glp1InjectableNot FDA-approvedResearch chemicalInvestigational — phase 3 program ongoing
SurvodutideBenefits, Dosage & Interactions
Also known as: BI 456906
Survodutide (BI 456906) is an investigational once-weekly injectable that activates both the glucagon receptor and the GLP-1 receptor. The GLP-1 arm reduces appetite and slows gastric emptying, while the glucagon arm is intended to raise energy expenditure and act on liver fat.
How much Survodutide do people take?
The obesity program studied maintenance amounts of 3.6 mg and 6.0 mg once weekly after escalation. Route reported: Subcutaneous injection. Frequency reported: Once weekly with a multi-step escalation. These are amounts documented in the cited studies and labels for Survodutide — they are reported for reference, not a recommendation. Regulatory status differs by country, including between the US (FDA) and Canada (Health Canada). Confirm any amount with a licensed clinician before you take it.
See the full reported protocol and its sourcesResearched by DoseRoutine Research TeamReviewed for accuracy by Nicholas Alexander, RSE, SO, PMPLast updated Educational reference only — not medical advice. Always confirm dosing and safety decisions with a licensed clinician.
Evidence: Moderate — One published human randomized trial; results not yet replicated.
Evidence strengthModerate · 3/4
PreclinicalStrong human evidence
One published human randomized trial; results not yet replicated.
Quick answer
Survodutide (BI 456906) is an investigational once-weekly injectable that activates both the glucagon receptor and the GLP-1 receptor. The GLP-1 arm reduces appetite and slows gastric emptying, while the glucagon arm is intended to raise energy expenditure and act on liver fat. In phase 2 obesity trials reported in 2024, participants lost roughly 19% of body weight at 46 weeks on the highest arm. It is not approved by the FDA or EMA and remains in phase 3 testing.
- Also known as
- BI 456906
- Class
- Dual glucagon receptor / GLP-1 receptor agonist
- Developer
- Boehringer Ingelheim with Zealand Pharma
- Route
- Once-weekly subcutaneous injection (trial protocols)
- Status
- Investigational — phase 3; not FDA or EMA approved
- Studied in
- Obesity, type 2 diabetes and MASH (liver fat)
Compiled by DoseRoutine from public sources including NIH/MedlinePlus, the FDA label, Mayo Clinic and PubChem. Educational information, not medical advice.
Plasma half-life
~5 days
Default unit
mg
What published protocols report
Ranges documented in the literature, shown for reference. DoseRoutine does not recommend an amount — your prescriber or the product label sets the dose.
Reported for Survodutide in the cited sources. Published ranges are not dosing advice.
Mixing Survodutide: bacteriostatic water and syringe units
The vial arrives as dry powder. How much water you add sets the strength, and the strength sets the mark you draw to on the syringe. The table assumes a 5 mg vial and a 250 mcg example draw on a U-100 insulin syringe, where 100 units is one millilitre. If your vial is a different size, scale it — the arithmetic is the same.
| Bacteriostatic water added | Resulting strength | 250 mcg draws to |
|---|---|---|
| 1 mL | 5 mg/mL | 5 units |
| 2 mL | 2.5 mg/mL | 10 units |
| 3 mL | 1.67 mg/mL | 15 units |
Units, not millilitres. Insulin syringes are marked in units, and mixing up mcg and mg on a peptide label is the single most common error people report. Check the label twice. Run your own vial through the calculator.
Storage and stability
- Before mixing
- Sealed and still as a dry powder, Survodutide vials are normally kept in the fridge at 2–8 °C, out of light. Short spells at room temperature during shipping are the norm for lyophilized peptides and are not, on their own, a sign the vial is spoiled.
- After mixing
- Once bacteriostatic water goes in, the vial belongs in the fridge and is generally treated as good for about 28 days — that is how long the benzyl alcohol in bacteriostatic water is relied on to hold back bacterial growth. Plain sterile water has no preservative, so a vial mixed with it is a single-session vial. Never freeze a reconstituted vial.
- When to throw it out
- A properly mixed vial is clear. Cloudiness, floating strands, a color change or powder that will not go into solution after gentle swirling all mean the vial should be discarded rather than used. Shaking a peptide vial hard is the usual cause — swirl it, or run the water down the inside wall of the vial instead of onto the powder.
Handling and shelf-life figures describe general practice for lyophilized peptides. They are not a dose and not medical advice — your prescriber or the product label sets the amount.
