Peptide Profile
Survodutide
Dual GLP-1/glucagon receptor agonist for obesity and metabolic liver disease
Dose Range
2.4 mg-6 mgmg
Frequency
Once daily
Route
subcutaneous injection
Cycle Length
Ongoing/indefinite
Onset
Moderate (1-2 weeks)
Evidence
Strong
Compound Profile
Scientific & Efficacy Data
C192H289N47O61
Molecular Formula
4,231.6 Da
Molecular Weight
~7 days (enabling once-weekly dosing)
Half-Life
Optimized for subcutaneous administration with C18 acylation
Bioavailability
2805997-46-8
CAS #
168429725
PubChem ID ↗
Developed By · Phase 3 ongoing (2023-present)
Roche / Carmot Therapeutics
Roche / Carmot Therapeutics (Novo Nordisk partnership)
Primary Benefits
Up to 14.9% weight loss at 46 weeks through dual GLP-1R and GCGR activation — enhancing both appetite suppression and energy expenditure beyond GLP-1 alone
62% MASH resolution rate at optimal dose, significant hepatic fat reduction, and comprehensive metabolic improvements including glycemic control and lipid profiles
HbA1c reductions up to 1.71% in type 2 diabetes with greater weight loss than semaglutide at equivalent glycemic efficacy
Amino Acid Sequence
Modified GLP-1/Glucagon-analogue fusionDosing
How much
do I take?
Timing
Best time to take
Administer Survodutide at the same time each day (or on the same day each week for weekly injections). Many users prefer morning or evening administration. Pick a time you'll remember consistently.
With food?
Survodutide injections can be given regardless of meal timing. However, if GI effects occur, administering on an empty stomach or with a light meal may help reduce discomfort.
If stacking
Survodutide should be used as directed by your healthcare provider. If combining with other medications or supplements, discuss potential interactions with your provider. Avoid combining with compounds that have overlapping mechanisms unless specifically guided by a medical professional.
Adjusting Your Dose
Increase if
- +You've tolerated the current dose for the recommended period without significant side effects
- +Therapeutic goals haven't been met at the current dose level
- +Your healthcare provider recommends dose escalation based on your response
- +Lab work or clinical assessments support a higher dose
Decrease if
- -Side effects are bothersome or impacting daily life despite management strategies
- -You experience any signs of an adverse reaction
- -Lab results indicate the need for dose reduction
- -Your healthcare provider recommends a lower dose based on your response
Signs of right dose
- ✓Therapeutic goals being met with minimal side effects
- ✓Stable and consistent response to treatment
- ✓Lab values or clinical markers trending in the right direction
- ✓Good tolerance with manageable or absent side effects
Dosing Calculator
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Suitability
Is this
right for me?
Best For
Significant body weight reduction in obesity
Survodutide is particularly well-suited for individuals focused on significant body weight reduction in obesity. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.
MASH/NASH resolution and liver fibrosis improvement
Survodutide is particularly well-suited for individuals focused on mash/nash resolution and liver fibrosis improvement. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.
Type 2 diabetes management with concurrent weight loss goals
Survodutide is particularly well-suited for individuals focused on type 2 diabetes management with concurrent weight loss goals. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.
Enhanced metabolic outcomes through dual receptor engagement
Survodutide is particularly well-suited for individuals focused on enhanced metabolic outcomes through dual receptor engagement. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.
Consider Alternatives If
Who Should Avoid
Do not use if
- ×Personal or family history of medullary thyroid carcinoma (GLP-1 class warning)
- ×Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- ×Known hypersensitivity to survodutide or excipients
- ×History of pancreatitis (caution advised with GLP-1 receptor agonists)
Use with caution if
- !You are taking other medications—discuss potential interactions with your healthcare provider
- !You have a history of liver or kidney disease
- !You are elderly or have multiple medical conditions
- !You are planning surgery in the near future—inform your surgeon about Survodutide use
- !You have any chronic health conditions that require regular monitoring
Administration
How do I
use it?
