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Phase IIIVendors pendingFacts verified · 2026-05-25

Survodutide

Also known as bi 456906, glp-1/glucagon dual agonist · Wikipedia

Survodutide (BI 456906) is a synthetic, fatty-acid-acylated dual GLP-1 / glucagon receptor agonist in Phase III development by Boehringer Ingelheim and Zealand Pharma for obesity and metabolic dysfunction-associated steatohepatitis (MASH). Phase 2 obesity data showed up to ~19% mean body-weight reduction at 46 weeks on 4.8 mg weekly, exceeding semaglutide in head-to-head comparison (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10844353/), and a Phase 2 MASH trial demonstrated significant MASH resolution and fibrosis improvement (https://pubmed.ncbi.nlm.nih.gov/38847460/). FDA granted Breakthrough Therapy and Fast Track designation for non-cirrhotic MASH with fibrosis. The SYNCHRONIZE Phase III program in obesity and LIVERAGE/LIVERAGE-Cirrhosis programs in MASH are ongoing in 2026. Also known as: BI 456906.

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Mechanism of action

Survodutide (BI 456906) is a 29-residue synthetic peptide with balanced dual agonist activity at the GLP-1 receptor and the glucagon receptor, with a C18 fatty-diacid moiety enabling albumin binding and once-weekly dosing. GLP-1 receptor activation drives glucose-dependent insulin secretion, slowed gastric emptying, and centrally mediated appetite suppression - including signaling through circumventricular organs and appetite-regulating brainstem and hypothalamic nuclei (https://www.

Survodutide (BI 456906) is a 29-residue synthetic peptide with balanced dual agonist activity at the GLP-1 receptor and the glucagon receptor, with a C18 fatty-diacid moiety enabling albumin binding and once-weekly dosing. GLP-1 receptor activation drives glucose-dependent insulin secretion, slowed gastric emptying, and centrally mediated appetite suppression - including signaling through circumventricular organs and appetite-regulating brainstem and hypothalamic nuclei (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12925197/). Glucagon receptor agonism increases hepatic fatty-acid oxidation, raises resting energy expenditure, and reduces hepatic steatosis - providing a mechanistic rationale for MASH efficacy beyond what monoagonist GLP-1 drugs achieve (https://pubmed.ncbi.nlm.nih.gov/38847460/). The dual agonism produces greater weight loss than semaglutide at comparable doses in Phase 2 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10844353/).

Pharmacokinetic properties

Half-life

~7 days subcutaneous

Routes

subcutaneous

Bioavailability

Fatty-acid acylation with albumin binding enables once-weekly dosing; not orally bioavailable.

Amino-acid sequence

H-Ac4c-QGTFTSDYSKYLDERAAKDFI-X-WLESA-NH2 (Ac4c=1-aminocyclobutane-1-carboxylic acid; X=Gly-Ser linker carrying C18 diacid)

Use & research dosing

Appetite ControlWeight LossWeight Management

Phase 2 obesity trials titrated weekly subcutaneous survodutide from 0.3 mg up to 4.8 mg over 16-20 weeks, reaching ~19% mean weight loss at 46 weeks on the 4.8 mg arm. Phase 2 MASH (NCT04771273) used 2.4, 4.8, and 6.0 mg weekly with titration (https://pubmed.ncbi.nlm.nih.gov/38847460/). Phase 3 SYNCHRONIZE-1 in obesity and LIVERAGE in MASH (NCT06632444) use similar titrated weekly SC dosing (https://pmc.ncbi.nlm.nih.gov/articles/PMC12673442/). Survodutide is not FDA-approved; community/research-source dosing typically mirrors the trial titration schedule. As with semaglutide and tirzepatide, slow titration is essential to mitigate GI adverse effects.

Research-use framing only. SavePeptides sells nothing for human consumption. Doses above reflect reported research / self-experimentation ranges, not clinical recommendations.

Editorial perspective

Survodutide stands out among next-generation incretin agents for the strongest current evidence of liver-fibrosis improvement (Phase 2 MASH trial, NEJM 2024) - the FDA Breakthrough Therapy designation for non-cirrhotic MASH with fibrosis reflects this. SYNCHRONIZE Phase III obesity program and LIVERAGE/LIVERAGE-Cirrhosis Phase III MASH programs are running in 2026 with primary completions expected late 2026 through 2027. The dual GLP-1 / glucagon mechanism produces greater weight loss than semaglutide in head-to-head Phase 2 data but with similar GI tolerability profile. Not FDA-approved as of mid-2026.

— SavePeptides editorial desk · last updated 2026-05-25

Cautions & contraindications

Before researching this compound, note:

  • Personal or family history of medullary thyroid carcinoma (class effect for GLP-1 receptor agonists - boxed warning analog)
  • Multiple endocrine neoplasia type 2 (MEN2)
  • History of pancreatitis - GLP-1 receptor agonists carry a pancreatitis signal
  • Pregnancy and breastfeeding - not studied; GLP-1 RAs are generally contraindicated in pregnancy
  • GI adverse effects (nausea, vomiting, diarrhea, constipation) are common during titration and dose-limiting in some patients
  • Modest heart-rate increase from glucagon-receptor agonism; caution in significant cardiovascular disease
  • Potential effects on lipids and hepatic glucose output via glucagon agonism - monitor in diabetes
  • Monitor liver enzymes given MASH-targeted activity and dual hepatic mechanism
  • Severe gastroparesis or pre-existing severe GI motility disorders
  • Risk of acute kidney injury secondary to volume depletion from GI side effects

Research foundation

The papers behind the page.

  1. [01]https://pubmed.ncbi.nlm.nih.gov/38847460/
  2. [02]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10844353/
  3. [03]https://pmc.ncbi.nlm.nih.gov/articles/PMC11701180/
  4. [04]https://pmc.ncbi.nlm.nih.gov/articles/PMC12673442/
  5. [05]https://clinicaltrials.gov/study/NCT06632444

Facts verified

2026-05-25

Confidence

high

What this means

  • Phase III; not yet FDA-approved
  • FDA Breakthrough Therapy + Fast Track for non-cirrhotic MASH with fibrosis

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Research-use disclaimer.

SavePeptides surfaces vendor, pricing, and coupon information for research compounds. These products are not intended, approved, or recommended for human consumption. Our content is informational only and does not constitute medical advice.