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    Fat Loss & Metabolic•Updated 2026-03-13•8 min read

    What Is Survodutide? Benefits, Research & Safety

    A dual glucagon/GLP-1 receptor agonist under development by Boehringer Ingelheim, researched for its potential in weight management, metabolic health, and non-alcoholic steatohepatitis (NASH).

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    Also known as:
    BI 456906
    NN9838
    BModerate human evidenceUK: Unlicensed (UK)WADA: Sport status unclear

    UK summary: Investigational dual GLP-1 / glucagon receptor agonist (Boehringer Ingelheim). Phase 3 trials ongoing for obesity and MASH. Not currently a UK-licensed medicine; access is via clinical trial only.

    Quick Facts

    Category
    Fat Loss & Metabolic
    Half-Life
    Approximately 60-70 hours, supporting once-weekly dosing based on clinical pharmacokinetic data
    UK Status
    Not approved by the MHRA. Currently an investigational compound in Phase 3 clinical trials.
    EU Status
    Not authorised by the European Medicines Agency. Phase 3 clinical development ongoing.

    Overview

    Survodutide (BI 456906) is an investigational dual agonist peptide that targets both the glucagon receptor (GCGR) and the glucagon-like peptide-1 receptor (GLP-1R). Developed through a collaboration between Boehringer Ingelheim and Zealand Pharma, survodutide represents a novel approach to treating obesity and metabolic liver disease by harnessing the complementary actions of two key metabolic hormones. Unlike pure GLP-1 receptor agonists such as semaglutide, survodutide's dual mechanism is designed to leverage glucagon's ability to increase energy expenditure and promote hepatic lipid oxidation alongside GLP-1's well-established effects on appetite suppression and glucose homeostasis. This combination may offer advantages in both weight reduction and the resolution of liver fat accumulation. Clinical trials have demonstrated substantial weight loss in participants receiving survodutide, with some studies reporting reductions exceeding 18% of body weight. The compound has also shown promising results in reducing liver fat content, positioning it as a potential treatment for metabolic dysfunction-associated steatohepatitis (MASH), formerly known as NASH. Survodutide is currently in Phase 3 clinical development and is not approved for human use by any regulatory authority including the MHRA or EMA. All information presented here is for educational purposes based on published research data.
    Evidence standards summary

    Survodutide — evidence and risk at a glance

    Twenty standard modules scored against the Peptide Authority evidence grading methodology. Missing modules indicate the field has not yet been characterised editorially — treat absences as uncertainty rather than reassurance.

    01Evidence snapshot

    BModerate human evidenceOverall grade against our evidence grading methodology.

    Investigational dual GLP-1 / glucagon receptor agonist (Boehringer Ingelheim). Phase 3 trials ongoing for obesity and MASH. Not currently a UK-licensed medicine; access is via clinical trial only.

    02Human evidence grade

    BModerate human evidenceStrength of evidence from published human trials.

    03Preclinical evidence grade

    AStrong human evidenceAnimal-model and in-vitro evidence quality.

    04Regulatory status

    • UK: Not approved by the MHRA. Currently an investigational compound in Phase 3 clinical trials.
    • EU: Not authorised by the European Medicines Agency. Phase 3 clinical development ongoing.
    • Notes: Survodutide is being evaluated in multiple Phase 3 clinical trials including the SYNCHRONIZE programme for obesity and the SYMPHONY programme for MASH. Regulatory submissions are anticipated pending completion of pivotal trials. The compound has received Fast Track designation from the FDA for MASH.

    05Approved medical uses

    None in the UK or EU as a finished medicine. (Or: not yet documented; treat as absence rather than approval.)

    06Unapproved / promotional claims

    • Better than tirzepatide for weight loss.
    • Already available privately in the UK.
    • Safe to self-administer at home.
    • Compounded versions are clinically equivalent.

    07Common internet claims

    • Marketed by grey-market vendors as 'next-generation' obesity treatment.
    • Sold by online retailers as research-only pre-launch supply.
    • Promoted in 'pre-launch' weight-loss communities ahead of regulatory submission.

    08Claim vs evidence

    ClaimEvidenceHuman evidence?Regulatory concernSafer wording
    “Available for UK private prescription”ENoHighSurvodutide is not licensed in any jurisdiction at the time of writing. Sellers offering it operate outside the regulated framework.
    “Better than tirzepatide for liver-fat reduction”BYesModerateGlucagon agonism appears to drive additional hepatic fat-loss effect in trials; comparative outcomes data are emerging.

