Survodutide dosage and evidence
Written by Aaron CuhaReviewed Sep 2026
The short answer
Survodutide is a weekly shot still being tested. It works on two signals, GLP-1 and glucagon, and is studied for obesity and fatty liver disease.
Evidence grade for Survodutide: Strong. The rule: at least two finished studies in people, and at least 1,000 people who took it. The sum on this page: 5 completed trials, 2,034 people given it. A grade counts how much has been done to people, not whether it works.
- People given it
- 2,034
- Human studies
- 5
- Found nothing
- 0
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.
7 effects reported, 4 unwanted, 3 wanted, by people using it, not a trial
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.
Survodutide is a once a week shot that turns down hunger and burns fat in the liver. It works on the Ozempic hunger signal plus a second one, glucagon, that tells your liver to burn fat. That is why it is being tested for fatty liver disease as much as for weight. It is not approved. Anything sold online as survodutide is not the drug from the trials.
What people take it for
- Getting fat out of the liver.
- Weight loss with a fat burning effect, not just less hunger.
- Reversing early liver scarring.
- A cheaper grey market option than Mounjaro.
What studies in people showed
In the weight trial, 387 adults without diabetes took it for 46 weeks. On the top dose they lost 14.9 percent of their body weight. The dummy shot group lost 2.8 percent. Stomach side effects were common. In the liver disease trial, 293 adults with liver damage proven by biopsy took it for 48 weeks. Between 47 and 62 percent got better on biopsy without their scarring getting worse. On the dummy shot, 14 percent did. In the large final stage liver fat trial, 216 adults took it for 48 weeks. On 6 mg, 84 percent cut their liver fat by at least 30 percent. On the dummy shot, 24 percent did. Weight fell 12.2 percent against 1.0 percent. The liver numbers are the strongest thing about this drug. The weight loss is real too.
What people report
Reports, not study results
The good
- Liver enzymes coming down on the next blood test.
- Steady weight loss with hunger turned down.
- Feeling warmer and burning through food faster, which people put down to the glucagon side.
The bad
- Nausea and vomiting, more than on Ozempic for many people. The glucagon side is rough on the stomach.
- A racing heart or a higher resting heart rate.
- Tiredness and feeling wiped out at dose jumps.
- Grey market vials with no way to check the dose.
Where these come from: The weight and liver numbers are from the early obesity trial, the early fatty liver disease trial, the large final stage SYNCHRONIZE-MASLD trial and their side effect tables. The real world reports are from grey market users on r/peptides, r/PeptidesUK and r/Retatrutide. They are not trial results and they are not the trial drug.
My bottom line
For the liver, this is the most interesting drug in the family, and I will be watching for the approval. But it is not approved, and what is sold online is not the thing in these trials. I would not put a grey market vial of it in my body.
An opinion, not a finding. I am a coach, not a doctor.
What it has been measured to do
Measured in people
Goals Survodutide 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 weight1,741 people · 4 studies
- Blood sugar and insulin413 people · 1 study
- Liver fat and liver health293 people · 2 studies
33 of the 36 indexed goals have no study of any kind behind Survodutide
No study in people, animals or cells on this page reports a result for these. That does not prove Survodutide does nothing for them. It does mean anything you have heard about Survodutide and one of these did not come from a study cited here.
Show full evidence
What is Survodutide?
Survodutide is a weekly shot still being tested. It works on two signals, GLP-1 and glucagon, and is studied for obesity and fatty liver disease.
Survodutide is a weekly shot that is not approved yet. It works on two signals, GLP-1 and glucagon. It is being built for obesity and for MASH, a fatty liver disease where the liver becomes inflamed. The GLP-1 part turns down appetite and helps blood sugar. The glucagon part adds more energy burning and acts on the liver.
In a large final-stage study of 216 adults with obesity and a fatty liver, 84% on the drug cut their liver fat by at least 30%, against 24% on a dummy shot. Weight fell 12.2% on the drug and 1.0% on the dummy over 48 weeks. In a mid-sized study of 387 adults without diabetes, the top dose cut weight by 14.9%, against 2.8% on the dummy. In 293 adults with MASH, liver damage got better without more scarring in 47 to 62% on the drug, against 14% on the dummy.
How does Survodutide work?
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.
What have studies in people found about Survodutide?
