Quick summary
Survodutide is Boehringer Ingelheim and Zealand Pharma's dual glucagon/GLP-1 receptor agonist in Phase 3 trials for obesity and MASH. It has received FDA Fast Track designation for MASH and is not yet approved.
Overview
Survodutide (BI 456906) is a dual glucagon receptor (GCGR) and GLP-1 receptor (GLP-1R) agonist developed by Boehringer Ingelheim and Zealand Pharma. It is in Phase 3 trials for obesity and overweight (SYNCHRONIZE program) and received FDA Fast Track Designation for metabolic dysfunction-associated steatohepatitis (MASH/NASH). The dual mechanism adds hepatic fat clearance and energy expenditure on top of appetite suppression.
Mechanism of action
Survodutide simultaneously activates two distinct receptor pathways. GLP-1 receptor agonism slows gastric emptying, enhances glucose-dependent insulin secretion, and reduces appetite via central hypothalamic signaling — effects shared with semaglutide and tirzepatide. The added glucagon receptor (GCGR) agonism introduces direct hepatic mechanisms not present in GLP-1-only agents: stimulation of mitochondrial fatty acid beta-oxidation, upregulation of energy expenditure through farnesoid X receptor (FXR) signaling, and induction of fibroblast growth factor 21 (FGF21) secretion. FGF21 is a key metabolic hormone that increases thermogenesis and improves insulin sensitivity. Together, the dual agonism increases both energy expenditure and reduces caloric intake, producing weight loss that may exceed GLP-1-only agents in certain populations.
Dosing protocols
| Purpose | Route | Dosage | Frequency | Notes |
|---|---|---|---|---|
| Obesity / weight management (Phase 3 trial) | subcutaneous | 0.6–4.8 mg | Once weekly | Doses titrated in clinical trials from 0.6 mg up to 4.8 mg weekly. Maximum studied dose: 4.8 mg. Not available outside trials. |
Dosing information is for educational purposes only. Consult a qualified healthcare professional before using any peptide.
Research summary
Phase 2 data showed mean weight loss ranging from 6.2% (0.6 mg) to 14.9% (4.8 mg) at 46 weeks vs 2.8% for placebo. In the Phase 2 MASH trial, up to 62% of patients at 4.8 mg achieved histological MASH improvement without worsening fibrosis, vs 14% placebo. Phase 3 SYNCHRONIZE-1 (obesity without T2D) and SYNCHRONIZE-2 (obesity with T2D) trials are ongoing globally, with SYNCHRONIZE-CVOT evaluating long-term cardiovascular safety. Results pending as of 2026.[1][2][3]
Evidence grading
Each claimed benefit is graded by the strength of available evidence. Grades reflect study quality, not effect size.
Strong = multiple RCTs · Moderate = limited trials or observational · Preliminary = animal or in vitro only · Insufficient = anecdotal or no published data
Side effects
Side effects vary by individual. This is not an exhaustive list. Report unusual symptoms to a healthcare professional.
Common stacks
Peptides commonly paired with Survodutide for synergistic effects.
Legal status
Investigational compound in Phase 3 clinical trials. Not approved for human use outside of clinical trials. Available only through authorized research programs. No compounding or research chemical availability.
Sourcing & access
Research compound
Survodutide is classified as a research compound. Regulatory status varies by jurisdiction. Always verify current legal status and source from vendors providing third-party certificates of analysis (COA).
Frequently asked questions
Survodutide (BI 456906) is a dual glucagon receptor and GLP-1 receptor agonist developed by Boehringer Ingelheim and Zealand Pharma. It is in Phase 3 trials for obesity and has received FDA Fast Track designation for metabolic dysfunction-associated steatohepatitis.
Survodutide simultaneously activates two receptors. GLP-1 receptor agonism slows gastric emptying and suppresses appetite, while glucagon receptor agonism stimulates hepatic fatty acid oxidation, increases energy expenditure, and induces FGF21 secretion to enhance thermogenesis and insulin sensitivity.
No. Survodutide is an investigational compound in Phase 3 clinical trials and is not approved for human use outside of those trials. It is available only through authorized research programs.
Phase 2 data showed mean weight loss ranging from 6.2% at 0.6 mg to 14.9% at 4.8 mg at 46 weeks, versus 2.8% for placebo. In a Phase 2 MASH trial, up to 62% of patients at 4.8 mg achieved histological MASH improvement without worsening fibrosis versus 14% on placebo.
Phase 3 SYNCHRONIZE protocols titrate from 0.6 mg once weekly subcutaneously up to a maximum studied dose of 4.8 mg, consistent with the dose-finding range from Phase 2 trials. The approximately one-week half-life supports once-weekly administration. Survodutide is not available outside authorized clinical trials and cannot be obtained through compounding or research chemical channels.
Reported side effects in Phase 2 and Phase 3 trials include nausea, vomiting, diarrhea, constipation, decreased appetite, injection site reactions, and fatigue. The profile is consistent with the broader GLP-1 class, and the glucagon component has not produced significant hepatic or glycemic safety signals in the clinical dose range studied so far. Long-term cardiovascular safety remains under evaluation in SYNCHRONIZE-CVOT.
Both are dual-mechanism weight loss peptides in clinical development, but they activate different receptor pairs. Tirzepatide is a GLP-1/GIP dual agonist, while survodutide is a GLP-1/glucagon dual agonist that additionally stimulates hepatic fat clearance and energy expenditure.
Research references
- Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trialPubMed
- A Phase 2 Randomized Trial of Survodutide in MASH and FibrosisPubMed
- Survodutide for treatment of obesity: Baseline characteristics of participants in a randomized, double-blind, placebo-controlled, phase 3 trial (SYNCHRONIZE-1)PubMed