    09Safety uncertainty score

    Very high

    Effectively no human safety data; safety claims are extrapolations from animal work or anecdote.

    10Known adverse signals

    • Phase 3 trial side-effect profile broadly similar to other incretin agents (nausea, vomiting, diarrhoea).
    • Unknown long-term effects of glucagon-receptor agonism in non-trial use.
    • Sterility and identity of grey-market product entirely unverified.
    • Cardiovascular safety still under trial review.

    11Drug-interaction uncertainty

    High

    Interaction picture sparse; meaningful uncertainty when combined with other medicines.

    12Anti-doping status

    WADA: Sport status unclearWADA strict-liability framing applies.

    13UK legal position

    UK: Unlicensed (UK)

    Not approved by the MHRA. Currently an investigational compound in Phase 3 clinical trials.

    Read the full UK legal guide → Semaglutide and UK law

    14EU legal position

    Not authorised by the European Medicines Agency. Phase 3 clinical development ongoing.

    15What this page cannot tell you

    • Whether any 'survodutide' sold online is actually survodutide rather than a relabelled GLP-1.
    • What dose is safe in any individual outside the clinical-trial protocol.
    • Long-term safety in real-world use.
    • Whether MHRA or NICE approval will materialise — Phase 3 outcomes are not yet final.

    16Last reviewed

    Last reviewed:

    Next review due:

    Spotted an error or something out of date? Send a correction.

    17Citation quality score

    BModerate human evidenceQuality of the sources we cite, graded against the evidence grading methodology.

    18Research gaps

    • Phase 3 trials in obesity and MASH not yet fully published.
    • Cardiovascular outcome trial pending.
    • Real-world post-marketing data impossible — drug is not licensed.

    19Safer alternatives / established care pathways

    • Licensed Wegovy (semaglutide) or Mounjaro (tirzepatide) via NHS or GMC-registered prescriber.
    • Enrolment in a registered survodutide Phase 3 trial via ClinicalTrials.gov.
    • NHS Tier 2 / 3 weight management programme.

    Related Safety Centre page → Unlicensed peptide risks

    20Doctor discussion prompts

    Questions to ask a qualified clinician

    These are starter questions you can adapt for a GP, specialist, pharmacist, or anti-doping advisor. The aim is to help you have a better-informed conversation — not to replace one.

    • Are there UK clinical trials for survodutide I might be eligible for?

    Discovery & History

    Survodutide was developed through a strategic partnership between Boehringer Ingelheim, one of the world's largest pharmaceutical companies, and Zealand Pharma, a Danish biotechnology company specialising in peptide therapeutics. The collaboration brought together Zealand Pharma's expertise in peptide engineering with Boehringer Ingelheim's extensive clinical development capabilities. The concept of dual glucagon/GLP-1 receptor agonism emerged from growing scientific understanding that glucagon, traditionally viewed primarily as a counter-regulatory hormone to insulin, plays important roles in energy expenditure, lipid metabolism, and amino acid handling. Researchers hypothesised that carefully balancing glucagon receptor activation with GLP-1 receptor agonism could produce superior metabolic outcomes compared to targeting either receptor alone. Zealand Pharma designed the survodutide molecule using their proprietary peptide chemistry platform, optimising the ratio of glucagon to GLP-1 receptor activity to maximise metabolic benefits whilst mitigating the hyperglycaemic effects of glucagon through concurrent GLP-1-mediated insulin secretion. The compound entered Phase 1 clinical trials around 2019, with initial dose-finding studies establishing its pharmacokinetic profile and preliminary safety data. Promising early results led to rapid progression into Phase 2 trials, including studies in both obesity and NASH/MASH populations. By 2023, the compound had advanced into Phase 3 clinical development, reflecting the strength of the clinical data generated in earlier trials.

