Survodutide (BI 456906)

Dual GLP-1/Glucagon Receptor Agonist | Weight Loss & Diabetes

Weight: ~4,500 Da
Half-life: Approximately 6 days (109-115 hours)
Chain: 29 amino acids
3 studies
2024 latest
Extensively Studied
Dose 0.6mg starting, titrate up to 3.6-6.0mg weekly
Frequency Once weekly (same day each week)
Cycle 24-76+ weeks continuous therapy
Storage Reconstituted: 2-8°C immediately after mixing
Accumulation Plotter

Community Research

Join others researching Survodutide — share findings, ask questions, and learn from real experiences

View Results Aggregated community findings
Discussion Questions & experiences
Submit Your Findings Contribute your research data

Investigational dual receptor agonist targeting metabolic disease through balanced GLP-1R and GCGR activation. Phase 2/3 clinical trials demonstrate superior weight loss and MASH treatment efficacy.

Mechanism of Action

Dual agonism: GLP-1R reduces appetite and slows gastric emptying; GCGR increases energy expenditure and hepatic fat oxidation. EC50 0.52nM GCGR, 0.33nM GLP-1R.

01 Superior weight loss vs monotherapy (14.9% at 46 weeks)
02 Once-weekly convenient dosing
03 Proven efficacy in obesity, MASH, and Type 2 diabetes
04 62% MASH improvement in clinical trials

Molecular Data

Molecular Weight
~4,500 Da
Chain Length
29 amino acids
Type
Peptide with fatty acid acylation
Amino Acid Sequence
29-amino acid peptide

Complex or non-standard sequence format

Peak 0.0 mcg
Trough 0.0 mcg
SS Peak 0.0 mcg
SS Trough 0.0 mcg

Research Indications

Weight Loss
Obesity Without Diabetes most effective

14.9% mean weight loss at 46 weeks (4.8mg); 55% achieved ≥15% reduction.

Obesity With Type 2 Diabetes most effective

Superior to semaglutide: -8.7% vs -5.3% at 16 weeks.

Sustained Weight Management most effective

Dual mechanism addresses both energy intake and expenditure.

Metabolic
MASH Treatment most effective

62% achieved MASH improvement without fibrosis worsening at 4.8mg.

Liver Fat Reduction most effective

63-67% achieved ≥30% liver fat reduction.

Type 2 Diabetes Control effective

HbA1c reduction up to -1.6% at highest doses.

Dosing Protocols

Subcutaneous injection to abdomen (2+ inches from navel), upper thigh, or upper arm. Any time of day, with or without food.

GoalDoseFrequencyRoute
Obesity - Conservative Start0.6mg titrated over 24 weeksOnce weekly with 4-week intervalsSubQ
Obesity - Standard Protocol3.6-6.0mgOnce weeklySubQ
MASH Treatment2.4-4.8mgOnce weeklySubQ
Type 2 Diabetes0.3-2.7mgOnce weeklySubQ

Reconstitution Instructions

Materials Needed:
  • Survodutide lyophilized powder vial
  • Bacteriostatic water (1-2mL)
  • Insulin syringe (29-31 gauge)
  • Alcohol swabs
  1. 1 Remove vial from refrigerator; allow 15-30 minutes to reach room temperature
  2. 2 Clean rubber stoppers with alcohol swabs
  3. 3 Draw prescribed amount of bacteriostatic water
  4. 4 Insert needle at 45-degree angle into vial
  5. 5 Inject BAC water down vial side slowly to minimize foaming
  6. 6 Gently swirl (do not shake vigorously)
  7. 7 Allow 2-3 minutes for complete dissolution
  8. 8 Solution should be clear to slightly opalescent without particles
  9. 9 Store reconstituted solution in refrigerator immediately

Interactions

~
Semaglutide/Tirzepatide
Both GLP-1 agonists; combining risks excessive activation and GI side effects.
monitor
+
Metformin
Demonstrated together in Phase 2 diabetes trials.
compatible
+
SGLT2 Inhibitors
No known interactions; allowed in Phase 3 with monitoring.
compatible
~
Sulfonylureas
Hypoglycemia risk; consider dose reduction.
monitor
~
Insulin
May require insulin dose reduction due to improved glycemic control.
monitor
~
Oral Contraceptives
Take 1+ hour before survodutide due to delayed gastric emptying.
monitor
!
Other Glucagon Agonists
Risk of excessive glucagon receptor activation.
avoid

What to Expect

Weeks 1-4
Possible nausea, reduced appetite (most common during escalation)
Weeks 4-8
Initial weight loss begins; improved satiety between meals
Weeks 8-16
Progressive weight loss; potential energy level improvements
Weeks 16-24
Approaching steady-state; more consistent effects
Weeks 24+
Sustained weight loss; average 15-19% by week 46

Side Effects & Safety

Common Side Effects

  • Nausea (40-66%)
  • Diarrhea (25-49%)
  • Vomiting (15-41%)
  • Slight heart rate increase (mean 2-5 bpm)

Stop Signs - Discontinue if:

  • Severe persistent nausea/vomiting preventing oral intake
  • Signs of pancreatitis (severe abdominal pain radiating to back)
  • Allergic reactions (rash, itching, difficulty breathing)
  • Severe hypoglycemia with insulin/sulfonylureas
  • Gallbladder symptoms (right upper quadrant pain)
  • Significant tachycardia or arrhythmias

Contraindications

  • Not recommended in pregnancy or breastfeeding
  • Use contraception during treatment

Quality Checklist

Good Signs

  • Clear to slightly opalescent solution without visible particles
  • Sealed vial with intact rubber stopper
  • Within expiration date

Warning Signs

  • Slight foam after reconstitution is normal if disappears within minutes

Bad Signs

  • Cloudy solution or visible particles indicates contamination
  • Discoloration of powder or solution

References

  • Phase 2 Obesity Trial Without Diabetes
    (2024)

    387 participants; BMI ≥27 kg/m²; 46 weeks. 14.9% mean weight loss at 4.8mg; 83% achieved ≥5%, 69% achieved ≥10%, 55% achieved ≥15%.

  • Phase 2 MASH and Fibrosis Trial
    (2024)

    293 participants with biopsy-confirmed MASH; 48 weeks. MASH improvement: 62% (4.8mg) vs 14% placebo; 63-67% achieved ≥30% liver fat reduction.

  • Phase 2 Type 2 Diabetes Trial
    (2023)

    Head-to-head vs semaglutide 1.0mg; 16 weeks. Survodutide -8.7% weight loss vs semaglutide -5.3%; HbA1c reduction up to -1.6%.

Disclaimer

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