Survodutide
GLP-1/glucagon receptor dual agonist · Also known as BI 456906
What is Survodutide?
A dual-acting peptide that activates both GLP-1 and glucagon receptors, producing significant weight loss while also improving liver fat and metabolic markers. Developed by Boehringer Ingelheim and Zealand Pharma.
Survodutide represents a newer approach to obesity treatment by targeting two receptors instead of one. Unlike pure GLP-1 agonists, adding glucagon receptor activity increases energy expenditure and promotes liver fat reduction, making it especially promising for people with metabolic dysfunction-associated steatohepatitis (MASH). It has received FDA Breakthrough Therapy designation for MASH.
Benefits & evidence
How it works
Survodutide binds to both GLP-1 and glucagon receptors, activating two complementary metabolic pathways. The GLP-1 component suppresses appetite, slows gastric emptying, and improves insulin sensitivity, similar to semaglutide. The glucagon component adds something unique: it increases hepatic fat oxidation and energy expenditure, helping the body burn more calories and clear fat from the liver.
This dual mechanism is why survodutide shows particular promise for MASH, where excess liver fat drives disease progression. By simultaneously reducing caloric intake through appetite suppression and increasing fat metabolism through glucagon signaling, survodutide addresses obesity from both sides of the energy balance equation.
Dosing information
Typical dosing protocol
0.6 mg/week
Weeks 1-2 (then titrate biweekly)2.4-4.8 mg/week
After 20-week titrationPhase 2 trials used biweekly dose escalation over 20 weeks, increasing from 0.6 mg to target dose. Phase 3 trials are testing doses up to 6.0 mg/week. Not yet approved for clinical use.
Side effects
Most side effects tend to improve as your body adjusts.