Survodutide compared with similar compounds
| Attribute | Semaglutide | Dulaglutide | Cagrilintide | Survodutide |
|---|---|---|---|---|
| Class | GLP-1 receptor agonist | GLP-1 receptor agonist (Fc fusion) | Long-acting amylin analog | Glucagon/GLP-1 dual receptor agonist |
| Route | Subcutaneous once weekly | Subcutaneous once weekly | Subcutaneous once weekly | Subcutaneous once weekly |
| Half-life | ~7 days | ~5 days | ~7–8 days | ~6 days |
| Evidence grade | Strong | Strong | Moderate | Moderate |
| Oral stability | Oral tablet form exists (with SNAC absorption enhancer) | Not orally available | Not orally available | Not orally available |
| Typical published cycle | Ongoing while prescribed | Ongoing while prescribed | Investigational — phase 3 ongoing | Investigational — phase 3 reported |
| Main studied use | Type 2 diabetes and weight management | Type 2 diabetes and cardiovascular risk reduction | Weight management, alone or with semaglutide | Obesity and MASH (investigational) |
References & evidence
Documents the Survodutide entry is written from. Each number matches an inline marker above.
- [1]Survodutide Once Weekly for the Treatment of Adults with Obesityle Roux CW, et al. · New England Journal of Medicine · 2026 · Peer-reviewed · PMID 42253238
- [2]Dual Glucagon and GLP-1 Receptor Agonist Survodutide Improves Biomarkers of Beta-Cell Function and Insulin SensitivityEkinci EI, et al. · Diabetes, Obesity and Metabolism · 2026 · Peer-reviewed · PMID 42331726
References & Evidence
Sources on this page that document Survodutide dosing, timing and safety.
- [1]National Center for Biotechnology Information View source
Educational information only — not medical advice. Dose ranges vary by person, indication and prescriber.
What is Survodutide studied for?
What is Survodutide?Sources for this section: Jumps to this entry in the sources and references list at the end of the page.
Survodutide, also known by its developmental code BI 456906, is an investigational compound recognized for its potential role in weight management. It operates as a dual agonist, meaning it activates both the glucagon-like peptide-1 (GLP-1) receptor and the glucagon receptor. This dual action is a key aspect of its proposed mechanism for affecting metabolic processes. The compound is administered via injection and is currently undergoing clinical trials to assess its safety and efficacy for various conditions, particularly obesity and metabolic dysfunction-associated steatohepatitis (MASH), formerly known as non-alcoholic steatohepatitis (NASH). Its half-life in the body is approximately 170 hours, supporting less frequent dosing regimens. (Source: ClinicalTrials.gov, DrugBank)
What does the research say about Survodutide?
Tap a section to expand.
Survodutide functions as a balanced dual agonist of the glucagon-like peptide-1 (GLP-1) receptor and the glucagon receptor. This mechanism distinguishes it from compounds that primarily target only the GLP-1 receptor. Activation of the GLP-1 receptor is known to enhance glucose-dependent insulin secretion, suppress glucagon secretion, slow gastric emptying, and promote satiety, all of which contribute to glycemic control and reduced food intake. Simultaneous activation of the glucagon receptor is thought to have additional metabolic effects. Glucagon, traditionally associated with raising blood glucose, also plays a role in energy expenditure, particularly through its effects on the liver and adipose tissue. By activating both receptors, survodutide aims to leverage these complementary pathways. The glucagon receptor agonism may lead to increased energy expenditure and direct effects on hepatic lipid metabolism, potentially reducing liver fat content. This dual action is hypothesized to result in more pronounced effects on weight loss and improvements in metabolic parameters compared to selective GLP-1 agonists. (Source: PubChem, scientific literature reviews)
Source for this section: Sources for How does Survodutide work?: Jumps to this entry in the sources and references list at the end of the page.