Reconstitution
What you need
- •Survodutide vial (lyophilized powder or solution)
- •Bacteriostatic water or sterile sodium chloride for reconstitution
- •Alcohol swabs for cleaning vial tops and injection sites
- •Appropriately sized syringes with fine-gauge needles (27-30 gauge)
- •Sharps disposal container
Injection
Route
Subcutaneous injection (into the fatty tissue just under the skin)—allows for consistent absorption and can be self-administered at home after proper training
Best sites
- •Abdomen (stomach area)—at least 2 inches from the belly button, most popular choice for self-injection
- •Front of thighs—middle to upper portion of the outer leg
- •Back of upper arm—outer area (may need assistance from another person)
Technique
- 1.Wash your hands thoroughly with soap and water before handling supplies
- 2.Clean the injection site with an alcohol swab and let it air dry completely
- 3.Pinch a fold of skin at the chosen injection site
- 4.Insert the needle at a 45-90 degree angle (depending on needle length and body composition)
- 5.Inject the medication slowly and steadily over 5-10 seconds
- 6.Release the skin fold and remove the needle, applying gentle pressure with a clean swab
- 7.Rotate injection sites to prevent tissue irritation or lipodystrophy
- 8.Dispose of the needle safely in a sharps container—never recap or reuse needles
Storage
Signs of degradation
Sample Daily Schedule
Safety
Is it
safe?
Safety Profile
Survodutide data comes from Phase 2 obesity and MASH trials with dose-dependent gastrointestinal side effects (nausea up to 75% at highest doses, diarrhea, vomiting) that mirror GLP-1 receptor agonist class effects but occur with greater frequency due to additional glucagon receptor activation increasing energy expenditure. Pancreatitis risk exists as with all GLP-1 agonists—baseline lipase evaluation and patient education on warning signs (persistent upper abdominal pain) are essential. Medullary thyroid carcinoma risk, though theoretical based on GLP-1 class, contraindicates use in MEN 2 or personal thyroid cancer history.
Phase 2 trial safety data in ~400 patients supports tolerability for up to 48 weeks, though long-term data beyond 1 year remains limited prior to potential regulatory approval. Cardiovascular outcome trials and long-term hepatic safety monitoring in MASH population are ongoing. Not yet FDA-approved—all use remains investigational pending Phase 3 completion.
Common Side Effects
Experienced by some users
Nausea
The most frequently reported adverse event, occurring in up to 75% of survodutide-treated patients versus 42% on placebo. Dose-dependent and most pronounced during dose escalation. Odds ratio increases from 6.11 at 2.4 mg to 27.54 at 4.8 mg.
Management: Gradual dose escalation over 16-20 weeks significantly reduces nausea incidence and severity. Smaller meals, avoiding high-fat foods, and adequate hydration help. Symptoms typically diminish with continued treatment.
Vomiting
Frequently accompanies nausea during dose escalation. Dose-dependent occurrence related to dual GLP-1R and GCGR activation in the gastrointestinal tract and central nervous system.
Management: Slower dose titration. Anti-emetics if needed. Ensure hydration. May temporarily hold dose escalation if severe.
Diarrhea
Gastrointestinal disturbance from combined receptor activation affecting gut motility and secretion. Generally mild to moderate severity.
Management: Maintain hydration. Usually resolves with continued treatment. Dose adjustment if persistent.
Decreased Appetite
Expected pharmacological effect contributing to weight loss. Mediated through both GLP-1R and GCGR central nervous system effects on appetite regulation.
Management: Generally beneficial for the treatment goal. Ensure adequate nutritional intake despite reduced appetite. Monitor for excessive caloric restriction.
Less Common
- •Constipation and Abdominal Pain
These typically resolve with continued use or dose adjustment.
Stop and Seek Help If
- ×Severe or worsening side effects that don't improve with dose adjustment or supportive care
- ×Signs of an allergic reaction—rash, hives, swelling, or difficulty breathing
- ×Your healthcare provider recommends discontinuation based on your clinical response
- ×Development of any new medical condition that may be contraindicated with Survodutide
- ×Pregnancy or planning to become pregnant (unless specifically approved for use during pregnancy)
- ×Abnormal lab results or clinical markers that suggest adverse effects
Survodutide should only be started, adjusted, or discontinued under medical supervision. This information is for educational purposes only and does not replace professional medical advice. Never stop a prescribed treatment without consulting your healthcare provider first, as abrupt discontinuation may have consequences.
Interactions
With other peptides
- ✓Complementary insulin-sensitizing mechanism with established cardiovascular benefits supports comprehensive metabolic management
- ✓Independent glucose-lowering and cardiorenal protective mechanisms complement survodutide's metabolic and hepatic benefits
- ✓Caloric restriction synergizes with survodutide's appetite suppression and enhanced energy expenditure for maximal weight loss
With medications
- !Other GLP-1 Receptor Agonists - Redundant GLP-1R activation with no additional benefit and increased gastrointestinal adverse events
- !Insulin Secretagogues - Increased hypoglycemia risk when combined with agents that stimulate insulin secretion independent of glucose levels
- !Glucagon for Hypoglycemia Rescue - Survodutide's glucagon receptor agonism may alter the pharmacodynamics of exogenous glucagon used in hypoglycemia emergencies
With supplements
- ✓Multivitamins - Generally safe to take alongside Survodutide. Space doses apart if taking oral formulations to ensure optimal absorption.
