What it is
Survodutide is a dual agonist of the GLP-1 receptor and the glucagon receptor, meaning a single molecule is designed to activate both. GLP-1 is a hormone the gut releases after eating, and glucagon is a hormone made in the pancreas. Survodutide is investigated for obesity and for MASH (metabolic dysfunction-associated steatohepatitis), a form of fatty liver disease with inflammation. The glucagon arm is thought to boost energy expenditure and liver fat clearance.
In the PeptidesAI encyclopedia, survodutide is categorized under weight management. The human research on this page comes from clinical trials of an investigational drug, not from an approved product.
How it's thought to work
Survodutide activates GLP-1 receptors for appetite suppression while engaging glucagon receptors to increase energy expenditure and hepatic (liver) fat metabolism. Reviews describe glucagon signalling as linked to fat breakdown and fat oxidation in the liver and, at least in animal models, to higher energy expenditure. Because glucagon also raises blood sugar, compounds of this kind pair it with GLP-1 receptor activation, which stimulates insulin secretion. The long-term effects of chronic glucagon receptor activation in people are still being worked out.
What the research says
A 46-week phase 2 trial in 387 adults with obesity and without diabetes reported dose-dependent reductions in body weight compared with placebo.
In a separate 48-week phase 2 trial in adults with biopsy-confirmed MASH and fibrosis, improvement in MASH with no worsening of fibrosis occurred in 43% to 62% of participants across the three survodutide groups, compared with 14% on placebo, and a decrease in liver fat content of at least 30% occurred in 57% to 67%, compared with 14%. Improvement in fibrosis by at least one stage, a secondary end point, occurred in 34% to 36% of survodutide participants and 22% of those on placebo.
In the phase 3 SYNCHRONIZE-1 trial in adults with obesity without diabetes, the mean change in body weight at week 76 was -12.2% and -13.0% in the two survodutide groups, compared with -5.4% on placebo.
Reported side effects
Nausea, vomiting, diarrhea and decreased appetite are the commonly listed effects, and gastrointestinal effects concentrate during dose titration. In the phase 2 MASH trial, nausea (66% versus 23% on placebo), diarrhea (49% versus 23%) and vomiting (41% versus 4%) were more frequent with survodutide, and serious adverse events occurred in 8% with survodutide and 7% with placebo.
In the phase 3 obesity trial, gastrointestinal events, typically mild to moderate, occurred in 80.9% and 89.7% of the two survodutide groups, compared with 47.9% on placebo.
Reconstitution
Survodutide is supplied as a lyophilized (freeze-dried) powder and is typically reconstituted with bacteriostatic (BAC) water before use. It commonly comes in 5 mg and 10 mg vials. The amount of peptide in the vial is fixed; the water added only changes how concentrated the solution is.
Worked example. A 10 mg vial is 10,000 mcg. Reconstituted with 2 mL of BAC water, that works out to 10,000 mcg ÷ 2 mL = 5,000 mcg/mL. On a U-100 insulin syringe, where each unit is 0.01 mL, each unit holds 5,000 × 0.01 = 50 mcg. Use the peptide reconstitution calculator to work out the concentration and units for any vial size and water volume.
Important notes
Survodutide is an investigational compound and is not FDA-approved; the 2026 phase 3 report describes it as investigational. Material sold as a research chemical is not a regulated medicine, so its quality and purity are not independently verified the way an approved medicine's would be.
Sources
- Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial.. le Roux CW et al. Lancet Diabetes Endocrinol, 2024. Human trial
- A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis.. Sanyal AJ et al. N Engl J Med, 2024. Human trial
- Survodutide Once Weekly for the Treatment of Adults with Obesity.. le Roux CW et al. N Engl J Med, 2026. Human trial
- Shared mechanistic pathways of glucagon signalling: Unlocking its potential for treating obesity, metabolic dysfunction-associated steatotic liver disease, and other cardio-kidney-metabolic conditions.. Neff GW et al. Diabetes Obes Metab, 2025. Review
Frequently asked questions
These questions cover the same ground as the sections above, in a shorter format.
What is survodutide?
A dual GLP-1 and glucagon receptor agonist investigated for obesity and MASH. It is not FDA-approved.
How is survodutide thought to work?
It activates GLP-1 receptors for appetite suppression while engaging glucagon receptors, which is thought to increase energy expenditure and liver fat metabolism.
What does the research on survodutide say?
A phase 2 obesity trial reported dose-dependent weight reductions versus placebo, and a phase 3 trial reported -12.2% and -13.0% at 76 weeks versus -5.4%. A phase 2 MASH trial reported histologic improvement in 43% to 62% versus 14% on placebo.
What are the reported side effects of survodutide?
Mainly gastrointestinal: nausea, vomiting and diarrhea, concentrated during dose titration. In the phase 3 obesity trial, gastrointestinal events occurred in 80.9% and 89.7% of survodutide groups versus 47.9% on placebo.
How much is one unit from a 10 mg Survodutide vial?
With 2 mL of BAC water, a 10 mg vial is 5,000 mcg/mL, so one unit on a U-100 syringe (0.01 mL) holds 50 mcg.
The full entry, plus the calculator
The PeptidesAI app has the complete encyclopedia entry for Survodutide — one of 70 compounds covered — plus the reconstitution calculator, a dose log and reminders. Free to download on iPhone.
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