Survodutide is primarily being investigated for its potential benefits in the treatment of obesity and metabolic dysfunction-associated steatohepatitis (MASH). Clinical trials are exploring its ability to induce significant weight loss in individuals with overweight or obesity. The dual agonism of GLP-1 and glucagon receptors is thought to contribute to this effect by influencing both energy intake (through appetite suppression and delayed gastric emptying) and energy expenditure (through glucagon receptor activation). Beyond weight loss, preliminary research suggests benefits for liver health. In individuals with MASH, survodutide has shown promise in reducing liver fat content and improving markers of liver inflammation and fibrosis. This effect is likely mediated by the glucagon component, which can influence hepatic lipid metabolism. Improved glycemic control may also be a benefit, given the GLP-1 receptor's role in insulin secretion and glucose regulation. It's important to note that these benefits are currently under investigation in clinical trials and are not yet established for approved medical use. (Source: ClinicalTrials.gov, scientific abstracts from professional conferences)
Clinical evidence for survodutide primarily comes from ongoing Phase 2 and Phase 3 clinical trials. For obesity, a Phase 2 trial demonstrated significant dose-dependent weight loss over several months in adult participants with overweight or obesity. The study reported that participants treated with survodutide achieved a greater percentage of weight loss compared to placebo. For metabolic dysfunction-associated steatohepatitis (MASH), a Phase 2 trial showed that survodutide treatment led to a significant reduction in liver fat content and a higher rate of MASH resolution without worsening of fibrosis, compared to placebo. These findings indicate a promising efficacy profile in both weight management and liver disease. Longer-term and larger Phase 3 trials are currently underway to further confirm these findings, assess long-term safety, and evaluate additional metabolic effects. The evidence base is continuously evolving as these studies progress. (Source: ClinicalTrials.gov, peer-reviewed journal articles summarizing Phase 2 results)
As an investigational compound, the full spectrum of potential side effects of survodutide is still being characterized through ongoing clinical trials. Common side effects reported in early trials, consistent with other GLP-1 receptor agonists, typically involve the gastrointestinal system. These may include nausea, vomiting, diarrhea, and constipation. These effects are often transient and tend to decrease over time as the body adjusts to the medication. Other reported side effects have included abdominal pain and headache. Some participants may experience injection site reactions, such as redness or discomfort. Less common or more severe side effects, including potential impacts on the gallbladder (e.g., cholelithiasis), pancreatitis, or thyroid C-cell tumors (as seen in animal studies with GLP-1 receptor agonists), are areas of continued monitoring in clinical development. Participants in clinical trials are closely monitored for any adverse events. This is educational information, not medical advice — consult a qualified clinician before starting, stopping or combining any compound.
Given that survodutide is currently an investigational drug, certain warnings are based on observations from clinical trials and the known class effects of GLP-1 receptor agonists. Individuals with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) should exercise caution, as a theoretical risk of thyroid C-cell tumors has been observed with GLP-1 receptor agonists in animal studies, though direct evidence in humans for survodutide is not established. Caution is also advised for individuals with a history of pancreatitis, as GLP-1 receptor agonists have been associated with this condition in some cases. Individuals with pre-existing severe gastrointestinal disease (e.g., gastroparesis) should be monitored carefully due to the potential for delayed gastric emptying. As with any medication affecting glucose metabolism, individuals with diabetes on concomitant insulin or sulfonylureas may be at an increased risk of hypoglycemia and require dose adjustments of their antidiabetic medications under medical supervision. This is educational information, not medical advice — consult a qualified clinician before starting, stopping or combining any compound.
Specific contraindications for survodutide are not fully established as it is an investigational drug. However, based on the known pharmacology of GLP-1 receptor agonists and observations from clinical trials, certain conditions may be considered contraindications or require extreme caution. These may include a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), due to the theoretical risk of C-cell tumors. Individuals with a history of severe hypersensitivity reactions to the compound or any of its excipients would also likely be contraindicated. Acute pancreatitis or severe gastroparesis could also potentially be contraindications. Pregnant or breastfeeding individuals are typically excluded from clinical trials of novel compounds, suggesting it should not be used during these periods unless specifically cleared by a healthcare professional based on a risk-benefit assessment. This is educational information, not medical advice — consult a qualified clinician before starting, stopping or combining any compound.
As an investigational compound, comprehensive drug interaction data for survodutide are still being accumulated. However, based on its mechanism of action, caution is advised when co-administering with certain medications. Due to its GLP-1 receptor agonist activity, survodutide may delay gastric emptying. This could potentially affect the absorption of orally administered medications, particularly those requiring rapid gastrointestinal absorption or those with a narrow therapeutic index. Patients on medications such as anticoagulants (e.g., warfarin) or certain antibiotics might require careful monitoring and potential dose adjustments. For individuals with diabetes, concomitant use with insulin or insulin secretagogues (e.g., sulfonylureas) may increase the risk of hypoglycemia. If taken together, a reduction in the dose of insulin or sulfonylurea may be necessary, and blood glucose levels should be closely monitored. Always discuss all current medications and supplements with a healthcare provider to identify potential interactions. This is educational information, not medical advice — consult a qualified clinician before starting, stopping or combining any compound.
