Efinopegdutide dosage and evidence
Written by Aaron CuhaReviewed Sep 2026
The short answer
In a head-to-head test against semaglutide, it cut liver fat by 72.7 percent against 42.3 percent. Weight loss was about the same. Adding glucagon seems to do something to the liver that GLP-1 alone does not.
Evidence grade for Efinopegdutide: Moderate. The rule: at least one finished study in people, and at least 100 people who took it. The sum on this page: 1 completed trial, 145 people given it. A grade counts how much has been done to people, not whether it works.
- People given it
- 145
- Human studies
- 1
- Found nothing
- 1
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.
1 completed trial, 145 people given it
No first-hand reports gathered yet. That is a gap in what we have collected, not a finding that nothing has been reported.
Goal pages: Fat loss and metabolism, Gut health
In plain English
In plain English, from Aaron
This is how I would explain it to a friend. The evidence, with the numbers, is further down the page.
Efinopegdutide is a weekly shot that works on two hormone signals, GLP-1 and glucagon. GLP-1 is the signal semaglutide uses. Glucagon works right on the liver and makes it burn fat. So this drug is aimed at fatty liver more than at weight. Merck is testing it. It is not approved.
What people take it for
- Clearing fat out of the liver.
- Fatty liver that has turned into swelling and scarring.
- Weight loss.
What studies in people showed
There is one head-to-head study, against semaglutide, in 145 people with fatty liver. After 24 weeks, liver fat fell 72.7 percent on this drug. On semaglutide it fell 42.3 percent. Weight loss was about the same, 8.5 percent against 7.1 percent. So the extra liver effect was not just from losing more weight. The semaglutide dose was 1 mg, a diabetes dose, not the higher weight loss dose. Everyone knew which drug they were on. Nobody has shown yet that it slows scarring or saves a liver. A study on that is running.
What people report
Reports, not study results
The good
- In the head-to-head study, liver fat dropped much more than on semaglutide.
The bad
- Side effects were a little more common than on semaglutide, mainly stomach and gut problems.
Where these come from: These come from the study on this page. We have not collected user reports on this one yet.
My bottom line
Liver fat on a scan is a marker, not a saved liver. If your liver numbers are off, get blood work and a scan, lose the weight, and see your doctor. In my opinion, this is one to watch, not one to chase.
An opinion, not a finding. I am a coach, not a doctor.
What it has been measured to do
Measured in people
Goals Efinopegdutide has been tested for in people, biggest studies first. We count only what the studies on this page say, so the real numbers may be higher.
- Losing weight145 people · 1 study · 1 found nothing
- Blood sugar and insulin145 people · 1 study · 1 found nothing
- Liver fat and liver health145 people · 2 studies · 1 found nothing
33 of the 36 indexed goals have no study of any kind behind Efinopegdutide
No study in people, animals or cells on this page reports a result for these. That does not prove Efinopegdutide does nothing for them. It does mean anything you have heard about Efinopegdutide and one of these did not come from a study cited here.
Show full evidence
What is Efinopegdutide?
In a head-to-head test against semaglutide, it cut liver fat by 72.7 percent against 42.3 percent. Weight loss was about the same. Adding glucagon seems to do something to the liver that GLP-1 alone does not.
Most two-in-one weight drugs on this site pair GLP-1 with GIP. This one pairs GLP-1 with glucagon. That sounds wrong if you know glucagon raises blood sugar, but the logic is worth following. Glucagon acts right on the liver. It makes the liver burn more fat and make less of it. Add enough GLP-1 to keep blood sugar in check, and you get a drug aimed at the liver rather than the scale.
The head-to-head study backs that up. It compared this drug with semaglutide 1 mg for 24 weeks in 145 people with fatty liver disease. Liver fat fell 72.7 percent on efinopegdutide against 42.3 percent on semaglutide, a gap far too big for chance. Weight loss was 8.5 percent against 7.1 percent, a gap chance could explain. So the liver effect was much bigger while the weight effect was not. That is the sign that something besides weight loss is going on.