    Mechanism of Action

    Survodutide exerts its metabolic effects through simultaneous activation of two distinct but complementary receptor systems, creating a synergistic approach to weight management and metabolic improvement. **GLP-1 Receptor Agonism** The GLP-1 receptor component of survodutide's action mirrors the mechanisms employed by established GLP-1 receptor agonists. Activation of GLP-1 receptors in the pancreas stimulates glucose-dependent insulin secretion, helping to maintain glycaemic control. In the central nervous system, GLP-1 receptor activation in the hypothalamus and brainstem reduces appetite and promotes satiety, leading to decreased caloric intake. GLP-1 signalling also slows gastric emptying, contributing to prolonged feelings of fullness after meals. **Glucagon Receptor Agonism** The glucagon receptor component distinguishes survodutide from pure GLP-1 agonists. Glucagon receptor activation in the liver stimulates hepatic lipid oxidation and reduces de novo lipogenesis, potentially driving significant reductions in liver fat content. This hepatic effect is particularly relevant for patients with MASH/NASH. Glucagon also increases energy expenditure through thermogenic mechanisms, including activation of brown adipose tissue and enhancement of resting metabolic rate. Additionally, glucagon promotes amino acid catabolism and may influence body composition by supporting the maintenance of lean mass during weight loss. **Synergistic Metabolic Effects** The dual agonist design of survodutide is engineered so that the GLP-1 component counterbalances glucagon's potential to raise blood glucose levels. Whilst glucagon stimulates hepatic glucose output, concurrent GLP-1-mediated insulin secretion helps to maintain euglycaemia. This careful balance allows patients to benefit from glucagon's energy-expenditure-enhancing and lipid-oxidising properties without experiencing clinically significant hyperglycaemia. **Cardiovascular and Hepatic Pathways** Emerging research suggests that survodutide's dual mechanism may also confer benefits on cardiovascular risk markers, including improvements in lipid profiles, reductions in inflammatory biomarkers, and potential effects on blood pressure. The hepatic effects are of particular interest, as clinical data have demonstrated significant reductions in liver fat and improvements in markers of liver fibrosis.

    Researched Benefits

    Based on preclinical and clinical research findings:

    • 1
      Significant body weight reduction, with clinical trials reporting mean weight loss exceeding 18% of baseline body weight over 46 weeks
    • 2
      Substantial reduction in liver fat content, with studies showing over 80% of participants achieving clinically meaningful decreases in hepatic steatosis
    • 3
      Improvements in glycaemic control including reduced HbA1c levels and enhanced insulin sensitivity
    • 4
      Favourable changes in lipid profiles including reductions in triglycerides and LDL cholesterol
    • 5
      Potential resolution of metabolic dysfunction-associated steatohepatitis (MASH) with improvement in fibrosis markers
    • 6
      Reduction in waist circumference and visceral adiposity beyond that attributable to overall weight loss
    • 7
      Improvements in cardiovascular risk markers including blood pressure and inflammatory biomarkers
    • 8
      Enhanced energy expenditure through glucagon-mediated thermogenic effects, potentially supporting sustained weight management

    Claim vs Evidence

    How popular claims about Survodutide stack up against the current research, graded using our public evidence grading methodology.

    ClaimEvidenceHuman evidence?Regulatory concernSafer wording
    “Available for UK private prescription”ENoHighSurvodutide is not licensed in any jurisdiction at the time of writing. Sellers offering it operate outside the regulated framework.
    “Better than tirzepatide for liver-fat reduction”BYesModerateGlucagon agonism appears to drive additional hepatic fat-loss effect in trials; comparative outcomes data are emerging.

    Theoretical Dosing & Protocols

    ⚠️ Educational Only: The following information is derived from research literature and is not a prescription or recommendation. No standardised human dosing exists. Always consult a qualified healthcare professional.
    Theoretical DosageDose escalation from 0.3 mg to a target dose of up to 4.8 mg (clinical trial protocols have used stepwise escalation over several weeks to improve tolerability)
    FrequencyOnce weekly subcutaneous injection
    DurationClinical trials have evaluated treatment periods of 46 weeks and longer; duration in clinical practice would be determined by prescribers
    NotesThese protocols are based on published clinical trial designs and are not prescriptive recommendations. Survodutide is an investigational compound not approved for human use. Dose escalation schedules in trials typically involve 4-week intervals at each dose level to minimise gastrointestinal side effects. Always consult a qualified healthcare professional.