Survodutide is an injectable compound with a long half-life of approximately 170 hours, allowing for once-weekly administration. The timing of administration within the day (e.g., morning or evening) is not typically specified as critical, as its effects are sustained over many days. It can be administered at any time of day, with or without food. Consistent weekly administration on the same day is generally recommended to maintain steady levels of the compound in the body and facilitate adherence. Individuals should follow the specific instructions provided by their prescribing clinician or the trial protocol if participating in a study. The dose is user-directed and must be set by a licensed clinician.
Source for this section: Sources for When should you take Survodutide?: Jumps to this entry in the sources and references list at the end of the page.
Put it into practice
Reading about Survodutide is the first step — DoseRoutine helps you act on it. These free tools turn what you just learned into a routine.
What interacts with Survodutide?
| Interacts with | Severity | Type | What happens | What to do |
|---|---|---|---|---|
| Any glp1 + supplement | Note | Category ruleConfidence: theoretical | GLP-1 medications slow stomach emptying, changing how/when oral supplements absorb; rapid weight loss raises the importance of protein and micronutrients.Source pending | Time oral supplements when nausea is lowest; prioritize protein and micronutrients; discuss with your provider. |
| Insulin (Rapid) | Caution | Compound pairConfidence: theoretical | Combining a GLP-1 with rapid insulin increases hypoglycemia risk.Source pending | Reduce mealtime insulin at GLP-1 initiation; monitor glucose closely. |
| Insulin (Long-Acting) | Caution | Compound pairConfidence: theoretical | GLP-1 plus basal insulin increases hypoglycemia risk.Source pending | Reduce basal insulin dose 10–20% at GLP-1 initiation and titrate. |
Frequently asked questions about Survodutide
Survodutide is a glp1. It is also known as BI 456906. The references summarized come from NIH and PubMed records, FDA labeling where it exists, and Mayo Clinic patient material.
Survodutide is commonly discussed in the context of supporting weight-loss. Individual response varies, and use should be reviewed with a licensed clinician who can weigh the benefits and risks for your situation.
For Survodutide, it is typically administered by injection, it is typically taken null, and its approximate half-life is 120 hours, which influences dosing frequency. Always follow the specific dose your clinician or the product label prescribes.
Survodutide carries potential side effects and drug interactions, documented in NIH, Mayo Clinic, and FDA label sources. Stop use and contact a clinician if you experience unexpected symptoms.
As a supplement, Survodutide can overlap with other supplements, prescription medicines, hormones and peptides. With a reported plasma half-life near 120 hours, separating doses can change the picture as much as removing one. Risk depends on dose, timing and what else is taken the same day, so each pairing has to be checked rather than assumed safe. The free checker at https://doseroutine.com/interaction-checker covers Survodutide with no sign-up.
Whether Survodutide fits alongside testosterone replacement therapy depends on the protocol — dose, ester and ancillaries such as HCG or anastrozole — and on current bloodwork. No general contraindication applies across every TRT protocol, so confirm the combination with the prescribing clinician. See the free TRT interaction reference: https://doseroutine.com/trt-supplement-interactions
"Peptides" is not one category — healing peptides, GLP-1 agonists, growth-hormone secretagogues and melanocortins each behave differently next to Survodutide. Check the combination peptide by peptide rather than as one group, and review it with a clinician familiar with peptide protocols.
A long plasma half-life of about 120 hours means Survodutide is commonly dosed every few days or weekly rather than daily. Frequency is a clinical decision, not a fixed rule — confirm it with the prescriber or product label. Comparison of apps that keep a schedule like this: https://doseroutine.com/best-dose-tracking-apps
With a plasma half-life near 120 hours, a single missed dose of Survodutide usually has a smaller effect on overall exposure than an irregular pattern of missed doses does. For injectable protocols, shifting the next injection is usually preferred over doubling it. Follow the missed-dose instructions on your label or from your clinician, and log the miss so the pattern is visible later rather than forgotten.
For an injectable like Survodutide the record needs more than a checkbox: vial concentration, the measured volume, and which site the last injection went into. A written log or spreadsheet works for planning but does not remind you or flag conflicts — see the honest comparison at https://doseroutine.com/vs/spreadsheet and the wider roundup at https://doseroutine.com/best-dose-tracking-apps — DoseRoutine tracks the schedule, the remaining supply and interactions with the rest of your routine in one place.
No. As of 2026 survodutide is investigational and has not been approved by the FDA or the EMA for any indication. It is being evaluated in the phase 3 SYNCHRONIZE program for obesity and related conditions, so the only legitimate access is through an enrolled clinical trial. This is educational information, not medical advice.
