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Retatrutide

Extensively Studied

Triple GLP-1/GIP/Glucagon Agonist | Weight Loss & Diabetes

Dose 0.5mg starting, titrate up to 8-12mg weekly
Frequency Once weekly (same day each week)
Cycle Continuous therapy as prescribed
Storage Reconstituted: 2-8°C, use within 28 days

Novel triple hormone receptor agonist targeting GLP-1, GIP, and glucagon receptors. Phase II trials demonstrated 24.2% weight loss at 48 weeks—the highest recorded for obesity medications.

Mechanism of Action

Activates GLP-1 for appetite suppression, GIP for insulin sensitivity, and glucagon for increased energy expenditure and hepatic fat oxidation.

Key Benefits

  • Superior weight loss (24.2% at 48 weeks)
  • Improved glycemic control (HbA1c reduction up to 2.16%)
  • Enhanced cardiovascular benefits
  • Hepatic fat reduction (up to 82%)
  • Triple mechanism addresses obesity through multiple pathways
Molecular Weight
4,731.33 Da
Chain Length
39 amino acids
Type
Triple GLP-1/GIP/glucagon agonist
Amino Acid Sequence
One-letter: HUEGTFTSDVSSYLEGQAAKEFIAWLVRGRGPSSGAPPPS
H₂N
H 1
O C
N
U 2
O C
N
E 3
O C
N
H
G 4
O C
N
T 5
O C
N
F 6
O C
N
T 7
O C
N
S 8
O C
N
D 9
O C
N
V 10
O C
N
S 11
O C
N
S 12
O C
N
Y 13
O C
N
L 14
O C
N
E 15
O C
N
H
G 16
O C
N
Q 17
O C
N
A 18
O C
N
A 19
O C
N
K 20
O C
N
E 21
O C
N
F 22
O C
N
I 23
O C
N
A 24
O C
N
W 25
O C
N
L 26
O C
N
V 27
O C
N
R 28
O C
N
H
G 29
O C
N
R 30
O C
N
H
G 31
O C
N
P 32
O C
N
S 33
O C
N
S 34
O C
N
H
G 35
O C
N
A 36
O C
N
P 37
O C
N
P 38
O C
N
P 39
O C
N
S 40
COOH
His
1

Histidine

Position 1

Aib
2

Aminoisobutyric Acid

Position 2

Glu
3

Glutamic Acid

Position 3

Gly
4

Glycine

Position 4

Thr
5

Threonine

Position 5

Phe
6

Phenylalanine

Position 6

Thr
7

Threonine

Position 7

Ser
8

Serine

Position 8

Asp
9

Aspartic Acid

Position 9

Val
10

Valine

Position 10

Ser
11

Serine

Position 11

Ser
12

Serine

Position 12

Tyr
13

Tyrosine

Position 13

Leu
14

Leucine

Position 14

Glu
15

Glutamic Acid

Position 15

Gly
16

Glycine

Position 16

Gln
17

Glutamine

Position 17

Ala
18

Alanine

Position 18

Ala
19

Alanine

Position 19

Lys
20

Lysine

Position 20

Glu
21

Glutamic Acid

Position 21

Phe
22

Phenylalanine

Position 22

Ile
23

Isoleucine

Position 23

Ala
24

Alanine

Position 24

Trp
25

Tryptophan

Position 25

Leu
26

Leucine

Position 26

Val
27

Valine

Position 27

Arg
28

Arginine

Position 28

Gly
29

Glycine

Position 29

Arg
30

Arginine

Position 30

Gly
31

Glycine

Position 31

Pro
32

Proline

Position 32

Ser
33

Serine

Position 33

Ser
34

Serine

Position 34

Gly
35

Glycine

Position 35

Ala
36

Alanine

Position 36

Pro
37

Proline

Position 37

Pro
38

Proline

Position 38

Pro
39

Proline

Position 39

Ser
40

Serine

Position 40

N-terminus C-terminus
Hydrophobic
Polar
Positive (+)
Negative (-)
Modified

Weight Loss

  • Superior Weight Reduction

    Clinical trials show 17.5% weight loss at 24 weeks and 24.2% at 48 weeks.

  • Sustained Weight Management

    Continuous weight loss with no plateau at 48 weeks suggests greater long-term potential.

  • Triple Mechanism

    Addresses obesity through appetite suppression, energy expenditure, and metabolic efficiency.

Type 2 Diabetes

  • Superior Glycemic Control

    HbA1c reductions up to 2.16% with 82% achieving target levels below 6.5%.

  • Glucose-Dependent Regulation

    Balanced glycemic control with minimal hypoglycemia risk.

  • Insulin Sensitivity

    Marked improvements in sensitivity with potential for reduced exogenous insulin requirements.

Cardiovascular/Metabolic

  • Lipid Improvement

    Non-HDL cholesterol reductions up to 26.9%, triglyceride reductions up to 40.6%.

  • Blood Pressure Optimization

    Consistent decreases in systolic and diastolic blood pressure across trials.

