Research
What Is Survodutide? The Glucagon/GLP-1 Drug Explained
Survodutide is an experimental weekly injection from Boehringer Ingelheim and Zealand Pharma that activates two hormone receptors at once: glucagon and GLP-1. In 2026 it reported its first phase 3 results, with up to 16.6% average weight loss and large drops in liver fat. This guide explains what survodutide is, how it differs from semaglutide and tirzepatide, what the trials show, and where it stands today.
Reviewed for accuracy · Last reviewed October 19, 2026
What Is Survodutide?
Survodutide (development code BI 456906) is a synthetic peptide that acts as a dual glucagon receptor and GLP-1 receptor agonist. It was discovered by Zealand Pharma and is developed by Boehringer Ingelheim. It is given as a once-weekly injection under the skin.
It is being developed for two main uses: obesity and metabolic dysfunction-associated steatohepatitis (MASH), the advanced, inflammatory form of fatty liver disease. The FDA gave it Fast Track status in 2021 and Breakthrough Therapy designation in 2024 for MASH with liver fibrosis.
How Does Survodutide Work?
Survodutide combines two signals that affect appetite and energy use in different ways:
- GLP-1 receptor: the same target as semaglutide. It reduces appetite, slows stomach emptying and improves insulin release after meals.
- Glucagon receptor: glucagon normally raises blood sugar, but it also increases energy expenditure and pushes the liver to burn stored fat. This is why glucagon-based drugs are studied for fatty liver disease.
The GLP-1 activity offsets glucagon’s tendency to raise blood sugar, so the combination aims to reduce weight and liver fat without worsening glucose control.
What Does the Research Show?
SYNCHRONIZE-1 (obesity, 2026). In 725 adults with obesity or overweight but no type 2 diabetes, 76 weeks of survodutide produced up to 16.6% average weight loss versus 3.2% with placebo among people who stayed on treatment. An MRI sub-study found visceral (belly) fat fell by up to 34% and liver fat by up to 63%. Results were published in the NEJM and presented at ADA 2026.
SYNCHRONIZE-2 (obesity with type 2 diabetes, 2026). In 755 adults with type 2 diabetes, weight loss reached up to 13.1% versus 3.1% with placebo, and HbA1c fell by up to 1.2 points. People with diabetes usually lose less weight on these drugs, which matches what was seen with semaglutide and tirzepatide.
Fatty liver disease. In SYNCHRONIZE-MASLD (218 adults), 84% of people on the highest dose cut liver fat by at least 30%, and 61% brought liver fat into the normal range, versus 6% on placebo. An earlier phase 2 biopsy trial in MASH, published in the NEJM in 2024, found up to 83% of treated people who completed the study had MASH improvement without worsening fibrosis, versus 18% with placebo. Larger phase 3 MASH trials (LIVERAGE) are ongoing.
| Trial | Population | Key result |
|---|---|---|
| SYNCHRONIZE-1 | 725 adults, obesity, no diabetes | Up to 16.6% vs 3.2% weight loss (76 weeks) |
| SYNCHRONIZE-2 | 755 adults with type 2 diabetes | Up to 13.1% vs 3.1% weight loss |
| SYNCHRONIZE-MASLD | 218 adults with fatty liver | 61% normalized liver fat vs 6% |
| Phase 2 MASH (NEJM 2024) | Biopsy-confirmed MASH | Up to 83% MASH improvement vs 18% |
Survodutide Side Effects
The most common side effects are gastrointestinal: nausea, vomiting, diarrhea and constipation, mostly mild to moderate and most frequent while the dose is being increased. In SYNCHRONIZE-1, about 19% of people stopped treatment because of GI side effects, compared with about 3% on placebo, which is higher than in many semaglutide and tirzepatide trials. Glucagon activity can also raise heart rate slightly, which researchers are watching.
Is Survodutide FDA-Approved?
No. As of October 2026, survodutide is investigational and not approved by the FDA or any other regulator. No filing date has been announced. It has Fast Track and Breakthrough Therapy designations for MASH, which can speed review but are not approvals.
