Survodutide Dosage, half-life & reference guide
Also known as BI 456906 · BI456906 · Survo
A weekly shot that activates two receptors: GLP-1, for appetite and blood sugar, and glucagon, which clears fat from the liver and, in mice, raises energy use. Boehringer Ingelheim's phase 3 trials read out in 2026, and it is not approved.
- Studied range
- 0.3–6 mgstarting dose 0.3 mg
- How often
- Weekly
- Evidence
- ●●●
Established - Route
- SubQ injection
Studied in research — not a recommendation.
How it works.
Glucagon and GLP-1 receptor dual agonist: a 29-amino-acid peptide built on the glucagon sequence, carrying a C18 fatty acid that binds albumin for once-weekly dosing. It fully activates the GLP-1 receptor (appetite, insulin) and partly activates the glucagon receptor, which raises energy expenditure (shown in mice) and draws down liver fat (the liver-fat drop is measured in people). Developed by Boehringer Ingelheim with Zealand Pharma; its phase 3 (SYNCHRONIZE) results were published in 2026, and it is not approved.
Commonly reported: Less appetite and early fullness, with nausea or vomiting during the long dose climb and a resting heart rate a few beats higher. Average weight loss at 76 weeks was 12–13% counting everyone and up to 16.6% for people who stayed on it, and most people in its liver trial cut their liver fat by at least 30%.
Week by week.
What to expect in the first 8 weeks
- Onset
- Days–2 weeks
- Peak effect
- 76 weeks (trial endpoint)
- Duration
- Ongoing
Day 1–14 · 0.3 mgRCT
The 0.3 mg start
You're on 0.3 mg, where every arm of its phase 2 obesity trial began. Commonly reported: appetite dipping in the first days, with some nausea.
The science
In the phase 2 obesity trial (le Roux et al., 2024; protocol 1404-0036, NCT04667377), every arm took 0.3 mg in weeks 1–2 and 0.6 mg in weeks 3–4; the higher arms kept stepping up every 2 weeks to 2.4, 3.6 or 4.8 mg by week 20. In the first single-dose study, 2 of 24 healthy men stopped early with nausea and vomiting (Jungnik 2023); Boehringer Ingelheim's protocols cite GI side effects easing with a more gradual climb, which is why later trials step up slowly.
Sources- le Roux et al. (2024)
- Jungnik et al. (2023)
- Boehringer Ingelheim protocol 1404-0036 (2022)
Updated Oct 2026
Day 15–168RCT
The slow climb
Survodutide's trials climb in small steps over about 24 weeks. Commonly reported: nausea and vomiting mostly during the climb, easing once the dose holds; the phase 3 trials allowed a short pause or a slower step when it got rough.
The science
In SYNCHRONIZE-MASLD (Kaplan 2026), GI events came mainly during the 24-week escalation to 6.0 mg: nausea 56.2%, vomiting 42.5%, diarrhea 29.5% and constipation 28.1%, vs 14.3%, 7.1%, 10.0% and 10.0% on placebo; 19.9% stopped for GI reasons (4.3% on placebo). SYNCHRONIZE-1 and -2 used dietary advice, symptom medicines, a pause of 1–2 doses, and a 2–4 week delay or step down when needed (Wharton 2025).
Sources- Kaplan et al. (SYNCHRONIZE-MASLD) (2026)
- Wharton et al. (SYNCHRONIZE design) (2025)
Updated Oct 2026
Any dayRCT
What Survodutide is built on
A phase 2 program and three phase 3 trials published in 2026: SYNCHRONIZE-1 and -2 for weight, and SYNCHRONIZE-MASLD for liver fat. It is not approved; its heart-outcomes trial is due to report later in 2026.
The science
Phase 2 (le Roux et al., Lancet Diabetes Endocrinol, 2024; 387 adults, 46 weeks): −6.2% (0.6 mg) to −14.9% (4.8 mg) vs −2.8% on placebo by planned treatment, and up to 18.7% on actual treatment (Wharton 2025). Phase 3: SYNCHRONIZE-1 and -2 (NEJM, 2026) and SYNCHRONIZE-MASLD (Nat Med, 2026). It fully activates the GLP-1 receptor and partly the glucagon receptor (Boehringer Ingelheim protocol), and a C18 fatty acid binds albumin for weekly dosing (Zimmermann 2022). Its cardiovascular outcomes trial is expected to report later in 2026.