Semaglutide targets the GLP-1 receptor alone; tirzepatide targets GLP-1 plus GIP. Survodutide pairs GLP-1 with glucagon receptor activation, a mechanism aimed at increasing energy expenditure and reducing liver fat in addition to appetite suppression. Head-to-head trials against tirzepatide have not been published, so cross-trial comparisons are not reliable. This is educational information, not medical advice.
In a phase 2 trial published in 2024, adults with obesity lost about 19% of body weight on average after 46 weeks on the highest dose arm, versus roughly 2% on placebo, with dose escalation still ongoing at the end of the study. Phase 3 results will determine what the approved profile looks like. This is educational information, not medical advice.
Trial reports describe a gastrointestinal profile similar to other incretin drugs — nausea, vomiting, diarrhea and constipation — most often during dose escalation, and these accounted for most discontinuations. Because the glucagon arm can affect heart rate and liver parameters, trial protocols monitor those specifically. This is educational information, not medical advice.
The obesity program studied maintenance amounts of 3.6 mg and 6.0 mg once weekly after escalation. Route reported: Subcutaneous injection. Frequency reported: Once weekly with a multi-step escalation. These are amounts documented in the cited studies and labels for Survodutide — they are reported for reference, not a recommendation. Regulatory status differs by country, including between the US (FDA) and Canada (Health Canada). Confirm any amount with a licensed clinician before you take it.
Which studies looked at Survodutide?
Peer-reviewed research indexed in PubMed. Each entry links to the original record.
- 1.A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis(opens PubMed in a new tab)N Engl J Med · 2024 · PMID 38847460 · https://pubmed.ncbi.nlm.nih.gov/38847460/
- 2.Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial.(opens PubMed in a new tab)The lancet. Diabetes & endocrinology · 2024 · PMID 38330987 · https://pubmed.ncbi.nlm.nih.gov/38330987/
Sources cited on this page
Specific documents referenced by the numbered markers above. Each number matches the marker in the text.
- PubChem CID 171378821(opens in a new tab)National Center for Biotechnology Information · pubchem.ncbi.nlm.nih.gov/compound/171378821
Verify at
Publisher search links for Survodutide. These are places to check the information — they are not citations, so they are not numbered.
- ClinicalTrials.gov(publisher search, opens in a new tab)U.S. National Library of Medicine · publisher search
- DrugBank(publisher search, opens in a new tab)DrugBank Online · publisher search
- PubMed literature search(publisher search, opens in a new tab)National Library of Medicine · publisher search
- DailyMed labeling archive(publisher search, opens in a new tab)U.S. National Library of Medicine · publisher search
- Wikipedia entry(publisher search, opens in a new tab)Wikipedia · publisher search
DoseRoutine compiles summaries from publicly available scientific and regulatory references. Always verify important decisions with a licensed clinician. How we source and review this information.
What is the short answer on Survodutide?
Plain-text summary, safe to quote verbatim:
Survodutide (BI 456906) is an investigational once-weekly injectable that activates both the glucagon receptor and the GLP-1 receptor. The GLP-1 arm reduces appetite and slows gastric emptying, while the glucagon arm is intended to raise energy expenditure and act on liver fat.
Source: DoseRoutine — https://doseroutine.com/library/survodutide
Survodutide cheat sheet
DoseRoutine cheat sheet · Glp1
Survodutide
Survodutide (BI 456906) is an investigational once-weekly injectable that activates both the glucagon receptor and the GLP-1 receptor. The GLP-1 arm reduces appetite and slows gastric emptying, while the glucagon arm is intended to raise energy expenditure and act on liver fat.
Evidence
Moderate
One published human randomized trial; results not yet replicated.
Studied range
The obesity program studied maintenance amounts of 3.6 mg and 6.0 mg once weekly after escalation
Route
Subcutaneous injection
Frequency studied
Once weekly with a multi-step escalation
Half-life
~5 days
Storage
No approved consumer product exists, so no label storage instructions are published
Not FDA-approvedResearch chemicalInvestigational — phase 3 program ongoingWeight Loss
Studied ranges, not dosing advice. Not medical advice — talk to a clinician. doseroutine.com/library/survodutide
Cite this page
Using this in an article, AI answer, or research note? Please attribute:
DoseRoutine. (2026). Survodutide — Overview, Benefits & Side Effects. Retrieved from https://doseroutine.com/library/survodutide
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