How does Efinopegdutide work?
It acts on two hormone receptors at once: GLP-1 and glucagon. It is built on a long-lasting carrier, so one shot lasts a week. The GLP-1 part cuts appetite and helps blood sugar, the usual way. The glucagon part makes the liver burn more fat and make less new fat. It also raises how much energy the body burns. That is how it is meant to clear liver fat. Glucagon can push blood sugar up, which is why these drugs are balanced so the glucagon part does not dominate.
What have studies in people found about Efinopegdutide?
One head-to-head study against another drug, which is a stronger design than most drugs have at this stage. A follow-on study in a later stage of liver disease is running. No data yet on real health results.
- 145 people, 24 weeks, compared directly with semaglutide 1 mg rather than with a dummy injection.
- Liver fat fell 72.7 percent, against 42.3 percent on semaglutide. Chance is very unlikely to explain the gap.
- Weight fell 8.5 percent against 7.1 percent, a gap chance could explain. So the liver effect is not explained by extra weight loss. That is the study's most useful feature.
- Side effects were a little more common on efinopegdutide, mainly stomach and gut problems, the usual pattern for this kind of drug.
- A third of the people had type 2 diabetes, and the groups were balanced for that.
What this does not tell you: The semaglutide dose deserves the same scrutiny this site uses elsewhere. 1 mg is a diabetes dose, well below the 2.4 mg used for weight loss. So this is not semaglutide at its best. Everyone knew which drug they were on. That matters less for liver fat measured on an MRI scan than for how people say they feel. And liver fat is a marker. It predicts risk, but it is not the same as scarring, cirrhosis or death. This study measured none of those, and 145 people over 24 weeks cannot speak to any of them.
The state of the research
This study shows why this site reports head-to-head results rather than refusing to compare. A study against a dummy injection showing a 72.7 percent drop in liver fat would be interesting and nearly impossible to read, because GLP-1 drugs already cut liver fat through weight loss. Testing it against semaglutide, and finding a much bigger liver effect while weight loss was about the same, is what isolates what the glucagon adds. That is a study result, not an opinion, and it is reported as one.
What it does not allow is a ranking. Semaglutide at 1 mg is not semaglutide at its approved weight loss dose. And a win on a liver marker over 24 weeks in 145 people is not evidence that anyone's liver disease got worse more slowly.
The evidence, in charts
Fig. 1a · how many people
145people, across 1 study in people cited here
| Study | People | Share |
|---|---|---|
| Journal of Hepatology 2023 | 145 | 100% |
The whole total is one study of 145. Counts are the number of people each study on this page says it signed up. That includes studies that only watched people and gave nobody the compound. 2 more studies in people give no headcount and are not counted here. Studies still signing people up are left out, and only studies cited on this page are counted.
Fig. 1b · evidence mix
All 3 sources here are studies in people.
- Study in people · done in people3100%
Counted from the list of sources on this page. It counts only what we cite, so there may be more studies out there. A review counts once, however many studies it sums up.
Fig. 2 · evidence over time
Sources here come from just two years, 2023 and 2026.
Too few different years on this page to draw a timeline.
Fig. 3 · legal status at a glance
US
Not approved
UK
Not approved
AU
Not approved
CA
Not approved
Not approved in any of the four countries shown. This is what the law says, not a verdict on the science. See Legal status below for the full text and any notes.
Fig. 4 · how much does what
Nobody has tested different amounts in people
This chart would show how the effect changes as the amount goes up. For this compound, nobody has measured that in people. So we leave it empty. We will not borrow an animal chart and pretend it works the same in people.
Fig. 5 · what the molecule is
- Kind of compound
- Peptide
- Molecule weight
- Peptide conjugated to a long-acting carrier. No mass asserted; no source loaded states one.
- Half-life
- Stated in words, not a numbersee the exact wording below
- Chain length
- None on file
Half-life as stated on file: Long-acting, dosed once weekly by subcutaneous injection. No specific half-life figure was resolved in the sources loaded.