Sources- le Roux et al. (2024)
- Wharton et al. (SYNCHRONIZE design) (2025)
- le Roux et al. (SYNCHRONIZE-1) (2026)
- Wharton et al. (SYNCHRONIZE-2) (2026)
- Kaplan et al. (SYNCHRONIZE-MASLD) (2026)
- Zimmermann et al. (2022)
- Zealand Pharma (SYNCHRONIZE-2 results) (2026)
Updated Oct 2026
With BPC-157Community
Why people add BPC-157 to survodutide
Survodutide's long dose climb is where most of its stomach upset happens, and some people add BPC-157, first studied as a stomach-protecting peptide, hoping to ease it. Commonly reported: smoother step-ups; no trial has tested the pairing.
The science
BPC-157 is a fragment of a body protection compound first isolated from human gastric juice, and its gut research is almost all in animals (Sikiric 2018). No trial has tested the pairing; the pattern comes from community reports.
Sources- Sikiric et al. (2018)
Updated Oct 2026
After week 8
Day 99+ · 3.6 mgRCT
3.6 mg, the lower phase 3 dose
3.6 mg is the lower of the two phase 3 doses. In SYNCHRONIZE-1, people without diabetes averaged 12.2% weight loss at 76 weeks counting everyone randomized, vs 5.4% on placebo.
The science
SYNCHRONIZE-1 (NEJM, 2026; 725 adults without diabetes, 76 weeks, treatment-regimen estimand): −12.2% (3.6 mg) and −13.0% (6.0 mg) vs −5.4%; at least 5% loss in 72.6%, 71.9% and 46.3%. SYNCHRONIZE-2 (NEJM, 2026; 752 adults with type 2 diabetes): −8.2% and −9.8% vs −3.9%, and HbA1c fell 0.9 and 0.8 points vs 0.2 from 7.4%.
Sources- le Roux et al. (SYNCHRONIZE-1) (2026)
- Wharton et al. (SYNCHRONIZE-2) (2026)
Updated Oct 2026
Day 141+ · 6 mgRCT
6.0 mg, the top phase 3 dose
6.0 mg is the top phase 3 dose. For people who stayed on treatment, SYNCHRONIZE-1 reported up to 16.6% average weight loss at 76 weeks, against 3.2% on placebo.
The science
Boehringer Ingelheim and Zealand Pharma's topline (April 2026): up to 16.6% on the efficacy estimand vs 3.2%, with up to 85.1% reaching at least 5% loss; counting everyone randomized, the 6.0 mg arm averaged −13.0% (NEJM, 2026). In SYNCHRONIZE-2 (type 2 diabetes), the efficacy-estimand figure was up to 13.1% vs 3.1%, and 18% stopped for GI side effects vs 1.2% on placebo (October 2026 release).
Sources- Zealand Pharma (SYNCHRONIZE-1 topline) (2026)
- le Roux et al. (SYNCHRONIZE-1) (2026)
- Zealand Pharma (SYNCHRONIZE-2 results) (2026)
Updated Oct 2026
Day 169–336RCT
Liver fat: where the glucagon arm shows
The glucagon half pushes the liver to burn its stored fat. In its liver trial, 84% of people who stayed on 6.0 mg cut their liver fat by at least 30% by week 48, against 24% on placebo.
The science
SYNCHRONIZE-MASLD (Kaplan 2026; 216 adults with obesity and at-risk MASLD): at least 30% liver-fat reduction on MRI in 84.2% vs 24.3% (efficacy estimand; 68.5% vs 28.6% on the treatment-regimen estimand), with weight −12.2% vs −1.0%. In the phase 2 MASH biopsy trial (Sanyal 2024), MASH improved without fibrosis worsening in 43–62% across the 2.4–6.0 mg doses vs 14% on placebo. More fat burning in the liver comes from glucagon biology, not a measurement; the drop in liver fat itself is measured in people.
Sources- Kaplan et al. (SYNCHRONIZE-MASLD) (2026)
- Sanyal et al. (2024)
Updated Oct 2026
Day 1 is the day you start it.