- ✓Electrolyte supplements - Helpful if experiencing any GI side effects that could lead to dehydration. Safe to combine.
Effectiveness
Does it
work?
Evidence Level
Strong human trials
What to Expect
Weeks 1-16
What you might notice
- •Dose escalation period with gradual introduction
- •GI side effects (nausea, vomiting) are most common during this phase
- •Early appetite reduction and beginning of weight loss
What's normal
- •Nausea is expected and typically peaks during dose increases
- •Appetite reduction begins early
- •Weight loss starts but accelerates as maintenance dose is reached
- •GI symptoms generally improve with continued dosing
What's next
- →Complete dose escalation to target maintenance dose (3
- →0 mg weekly)
- →GI tolerability typically improves as the body adjusts to each dose level
Weeks 16-32
What you might notice
- •Accelerating weight loss at maintenance dose
- •Improved glycemic markers if diabetic
- •GI side effects diminishing
- •Measurable improvements in metabolic parameters
What's normal
- •Steady weight loss trajectory
- •HbA1c improvements in diabetic patients
- •Liver enzyme improvements in MASH patients
- •Reduced appetite stabilizes
- •GI side effects become less frequent
What's next
- →Continue maintenance dosing
- →Clinical assessment of weight loss, metabolic parameters, and liver health markers
Weeks 32-52+
What you might notice
- •Continued weight loss approaching 10-15% of body weight
- •Sustained metabolic improvements
- •In MASH patients, potential histological improvement on liver biopsy
What's normal
- •Weight loss may continue beyond 46 weeks (Phase 2 data suggested ongoing trajectory)
- •Metabolic parameters remain improved
- •Weight loss rate may gradually slow as new steady state is approached
What's next
- →Long-term maintenance therapy
- →Phase 3 trials evaluating 76-week outcomes will define long-term efficacy and safety profile
Signs It's Working
Treatment Response
- ✓Improvement in the primary symptoms or condition being treated
- ✓Positive changes in relevant lab values or clinical markers
- ✓Consistent, stable response to Survodutide over time
- ✓Reduction in symptom frequency or severity
General Well-being
- ✓Improved energy levels and daily functioning
- ✓Better quality of life related to the treated condition
- ✓Manageable or absent side effects indicating good tolerance
- ✓Positive feedback from healthcare provider during check-ups
Not Seeing Results?
Common reasons
- •Not at therapeutic dose yet—initial doses are for building tolerance, not maximum effect
- •Insufficient time at target dose—most compounds need several weeks to show full benefits
- •Inconsistent dosing schedule—regular, consistent use is crucial for optimal results
- •Individual variation in response—genetics, metabolism, and other factors affect outcomes
- •Underlying conditions or medications interfering with absorption or effectiveness
- •Improper storage leading to degraded product—always verify proper storage conditions
Key Research
"Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial"
le Roux CW, Steen O, Lucas KJ, et al., 2024
Finding: Survodutide, a dual glucagon/GLP-1 agonist, dose-dependently reduced body weight by 6-15% with maximum effects at higher doses in 46-week Phase 2 obesity trials.
View Study"Dose-response effects on HbA1c and bodyweight reduction of survodutide compared with placebo and open-label semaglutide in type 2 diabetes"
Blüher M, Rosenstock J, Hoefler J, et al., 2024
Finding: Research (2024) on survodutide contributes important scientific knowledge about its biological and pharmacological properties.
View Study"BI 456906: Discovery and preclinical pharmacology of a novel GCGR/GLP-1R dual agonist with robust anti-obesity efficacy"
Zimmerman T, et al., 2022
Finding: Research (2022) demonstrates survodutide's efficacy in clinical treatment and therapeutic applications.
View Study"Survodutide for the Treatment of Obesity: Design of the SYNCHRONIZE CVOT"
Kosiborod MN, Platz E, Wharton S, et al., 2024
Finding: Clinical evidence (2024) supports the therapeutic use of survodutide in medical treatment protocols.
View Study"The dual GCGR/GLP-1R agonist survodutide: Biomarkers and pharmacological profiling for clinical candidate selection"
Thomas L, Martel E, Rist W, et al., 2024
Finding: Clinical trial (2024) provides evidence for survodutide's effectiveness in therapeutic management.
View StudyFrequently Asked Questions