Survodutide has a large, standard drug company record in people. Boehringer Ingelheim runs a registered set of final-stage trials. They include published mid-stage dose studies and a 725-person final-stage obesity trial reported in 2026. A 5,531-person heart safety trial finished in June 2026 with no results posted. Liver trials run to 2031. It is not approved anywhere.
- Obesity: 725 adults with obesity and no diabetes got weekly shots raised to 3.6 mg or 6.0 mg, or a dummy shot, for 76 weeks. Their average age was 47.1, average body mass index 37.9 and average weight 108.8 kg. Weight fell 12.2% on 3.6 mg, 13.0% on 6.0 mg and 5.4% on the dummy. At least 5% was lost by 72.6%, 71.9% and 46.3%. Stomach and gut side effects hit 80.9%, 89.7% and 47.9%. Nobody died.
- Type 2 diabetes, against semaglutide: 413 people on metformin got one of six survodutide doses, semaglutide raised to 1.0 mg weekly, or a dummy shot, for 16 weeks. Everyone knew who got semaglutide. Three-month average blood sugar fell 1.46 points on the second survodutide dose and 1.47 on semaglutide. Weight fell up to 8.7% on the top survodutide dose, against 5.3% on semaglutide. Side effects hit 77.8% on survodutide, 52.0% on semaglutide and 52.5% on the dummy.
- Mid-stage obesity dose study (already cited): 387 adults without diabetes lost 14.9% on 4.8 mg weekly at 46 weeks, against 2.8% on a dummy shot.
- Fatty liver with inflammation, confirmed by a liver sample (already cited): 293 adults. The liver improved without the scarring getting worse in 47% to 62% on the drug, against 14% on a dummy, over 48 weeks.
- Fatty liver (already cited): 216 adults. 84% on the drug cut liver fat by at least 30%, against 24% on a dummy. Weight fell 12.2% against 1.0% at 48 weeks.
- Finished but not reported: a heart safety trial in 5,531 people (NCT06077864) that closed on 30 June 2026 with no results posted, and a type 2 diabetes trial in 755 people (NCT06066528).
- Still running: two liver trials, one in 1,800 people with inflamed fatty liver (NCT06632444) and one in 1,590 people with cirrhosis (NCT06632457). Both are due to finish in December 2031.
What this does not tell you: The longest finished trial ran 76 weeks. So nothing here tells you about years of use or what happens after stopping. The obesity trials left out people with diabetes, and the diabetes trials required it. The two groups do not overlap, so their results should not be lumped together. The semaglutide comparison ran only 16 weeks and everyone knew who got semaglutide. That is too short and too open to settle which is better. Stomach and gut side effects hit 89.7% at the higher dose. A headline weight number says nothing about who could handle raising the dose. The heart safety trial will show whether the glucagon half of this molecule carries a cost, and it has not reported.
The state of the research
Survodutide is what the rest of this site is missing, and the difference is ownership. Boehringer Ingelheim and Zealand Pharma own it. So the trials are large, planned in advance, registered before they start, and reported whether the answer is welcome or not. That is why this page can give exact results and side effect rates. A page for an unpatentable peptide with the same kind of story has only animal work to quote. The question is not which molecule is more promising. It is which one somebody can own the answer to.
The price of that is that every number here comes from the company. Boehringer designed, paid for, analysed and co-wrote all of it. The same university names show up across trials. This is the normal way drugs get developed, and it is not a scandal. But it means no independent group has repeated any survodutide result. You are trusting a regulated process, not a second research team.
The live science question is whether adding the glucagon receptor to GLP-1 buys anything over GLP-1 alone. Switching on glucagon burns more energy and works on the liver. That is the case for the design, and it fits the liver results. It also raises blood sugar, which is why drugs like this have been hard to get right. In the diabetes comparison, where everyone knew who got semaglutide, blood sugar fell the same on both drugs. Survodutide gave more weight loss and a lot more side effects. Nobody has run a head-to-head where people did not know which drug they got. The heart safety trial has not reported. Until both exist, the two-receptor advantage is a reasonable idea with supportive dose data behind it, not a settled fact.
The evidence, in charts
Fig. 1a · how many people
2,034people, across 5 studies in people cited here
| Study | People | Share |
|---|---|---|
| SYNCHRONIZE-1, New England Journal of Medicine 2026 | 725 | 36% |
| Diabetologia 2024 | 413 | 20% |
| The Lancet Diabetes and Endocrinology 2024 | 387 | 19% |
| New England Journal of Medicine 2024 | 293 | 14% |
| Nature Medicine 2026 | 216 | 11% |
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 7 sources here are studies in people.
