Survodutide

Survodutide (BI 456906) is a once-weekly synthetic peptide dual agonist of the GLP-1 and glucagon receptors developed by Boehringer Ingelheim and Zealand Pharma. The compound is in Phase 3 development for obesity and is being studied for non-alcoholic steatohepatitis (NASH / MASH).

Peppudex card: see the mechanism + evidence-grade summary at [Peppudex / Survodutide](https://peppudex.com/peptides/survodutide).

Overview

The dual-agonism strategy combines GLP-1 receptor activation (satiety, slowed gastric emptying, glucose-dependent insulin secretion) with glucagon receptor activation (increased hepatic lipolysis and energy expenditure). The expected net effect is greater fat-mass reduction than GLP-1 monotherapy at comparable doses.

Mechanism

Survodutide is a single peptide engineered to bind both receptors. The glucagon-agonist arm differentiates it from semaglutide (GLP-1 only) and is intended to drive additional fat oxidation and energy expenditure beyond appetite suppression alone.

See: GLP-1_receptor, Glucagon_receptor, Incretin_effect.

Evidence

Clinical evidence:

• Phase 2 obesity · 46-week trial in 387 adults with obesity reported placebo-subtracted weight loss of 14.9% at 4.8 mg weekly (Le Roux et al., Lancet 2024; PMID 38219768).
• Phase 2 NASH/MASH · improvement in liver-fat content and histology endpoints (le Roux et al., 2024).
• Phase 3 obesity · SYNCHRONIZE-1 / SYNCHRONIZE-2 trials enrolling as of 2025.

Dosing literature

Phase 2 trials titrated weekly subcutaneous doses up to 4.8 mg. The wiki does not recommend any human dose; survodutide is investigational and not FDA-approved.

Pharmacokinetics

Survodutide carries a C18 fatty-diacid linker driving albumin binding, with terminal half-life of approximately 6 to 7 days, supporting once-weekly subcutaneous dosing. Steady-state plasma concentration is reached after 4 to 5 weeks. The molecule is cleared primarily through proteolytic catabolism, similar to other large incretin agonists.

Storage

Lyophilized survodutide is stable at –20 °C for at least 24 months. After reconstitution with bacteriostatic water, store at 2-8 °C and use within 28 days.

Regulatory status

• United States. Investigational. Not FDA-approved as of 2026-05.
• WADA. Not listed on the 2024 Prohibited List.

Side effects (per published Phase 2)

The Le Roux 2024 Phase 2 trial in obesity reported a dose-dependent adverse-event profile dominated by gastrointestinal effects (nausea, vomiting, diarrhea, constipation). Discontinuation rates due to adverse events were higher than placebo, concentrated in the titration period. Glucagon-receptor agonism produces dose-dependent heart-rate increases similar to retatrutide.

See also

• Semaglutide · GLP-1 mono-agonist comparator
• Tirzepatide · GLP-1/GIP dual agonist
• Retatrutide · GLP-1/GIP/glucagon triple agonist
• Mazdutide · GLP-1/glucagon dual agonist (Innovent)
• [Peppudex card · Survodutide](https://peppudex.com/peptides/survodutide) · mechanism, evidence grades A-F, FAQs, peer-reviewed sources

References

• Le Roux CW, et al. "Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial." Lancet Diabetes Endocrinol. 2024;12(3):162-173. PMID 38219768.
• Bossart M, et al. "Effects on weight loss and glycemic control with SAR441255, a potent unimolecular peptide GLP-1/GIP/GCG receptor triagonist." Cell Metab. 2022;34(1):59-74.e10. PMID 34861155.