Survodutide vs Tirzepatide, Retatrutide and Mazdutide
| Drug | Receptors | Status (Oct 2026) |
|---|---|---|
| Semaglutide | GLP-1 | FDA-approved (Ozempic, Wegovy) |
| Tirzepatide | GIP + GLP-1 | FDA-approved (Mounjaro, Zepbound) |
| Survodutide | Glucagon + GLP-1 | Phase 3, not approved |
| Mazdutide | Glucagon + GLP-1 | Approved in China (2025) |
| Retatrutide | GIP + GLP-1 + glucagon | Phase 3, not approved |
Survodutide vs tirzepatide. Tirzepatide pairs GLP-1 with GIP, while survodutide pairs it with glucagon. Survodutide’s average weight loss in phase 3 was somewhat lower than tirzepatide’s, but its glucagon component gives it a stronger case for liver disease.
Survodutide vs mazdutide. Both are glucagon/GLP-1 dual agonists. Mazdutide, from Innovent and Eli Lilly, was approved in China in 2025, while survodutide is still in trials.
Buying Research-Grade Survodutide: What to Check
Products sold as Survodutide by research suppliers are laboratory chemicals, not medicines. They are not made under drug manufacturing rules, so quality varies a lot between vendors. If you are evaluating a Survodutide supplier for lab research, these are the checks that matter:
- Batch-specific COA: the certificate should match the lot number on your vial, not a generic sample.
- Independent lab: testing should come from a named third-party lab, ideally with a way to verify the report online.
- Identity, not just purity: HPLC purity alone does not confirm the right molecule; look for mass spectrometry (MS) identity confirmation.
- Endotoxin and sterility results: these matter for any injectable research material.
- Correct fill amount: the measured content should be close to the labeled milligrams.
Our Trusted Sources page lists vendors we track, with current community codes. Our guide to reading a certificate of analysis explains each line of a COA.
Key Takeaways
- Survodutide is a weekly glucagon/GLP-1 dual agonist from Boehringer Ingelheim and Zealand Pharma.
- Phase 3 trials in 2026 showed up to 16.6% weight loss without diabetes and 13.1% with diabetes.
- It produced large reductions in liver fat and is in phase 3 trials for MASH.
- GI side effects caused about 19% of people to stop treatment in SYNCHRONIZE-1.
- It is not approved anywhere as of October 2026.
Frequently Asked Questions
What is survodutide?
Survodutide is an experimental once-weekly injection that activates both the glucagon and GLP-1 receptors. It is developed by Boehringer Ingelheim and Zealand Pharma for obesity and fatty liver disease.
How much weight do people lose on survodutide?
In the 2026 SYNCHRONIZE-1 trial, people without diabetes lost up to 16.6% of body weight on average over 76 weeks, versus 3.2% with placebo.
Is survodutide FDA-approved?
No. As of October 2026 it is investigational and not approved anywhere.
How is survodutide different from tirzepatide?
Tirzepatide activates GIP and GLP-1 receptors. Survodutide activates glucagon and GLP-1 receptors, which gives it a stronger effect on liver fat.
What are survodutide side effects?
Mostly nausea, vomiting, diarrhea and constipation. About 19% of people in SYNCHRONIZE-1 stopped treatment because of GI side effects.
Sources
- Boehringer Ingelheim – SYNCHRONIZE-1 and SYNCHRONIZE-MASLD phase 3 results (April and June 2026)
- NEJM (2026) – Survodutide for the treatment of obesity (SYNCHRONIZE-1)
- AJMC (October 2026) – Survodutide delivers up to 13.1% weight loss in type 2 diabetes (SYNCHRONIZE-2)
- Sanyal et al. (2024), NEJM – A phase 2 randomized trial of survodutide in MASH and fibrosis
MLCR SCTY provides educational information, not medical or legal advice. Research-use-only products are not intended for human consumption.