- Study in people · done in people7100%
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, 2024 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
- ~4,900 Da
- Half-life
- About 6 daysLong, 1 to 7 days
- Chain length
- None on file
No amino acid sequence is on file for Survodutide, so none is drawn rather than guessed from a name.
The studies we cite
- Study in people2024A Phase 2 randomized trial of survodutide in MASH and fibrosis
Survodutide healed liver damage in a lot of the people who had it. Two hundred and ninety-three adults with liver inflammation confirmed by a tissue sample were treated for eleven months. Between 47 and 62 out of every 100 on the drug, depending on dose, had their liver damage improve without their scarring getting worse. On a dummy injection, 14 out of 100 did. This is a mid stage trial. It measured what a pathologist sees down a microscope, not how long anyone lived.
48-week trial in 293 adults with biopsy-confirmed MASH: histologic improvement without worsening fibrosis in 47 to 62% on survodutide versus 14% on placebo.
- Study in people2024Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial
Survodutide produced large weight loss in people without diabetes. Three hundred and eighty-seven adults were treated for about eleven months, at several doses or with a dummy injection. At the highest dose people lost about 14.9% of their body weight. On the dummy they lost 2.8%. For someone of 100 kg that is roughly 12 kg of difference. Sickness, vomiting and other gut side effects were common. This was a mid stage trial built to find the right dose.
46-week trial in 387 adults without diabetes: mean weight change of minus 14.9% at 4.8 mg weekly versus minus 2.8% on placebo; gastrointestinal adverse events were common.
- Study in people2026Survodutide in adults with obesity and metabolic dysfunction-associated steatotic liver disease: SYNCHRONIZE-MASLD, a randomized, double-blind, placebo-controlled phase 3 trial
In a late stage trial, survodutide stripped fat out of the liver in most people who took it. Two hundred and sixteen adults with obesity and a fatty liver were treated for nearly a year. Cutting liver fat by at least 30% happened in 84 out of every 100 on the drug, against 24 out of 100 on a dummy injection. Body weight fell 12.2% on the drug and 1.0% on the dummy. Liver fat is a scan measurement, not a count of people who got ill.
Phase 3 in 216 adults: 84% on survodutide 6 mg versus 24% on placebo achieved at least a 30% liver-fat reduction, with minus 12.2% versus minus 1.0% body weight at 48 weeks.
- Study in people2026Survodutide Once Weekly for the Treatment of Adults with Obesity
Survodutide produced substantial weight loss in a large trial built to modern standards. It gave 725 adults with obesity and no diabetes a weekly injection at one of two doses, or a dummy injection, for about eighteen months. People on the drug lost around an eighth of their body weight. People on the dummy injection lost around a twentieth. Stomach and bowel side effects were close to universal on the higher dose and hit under half on the dummy. Nobody died.
SYNCHRONIZE-1, 725 adults over 76 weeks: weight change minus 12.2% at 3.6 mg, minus 13.0% at 6.0 mg and minus 5.4% on placebo, with at least 5% loss in 72.6%, 71.9% and 46.3%. Gastrointestinal adverse events in 80.9%, 89.7% and 47.9%.
- Study in people2024Dose-response effects on HbA(1c) and bodyweight reduction of survodutide, a dual glucagon/GLP-1 receptor agonist, compared with placebo and open-label semaglutide in people with type 2 diabetes: a randomised clinical trial
Against semaglutide, survodutide matched it on blood sugar, beat it on weight, and cost more in side effects. The trial put 413 people with type 2 diabetes on one of six survodutide doses, on semaglutide, or on a dummy injection for four months. Average blood sugar fell by about the same amount on both drugs. Weight fell further on the highest survodutide dose. Side effects hit around three quarters on survodutide and about half on semaglutide. Everyone knew who was getting semaglutide.
413 randomized over 16 weeks: HbA1c fell 1.46% on low-dose survodutide against 1.47% on open-label semaglutide, while weight fell up to 8.7% on the highest survodutide dose against 5.3% on semaglutide. Adverse events 77.8% against 52.0%.