  • Hepatic Fat Reduction

    Up to 82% reduction in liver fat with normalization in 90% of participants.

Weekly subcutaneous injection into abdomen, thigh, or upper arm with site rotation.

GoalDoseFrequencyRoute
Starting Dose (Week 1-4)0.5mgOnce weeklySubQ
Low Maintenance (Week 4-8)1mgOnce weeklySubQ
Escalation (Week 8-12)2mgOnce weeklySubQ
Moderate (Week 12-16)4mgOnce weeklySubQ
Advanced (Week 16-20)8mgOnce weeklySubQ
Maximum Efficacy (Week 20+)12mgOnce weeklySubQ

Reconstitution Instructions

Materials Needed:
  • Sterile bacteriostatic water for injection
  • Lyophilized Retatrutide vial
  • Insulin syringes (0.3-1mL capacity)
  • Alcohol swabs
  • Sharps disposal container
  1. 1 Allow vial to reach room temperature (15-20 minutes)
  2. 2 Clean vial top with alcohol swab and air dry completely
  3. 3 Add calculated bacteriostatic water slowly down vial side
  4. 4 Gently swirl in circular motions—avoid vigorous shaking
  5. 5 Allow full dissolution (2-3 minutes); solution should be clear and colorless
  6. 6 Store reconstituted solution refrigerated at 2-8°C for up to 28 days
  7. 7 Inject subcutaneously; rotate sites weekly
Tirzepatide

Do not combine with other dual/triple agonists—risk of severe hypoglycemia and excessive GI effects.

avoid
Semaglutide

Do not combine—overlapping GLP-1 agonist mechanisms increase severe hypoglycemia risk.

avoid
Cagrilintide

Both cause significant GI effects. Not recommended without specialist supervision.

monitor
Insulin

May significantly reduce insulin requirements. Monitor blood glucose and adjust insulin doses accordingly.

monitor
Metformin

Safe combination tested in clinical trials. Different mechanisms work complementarily for glucose control.

compatible
SGLT2 Inhibitors

Clinical trials included SGLT2 inhibitors with no safety concerns.

compatible
BPC-157

Safe combination; BPC-157 may provide GI protective benefits during retatrutide use.

compatible
Oral Contraceptives

Space oral contraceptives by 1 hour before retatrutide due to delayed gastric emptying.

monitor
Week 1-2

Initial appetite suppression and mild GI effects as body adapts to triple hormone activation

Week 2-4

Noticeable food cravings reduction and portion size decrease; early weight loss (2-5%)

Week 4-8

Significant appetite control and steady weight loss (5-10%); improved glucose control

Week 8-16

Substantial weight reduction (10-18%) with enhanced energy expenditure

Week 16-24

Major weight loss milestone (15-22%) with cardiovascular benefits and liver fat reduction

Week 24-48

Maximum clinical efficacy (20-24.2%) with comprehensive metabolic improvements

Common Side Effects

  • Gastrointestinal effects (nausea, vomiting, diarrhea)—typically mild to moderate
  • Heart rate increases—common especially in first 24 weeks
  • Appetite suppression
  • Mild dehydration

Stop Signs - Discontinue if:

  • Severe persistent nausea or vomiting preventing adequate nutrition
  • Signs of pancreatitis: severe abdominal pain radiating to back
  • Severe hypoglycemia symptoms: confusion, dizziness, sweating
  • Excessive weight loss (>3 lbs per week consistently or >25% total body weight)
  • Gallbladder problems: severe right upper abdominal pain

Contraindications

  • Personal or family history of medullary thyroid carcinoma
  • MEN2 syndrome
  • Severe renal impairment

Good Signs

  • Pharmaceutical-grade white powder with uniform texture
  • Proper cold chain maintenance (2-8°C refrigeration)
  • Clear, colorless reconstituted solution without particles
  • Stable extended half-life effects (consistent appetite suppression between doses)

Warning Signs

  • Source verification critical—counterfeit versions circulate due to investigational status

Bad Signs

  • Rapid tolerance or effectiveness loss suggests degraded or counterfeit product
  • Unusual side effect profile may indicate contamination
  • Phase II Obesity Trial
    (2023)

    Landmark RCT in 338 participants showing dose-dependent weight loss; 12mg dose achieved 24.2% reduction—highest recorded for any obesity medication. NEJM.

  • Phase II Type 2 Diabetes Study
    (2023)

    Trial in 281 participants with type 2 diabetes: 16.9% weight loss and HbA1c reductions up to 2.16%. The Lancet.

  • MASLD Substudy
    (2024)

    Metabolic dysfunction-associated steatotic liver disease study: 82% liver fat reduction with normalization in >90% at highest doses. Nature Medicine.

  • Structural Insights into Triple Agonism
    (2024)

    Cryo-EM structures reveal simultaneous activation of GLP-1R, GIPR, and GCGR, explaining superior clinical efficacy. Cell Discovery.

Disclaimer

This information is for educational and research purposes only. Consult a healthcare professional before use.