Cotadutide vs Survodutide
Written by Aaron CuhaReviewed Sep 2026
The short answer
Two GLP-1 and glucagon drugs developed for overlapping blood sugar, weight and liver uses. Their development paths split, and that is the useful part of the comparison. It shows how much of a drug type's fate is decided by company choices, not by how the drugs work.
- Cotadutide people
- 1,221
- Cotadutide nulls
- 1
- Survodutide people
- 2,034
- Survodutide nulls
- 0
Dose
No human dose established
Amounts that were given in studies sit in Human evidence on this page. None of them is a personal dose.
6 completed trials, 1,221 people given it
Dose
Doses used in trials
0.6, 2.4, 3.6, 4.8 and 6 mg
Doses used in the survodutide trials, in mg. Not an approved ladder.
First-hand reports are counted on each profile and never added together. This page sets two published records side by side. It does not pick a winner.
Column A
CotadutideCotadutide (MEDI0382), GLP-1 and glucagon receptor dual agonist
A once-a-day shot that acts on both GLP-1 and glucagon. AstraZeneca stopped developing it in 2023. Its own registry entries call the reason strategic pipeline planning, not safety. It leaves mid-stage studies in more than a thousand people with type 2 diabetes, kidney disease and fatty liver inflammation (MASH). It never reached a large final-stage study.
Column B
SurvodutideSurvodutide (GLP-1 / glucagon dual agonist)
A weekly shot still being tested. It works on two signals, GLP-1 and glucagon, and is studied for obesity and fatty liver disease.
Side by side, on the facts we can check
| What we compare | Cotadutide | Survodutide |
|---|---|---|
| Category | Metabolic | Metabolic |
| FDA status | Never approved anywhere. AstraZeneca stopped work on it in early 2023, and said it was a business choice about which drugs to pursue (ClinicalTrials.gov NCT05668936 and NCT05517226). No final-stage study was ever registered. | Investigational, not FDA-approved |
| Half-life | Not reported | ~6 days |
| Molecular weight | Not reported | ~4,900 Da |
| How it works | In people, cotadutide's GLP-1 side does the familiar things for this drug family. It boosts insulin after meals, slows how fast the stomach empties, and cuts how much people eat. In a 65 person study, the blood sugar rise after meals fell 21.5 percent, against a 6.3 percent increase on a dummy injection. Insulin after meals rose, and the stomach took about two hours longer to empty half its contents. In a 19 person energy study, weight loss came from eating 41.3 percent less. Energy burned, measured with a gold-standard water test, barely changed. The glucagon side is what set it apart. In a study that scanned the liver, cotadutide cut stored liver sugar (glycogen) after meals and while fasting. It also cut liver fat. Both fell more than on a dummy injection and more than on liraglutide. The researchers read this as glucagon acting directly on the human liver and making it release stored sugar. The rest comes from animals. In animals, switching on the glucagon receptor also raises energy burned and fat burning in the liver. The mouse study most cited for cotadutide's liver effects (Nature Metabolism, 2020) found its weight and blood sugar effects ran mainly through GLP-1. Its effects on liver fat, stored sugar and the cell's energy factories ran through glucagon. At the same weight loss, it cut liver scarring in mice more than liraglutide or obeticholic acid did. That paper is animal work, in mice with fatty liver inflammation. It has been wrongly cited as a human study. It is not one. | It switches on both the GLP-1 and glucagon receptors. That turns down appetite, helps the body handle sugar, burns more energy and cuts fat in the liver. |
| Studies in people | 8 | 7 |
| Evidence | Strong: 6 completed trials, 1,221 people given it | Strong: 5 completed trials, 2,034 people given it |
| Legal status, US | Investigational, not approved | Investigational, not approved |
Frequently asked questions
What is the difference between Cotadutide and Survodutide?
Cotadutide: A once-a-day shot that acts on both GLP-1 and glucagon. AstraZeneca stopped developing it in 2023. Its own registry entries call the reason strategic pipeline planning, not safety. It leaves mid-stage studies in more than a thousand people with type 2 diabetes, kidney disease and fatty liver inflammation (MASH). It never reached a large final-stage study. Survodutide: A weekly shot still being tested. It works on two signals, GLP-1 and glucagon, and is studied for obesity and fatty liver disease.
Which has stronger research evidence, Cotadutide or Survodutide?
Each compound gets a band worked out from facts we counted, with the math shown. Cotadutide is Strong (6 completed trials, 1,221 people given it). Survodutide is Strong (5 completed trials, 2,034 people given it). That counts how much has been done in people. It does not rate whether either one works, and neither one is called the winner.
Are Cotadutide and Survodutide FDA-approved?
Cotadutide: Never approved anywhere. AstraZeneca stopped work on it in early 2023, and said it was a business choice about which drugs to pursue (ClinicalTrials.gov NCT05668936 and NCT05517226). No final-stage study was ever registered.. Survodutide: Investigational, not FDA-approved.
Reviewed Sep 2026. This page puts two published records side by side. It is for learning, and it is not medical advice. When this site shows a dose, it is the dose a trial or a clinic actually used, or what people say they did, with the source attached. None of it tells you what to take.