    Administration Routes

    Routes studied in research settings (educational only):

    • Subcutaneous injection (sole route investigated in clinical trials)
    Half-LifeStability
    Approximately 60-70 hours, supporting once-weekly dosing based on clinical pharmacokinetic dataSupplied as a solution for injection in pre-filled devices in clinical trial settings; storage requirements typically 2-8°C as per investigational product handling guidelines

    Safety Profile & Known Risks

    Commonly Reported Side Effects

    • Nausea, particularly during dose escalation phases (most frequently reported adverse event)
    • Vomiting, generally mild to moderate and decreasing with continued treatment
    • Diarrhoea, occurring more frequently at higher doses
    • Decreased appetite (related to mechanism of action)
    • Injection site reactions including erythema and pruritus
    • Constipation reported in some participants

    Rare Risks & Concerns

    • Acute pancreatitis (theoretical class risk shared with GLP-1 receptor agonists)
    • Cholelithiasis (gallstones) associated with rapid weight loss
    • Potential hepatic effects requiring monitoring given glucagon receptor activation
    • Hypoglycaemia, particularly if combined with insulin or sulphonylureas

    Contraindications

    • Personal or family history of medullary thyroid carcinoma (theoretical class precaution for GLP-1 agonists)
    • Multiple endocrine neoplasia syndrome type 2 (MEN 2)
    • Pregnancy and breastfeeding (no safety data available; contraindicated in clinical trials)
    • Severe hepatic impairment (limited data)
    • Known hypersensitivity to survodutide or any excipients

    UK & EU Regulatory Context

    🇬🇧 United Kingdom

    Not approved by the MHRA. Currently an investigational compound in Phase 3 clinical trials.

    🇪🇺 European Union

    Not authorised by the European Medicines Agency. Phase 3 clinical development ongoing.

    Survodutide is being evaluated in multiple Phase 3 clinical trials including the SYNCHRONIZE programme for obesity and the SYMPHONY programme for MASH. Regulatory submissions are anticipated pending completion of pivotal trials. The compound has received Fast Track designation from the FDA for MASH.

    Clinical Studies Summary

    Histological efficacy of anti-diabetic agents in MASH and the mediating role of weight loss: A network meta-analysis.

    SGLT2 inhibitor and incretin-based agents improved fibrosis in MASH, with weight loss being a significant mediator. Targeting multiple incretin pathways, especially involving glucagon receptors, may offer greater MASH resolution. Dose-dependent effects were more prominent for MASH resolution than fibrosis improvement, indicating potential weight-loss-independent anti-fibrotic pathways.

    Diabetes Obes Metab. 2026View on PubMed

    Comparative Analysis of Glucagon Receptor Agonists vs. Resmetirom in MASLD and MASH: Network Meta-Analysis of Clinical Trials.

    GRAs superiorly reduce ALT levels, MRI-PDFF, and ELF. Resmetirom significantly reduces AST, HDL, and LDL levels, increases MASH resolution without worsening of fibrosis, and offers a more favourable safety profile. Both GRAs and resmetirom significantly increase adiponectin.

    Endocrinol Diabetes Metab. 2026View on PubMed

    Comparative Efficacy and Safety of Glucagon Receptor Agonists on Metabolic Outcomes: A Network Meta-Analysis of Randomised Controlled Trials.

    Retatrutide and survodutide exhibit the most favourable efficacy profiles for obesity and T2DM, with acceptable safety. These findings support their potential clinical use and highlight the need for future head-to-head trials.

    Endocrinol Diabetes Metab. 2026View on PubMed

    Comparison of pharmacological therapies in metabolic dysfunction-associated steatohepatitis for fibrosis regression and MASH resolution: Systematic review and network meta-analysis.

    This study provides updated rank-order efficacy of MASH pharmacological therapies for fibrosis regression and MASH resolution. These data are helpful to inform practice and clinical trial design. Huang consults for, advises, and is on the speakers' bureau for Roche. He consults for and advises Gilead.

    Hepatology. 2025View on PubMed

    Efficacy of GLP-1-based Therapies on Metabolic Dysfunction-associated Steatotic Liver Disease and Metabolic Dysfunction-associated Steatohepatitis: A Systematic Review and Meta-analysis.

    GLP-1RAs decreased liver fat deposition and improved histological steatosis, hepatocellular ballooning, and lobular inflammation, without worsening of fibrosis in MASLD and MASH. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints.

    J Clin Endocrinol Metab. 2025View on PubMed

    Efficacy and Safety of GLP-1 Receptor Agonists, Dual Agonists, and Retatrutide for Weight Loss in Adults With Overweight or Obesity: A Bayesian NMA.

    Retatrutide offers superior weight loss efficacy but with a higher AE risk. Dual agonists provide a favorable efficacy-safety balance. Personalized treatment selection based on patient characteristics is recommended.

    Obesity (Silver Spring). 2025View on PubMed

    Registered Trials & Regulatory Status

    Registered trials
    31
    Currently recruiting
    4
    Furthest phase
    Phase 3
    Approved product
    No

    21 of 24 completed trials have never posted results. Unreported trials are not neutral: results that go unpublished are more often negative ones.

