 2026