- Study in people2026A Study to Test the Effect of Survodutide (BI 456906) on Cardiovascular Safety in People With Overweight or Obesity
The trial that will show whether survodutide is safe for the heart has finished and has said nothing. It followed 5,531 people carrying extra weight until enough heart events had happened to answer the question, and it closed on 30 June 2026. No results have been posted. This is the most important unread document about this drug, because the glucagon half of the molecule is the part with an open safety question against it.
SYNCHRONIZE-CVOT, an event-driven Phase 3 cardiovascular safety trial in 5,531 participants, completed 30 June 2026. No results have been posted, so the trial that would show whether glucagon agonism carries a cardiovascular cost is still unread.
- Study in people2026LIVERAGE: A Study to Test Whether Survodutide Helps People With a Liver Disease Called NASH/MASH Who Have Moderate or Advanced Liver Fibrosis
This trial is running and has published nothing, because it is not due to finish until 2031. It is giving survodutide or a dummy injection to 1,800 adults whose fatty liver disease has already scarred the liver. It is built to show two things: that the disease clears without the scarring worsening, and that the scarring itself improves. Nothing can be said about the answer yet. This is the test that would settle the liver claims.
A Phase 3 trial in 1,800 adults with MASH, with resolution of MASH without worsening fibrosis and at least a 1 point fibrosis improvement as co-primary endpoints, recruiting with estimated completion in December 2031.
Where to buy Survodutide
33 sellers list Survodutide in our latest read. They are ranked by trust score, then by archive rating, then by certificate tier, then by the lowest price per milligram. Archive evidence is counted before source-backed. Each path is out of 4, and the two are not added. A higher price does not raise the score. The letter is the certificate chip. 0 of them have a published certificate that names Survodutide.
Some seller links may pay this site when you buy through them. A payment never changes a seller's tier or rank, and no seller has a say in any page.
| Seller | Trust score | Vial sizes | From, per mg | Certificate for Survodutide | Seller link |
|---|---|---|---|---|---|
| Alpha Peptides | 80 StrongSource-backed 4 of 4. Archive evidence 2 of 4.A | 10 mg | $7.39 | None found for Survodutide | View |
| National Science Labs | 80 StrongSource-backed 4 of 4. Archive evidence 2 of 4.A | 5 mg, 10 mg | $18.2 | None found for Survodutide | View |
| Nationwide Peptides | 80 StrongSource-backed 4 of 4. Archive evidence 2 of 4.A | 10 mg | $18.2 | None found for Survodutide | View |
| Eros Peptides | 80 StrongSource-backed 3 of 4. Archive evidence 2 of 4.A | 10 mg | $7.50 | None found for Survodutide | View |
| EZ Peptides | 75 StrongSource-backed 4 of 4. Archive evidence 3 of 4.A | 10 mg | $7.80 | None found for Survodutide | View |
| General Peptides | 73 StrongSource-backed 4 of 4. Archive evidence 2 of 4.A | 10 mg | $18.2 | None found for Survodutide | View |
| Bulk Peptide Supply | 65 FairSource-backed 4 of 4. Archive evidence 2 of 4.A | 10 mg, 100 mg | $2.75 | None found for Survodutide | View |
| Supernova Sciences | 65 FairSource-backed 3 of 4. Archive evidence 2 of 4.A | 10 mg | $13.0 | None found for Survodutide | View |
| Plum Labs Research | 62 FairSource-backed 4 of 4. Archive evidence 2 of 4.A | 10 mg | $10.8 | None found for Survodutide | View |
| Omega Peps | 57 FairSource-backed 3 of 4. Archive evidence 2 of 4.B | 10 mg | $16.5 | None found for Survodutide | View |
| Zenergy USA | 49 WeakSource-backed 3 of 4. Archive evidence 2 of 4.A | 10 mg | $5.50 | None found for Survodutide | View |
| Liberty Peptides | 49 WeakSource-backed 3 of 4. Archive evidence 2 of 4.A | 5 mg | $14.0 | None found for Survodutide | View |
| Apexlab | 49 WeakSource-backed 2 of 4. Archive evidence 2 of 4.B | 10 mg | $33.3 | None found for Survodutide | View |