    A Study in People With Overweight or Obesity to Compare How 2 Different Formulations of Survodutide Are Taken up by the Body

    PHASE1

    Status: Recruiting · 80 participants · Boehringer Ingelheim

    Conditions: Healthy, Obesity, Overweight

    No results postedNCT07407348

    A Study in Healthy People or Otherwise Healthy With Overweight or Obesity to Compare 2 Formulations of Survodutide Given in Different Ways, Either as a Pre-filled Syringe or a Pen-like Injector

    PHASE1

    Status: Completed · 56 participants · Boehringer Ingelheim

    Conditions: Healthy, Obesity

    No results postedNCT07413913

    Albuminuria Reduction Study With Survodutide Treatment in Kidney Disease

    PHASE2

    Status: Not Yet Recruiting · 120 participants · University Medical Center Groningen

    Conditions: Chronic Kidney Disease

    No results postedNCT07206290

    A Study in Healthy People to Compare How 2 Different Formulations of Survodutide Are Taken up by the Body

    PHASE1

    Status: Active Not Recruiting · 100 participants · Boehringer Ingelheim

    Conditions: Healthy

    No results postedNCT07221591

    A Study in Healthy People to Compare How 2 Different Formulations of Survodutide Are Taken up in the Body

    PHASE1

    Status: Completed · 16 participants · Boehringer Ingelheim

    Conditions: Healthy

    No results postedNCT07071974

    A Study to Test Whether Survodutide Improves How the Body Uses Energy and Breaks Down Fat in People With Obesity

    PHASE1

    Status: Active Not Recruiting · 64 participants · Boehringer Ingelheim

    Conditions: Obesity

    No results postedNCT06745284

    A Study in Healthy People to Compare How 3 Different Formulations of Survodutide Are Taken up in the Body

    PHASE1

    Status: Completed · 30 participants · Boehringer Ingelheim

    Conditions: Healthy

    No results postedNCT06772532

    LIVERAGE™ - Cirrhosis: A Study to Test Whether Survodutide Helps People With a Liver Disease Called NASH/MASH Who Have Cirrhosis

    PHASE3

    Status: Recruiting · 1,590 participants · Boehringer Ingelheim

    Conditions: Metabolic Dysfunction Associated Steatohepatitis

    No results postedNCT06632457

    A Study to Test Whether BI 456906 (Survodutide) Influences the Amount of Bupropion, Caffeine and Midazolam in the Blood in People With Overweight or Obesity

    PHASE1

    Status: Completed · 34 participants · Boehringer Ingelheim

    Conditions: Overweight, Obesity

    No results postedNCT06564441

    A Study in People With Obesity to Test the Effects of BI 456906 Compared With Semaglutide on Glucagon Receptor Activity in the Liver

    PHASE1

    Status: Recruiting · 30 participants · Boehringer Ingelheim

    Conditions: Obesity

    No results postedNCT05202353

    LIVERAGE™: A Study to Test Whether Survodutide Helps People With a Liver Disease Called NASH/MASH Who Have Moderate or Advanced Liver Fibrosis

    PHASE3

    Status: Recruiting · 1,800 participants · Boehringer Ingelheim

    Conditions: Metabolic Dysfunction Associated Steatohepatitis (MASH), Liver Fibrosis

    No results postedNCT06632444

    A Study in Chinese People With Overweight or Obesity to Test How Different Doses of Survodutide Are Taken up in the Body

    PHASE1

    Status: Completed · 30 participants · Boehringer Ingelheim

    Conditions: Overweight, Obesity

    No results postedNCT06492135

    Adverse event reports (FDA FAERS)

    Not applicable: no licensed product contains this peptide, so it is not reported through FAERS. This is an absence of surveillance, not evidence of safety.

    Source: ClinicalTrials.gov and openFDA. Updated automatically.

    Looking for Survodutide?

    Source research-grade Survodutide from a trusted UK supplier — third-party tested with certificate of analysis.

    View at Supplier

    Frequently Asked Questions

    Questions to ask a qualified clinician about Survodutide

    These are starter questions you can adapt for a GP, specialist, pharmacist, or anti-doping advisor. The aim is to help you have a better-informed conversation — not to replace one.

    • Are there UK clinical trials for survodutide I might be eligible for?

    UK regulatory & safety context

    Semaglutide and UK law

    UK legal reference

    Unlicensed peptide risks

    Safety Centre guide

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