No amino acid sequence is on file for Efinopegdutide, so none is drawn rather than guessed from a name.
The studies we cite
- Study in people2023A phase IIa active-comparator-controlled study to evaluate the efficacy and safety of efinopegdutide in patients with non-alcoholic fatty liver disease
A dual-acting drug cleared far more liver fat than semaglutide in a head to head test. 145 people with fatty liver disease were split by chance between the two drugs for about six months. Everybody knew which drug they were taking. Liver fat fell by roughly three quarters on efinopegdutide against a little over two fifths on semaglutide. Weight loss was similar. Liver fat on a scan is a marker. Nobody here was followed long enough to see scarring, liver failure or death.
145 participants with liver fat content of 10 percent or more, randomised 1:1 to efinopegdutide 10 mg or semaglutide 1 mg weekly for 24 weeks, open-label. Mean baseline BMI 34.3 and liver fat 20.3 percent; 33.1 percent had type 2 diabetes. Relative reduction in liver fat 72.7 percent (90% CI 66.8 to 78.7) against 42.3 percent (90% CI 36.5 to 48.1), p < 0.001. Body weight reduction 8.5 percent against 7.1 percent, p = 0.085, not significant. Slightly higher adverse events on efinopegdutide, mainly gastrointestinal.
- Study in people2023A study of efinopegdutide in participants with non-alcoholic fatty liver disease
This is the registry entry for the head to head liver fat trial above. It records that the trial ran, finished, and reported. The result is in the paper above: more liver fat cleared with efinopegdutide, similar weight loss, and no look at what happens to the liver over years.
The registry record for the head to head trial above.
- Study in people2026A study of efinopegdutide in participants with metabolic dysfunction-associated steatohepatitis
The follow-on trial is running in the disease stage that actually matters, and it has reported nothing. It enrols people with steatohepatitis, which is the point where liver fat has turned into inflammation and scarring. Enrolment is closed and the study continues. No results have been posted. Liver fat on a scan is a stand-in. Scarring getting worse, and what happens to people because of it, is the real question and it is still open.
The follow-on programme in steatohepatitis, which is the disease stage where liver fat matters clinically. Liver fat is a biomarker; fibrosis progression and liver outcomes are not.
Where to buy Efinopegdutide
No seller we track lists Efinopegdutide yet. We read sellers’ public product lists every week, and this section fills in as soon as one does. Every seller, graded
Common questions
Has Efinopegdutide been tested in people?
Yes. 145 people given it across 1 completed trial cited here, 1 of which found nothing. In a head-to-head test against semaglutide, it cut liver fat by 72.7 percent against 42.3 percent. Weight loss was about the same. Adding glucagon seems to do something to the liver that GLP-1 alone does not.
What is the Efinopegdutide dosage?
No human dose established. Amounts that were given in studies sit in Human evidence on this page. None of them is a personal dose. 1 completed trial, 145 people given it
Is Efinopegdutide FDA-approved?
Investigational. Not approved. Merck holds the rights. It came from Hanmi, and earlier went by Johnson and Johnson and Hanmi code names.
Is it better than semaglutide?
On liver fat over 24 weeks, in 145 people, against semaglutide at 1 mg, yes, and by a wide margin: 72.7 percent against 42.3 percent. On weight, the gap was small enough for chance to explain. And 1 mg is a diabetes dose, not the 2.4 mg used for weight loss. So this is not a comparison against semaglutide at its strongest.
Why add glucagon, which raises blood sugar?
Because glucagon works on the liver directly. It makes the liver burn more fat and make less, and it raises how much energy the body burns. The GLP-1 half keeps blood sugar under control. The study suggests the pair does something to the liver that GLP-1 alone does not.
Does it treat liver disease?
Nobody knows yet. It cuts liver fat, which is a marker. Whether it slows scarring, cirrhosis or death has not been tested. That is what the study now running in steatohepatitis, the inflamed and scarring stage of fatty liver, is for.
Can I get it?
No. It is still being tested and is not approved anywhere.