| Pure Peptide Factory | 48 WeakSource-backed 1 of 4. Archive evidence 1 of 4.C | 10 mg | $10.0 | None found for Survodutide | View |
| Solution Peptides | 48 WeakSource-backed 1 of 4. Archive evidence 0 of 4.C | 12 mg | $8.33 | None found for Survodutide | View |
| Pryma Lab | 43 WeakSource-backed 1 of 4. Archive evidence 0 of 4.C | 10 mg | $5.90 | None found for Survodutide | View |
| Peptides.com | 42 WeakSource-backed 2 of 4. Archive evidence 2 of 4.B | 12 mg | $12.0 | None found for Survodutide | View |
| Peptides Lab UAE | 40 WeakSource-backed 1 of 4. Archive evidence 1 of 4.C | 10 mg | $21.4 | None found for Survodutide | View |
| Better Nak'd Aminos | 38 WeakSource-backed 2 of 4. Archive evidence 1 of 4.B | 10 mg | $18.4 | None found for Survodutide | View |
| Limitless Biotech ST | 36 WeakSource-backed 1 of 4. Archive evidence 1 of 4.C | 10 mg | $18.2 | None found for Survodutide | View |
| Paramount Peptides | 33 WeakSource-backed 1 of 4. Archive evidence 0 of 4.C | 6 mg | $37.5 | None found for Survodutide | View |
| LabRat Peptides | 28 InsufficientSource-backed 1 of 4. Archive evidence 1 of 4.C | 10 mg, 20 mg | $6.45 | None found for Survodutide | View |
| Boston Molecules | 28 InsufficientSource-backed 1 of 4. Archive evidence 1 of 4.C | 10 mg | $81.0 | None found for Survodutide | View |
| Profound Aminos | 25 InsufficientSource-backed 1 of 4. Archive evidence 1 of 4.C | 10 mg, 12 mg | $7.00 | None found for Survodutide | View |
| Elite Fitness Peptides | 25 InsufficientSource-backed 1 of 4. Archive evidence 1 of 4.C | 10 mg | $28.2 | None found for Survodutide | View |
| Ascend Peptides | 25 InsufficientSource-backed 1 of 4. Archive evidence 1 of 4.C | 10 mg | $31.2 | None found for Survodutide | View |
| Bulk Peptide Wholesale | 23 InsufficientSource-backed 2 of 4. Archive evidence 1 of 4.B | 100 mg | $2.25 | None found for Survodutide | View |
| RUO | 18 InsufficientSource-backed 3 of 4. Archive evidence 2 of 4.Letter withheld | 10 mg | $9.80 | None found for Survodutide | View |
| Tydes | 15 InsufficientSource-backed 1 of 4. Archive evidence 0 of 4.Letter withheld | 6 mg | $13.3 | None found for Survodutide | View |
| Polaris Peptides | 15 InsufficientSource-backed 1 of 4. Archive evidence 0 of 4.Letter withheld | 5 mg | $15.0 | None found for Survodutide | View |
| Glacier Aminos | 12 InsufficientSource-backed 4 of 4. Archive evidence 2 of 4.Letter withheld | 10 mg | $6.50 | None found for Survodutide | View |
| Skye Peptides | 0 InsufficientSource-backed 3 of 4. Archive evidence 1 of 4.Letter withheld | 6 mg, 12 mg | $12.4 | None found for Survodutide | View |
| Biostrategix | 0 InsufficientSource-backed 3 of 4. Archive evidence 0 of 4.Letter withheld | 12 mg | $5.83 | None found for Survodutide | View |
- LC Lab-confirmed: the issuing laboratory echoed this certificate back
- A Current certificate, independent laboratory named, laboratory not yet checked
- B Certificate published, but no laboratory link, older than a year, or the laboratory did not recognise the published lookup
- C No certificate could be read
Every listing and vial size for Survodutide · How the trust score is counted
Sellers named on the price pages are ranked by certificate tier, then price, and any affiliate income is disclosed there. Naming a seller is not a recommendation to buy or use anything.
Common questions
Has Survodutide been tested in people?
Yes. 2,034 people given it across 5 completed trials cited here, 0 of which found nothing. Survodutide is a weekly shot still being tested. It works on two signals, GLP-1 and glucagon, and is studied for obesity and fatty liver disease.
What is the Survodutide dosage?
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.
Is Survodutide FDA-approved?
Investigational, not FDA-approved
How is survodutide different from tirzepatide?
Both work on two signals. Survodutide works on GLP-1 and glucagon. Tirzepatide works on GLP-1 and GIP. The glucagon part is being studied mainly for liver fat.