Phase 2 RCT (le Roux 2024); phase 3 SYNCHRONIZE-1 and -2 (NEJM 2026) and SYNCHRONIZE-MASLD (Nat Med 2026). Not approved.
Clinical trial data
Mixing and a typical run.
Example numbers
Reconstitution example
Reconstitute a 10 mg vial of Survodutide with 2 mL of bacteriostatic water and a 0.3 mg dose is 6 units on a U-100 syringe, about 33 doses per vial.
- Vial
- 10 mg
- Water
- 2 mL
- Amount
- 0.3 mg
Draw to6 units
0.3 mL insulin syringe · 30 units
Run notes
- Cycle
- Phase 3 trials run it continuously for 76 weeks after a slow climb of about 24 weeks. Not approved; Boehringer Ingelheim expects its cardiovascular outcomes trial to report later in 2026.Community practice — opinions vary. Not a clinical recommendation.
- Timing
- Once weekly. Its trials climb slowly: phase 2 started every arm at 0.3 mg for 2 weeks and stepped up every 2 weeks over 20 weeks, to 0.6–4.8 mg; phase 3 stretched the climb to about 24 weeks, to 3.6 or 6.0 mg, with pauses allowed for GI symptoms. These are trial escalations, not an approved regimen.
- Route
- SubQ injection
- Stacks
- BPC-157 (GI support)
Safety.
Common side effects
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Decreased appetite
- Fatigue
- Higher resting heart rate
Interactions
No dedicated interaction studies are published beyond the GLP-1 class effect on stomach emptying: in phase I, a single 1.2 mg dose strongly reduced paracetamol absorption (Boehringer Ingelheim protocol). It is a GLP-1 receptor agonist itself, so it is not combined with another GLP-1 drug. Its glucagon arm raises resting heart rate a little, worth raising with your clinician alongside stimulants or a fast heart rhythm. With insulin or a sulfonylurea, discuss glucose monitoring with your clinician.
Safety notes
Survodutide has no label. In phase 3, GI side effects were the most common, mostly mild to moderate and clustered in the dose climb: in SYNCHRONIZE-1 they affected 80.9% (3.6 mg) and 89.7% (6.0 mg) vs 47.9% on placebo; at 6.0 mg in SYNCHRONIZE-MASLD, nausea affected 56% and vomiting 43%, and 20% stopped for GI reasons (4% on placebo). Resting heart rate rose about 3.6 beats per minute (0.8 on placebo). Its phase 3 trials leave out people with a personal or family history of medullary thyroid carcinoma or MEN 2, or a history of pancreatitis, as GLP-1 trials do; SYNCHRONIZE-MASLD saw no confirmed pancreatitis or drug-induced liver injury on survodutide. These are trial findings; review them with your clinician.
Goes with.
Questions people ask.
What is Survodutide?
A weekly shot that activates two receptors: GLP-1, for appetite and blood sugar, and glucagon, which clears fat from the liver and, in mice, raises energy use. Boehringer Ingelheim's phase 3 trials read out in 2026, and it is not approved.
How is Survodutide dosed in research?
The research range for Survodutide is 0.3–6 mg, weekly, with a 0.3 mg starting dose. Studied in research — not a recommendation.
How long does Survodutide last?
The half-life of Survodutide is long enough for once-weekly dosing: a fatty-acid chain binds it to albumin; phase I measured it in people (Jungnik 2023), but the figure is not in the trial summaries.
What do people report on Survodutide?
Commonly reported on Survodutide: less appetite and early fullness, with nausea or vomiting during the long dose climb and a resting heart rate a few beats higher. Average weight loss at 76 weeks was 12–13% counting everyone and up to 16.6% for people who stayed on it, and most people in its liver trial cut their liver fat by at least 30%.
Is Survodutide safe?
The research basis for Survodutide is established: clinical trials or FDA-approved use exists. Common side effects in the library: nausea, vomiting, diarrhea, constipation, decreased appetite, fatigue and higher resting heart rate.
What does Survodutide stack with?
Common stacks for Survodutide: BPC-157 (GI support).
Research.
Reference.
- Cadence
Weekly
- Half-life
Long enough for once-weekly dosing: a fatty-acid chain binds it to albumin; phase I measured it in people (Jungnik 2023), but the figure is not in the trial summaries
- Research basis
●●●
EstablishedClinical trials or FDA-approved use exists
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