Survodutide

Survodutide (BI 456906) is an investigational dual agonist of the glucagon receptor and the GLP-1 receptor, studied by subcutaneous injection, once weekly and in one trial twice weekly, for obesity, MASH and type 2 diabetes. No regulator in Vietnam or in any market this research reached has approved it; the US FDA granted it Breakthrough Therapy designation for MASH in 2024, which is not an approval.

Last updated: September 2026

What is Survodutide?

Survodutide, development code BI 456906, is an investigational dual agonist of the glucagon receptor (GCGR) and the glucagon-like peptide-1 (GLP-1) receptor (PMID 42253238). It is a peptide: an acylated chain that carries a C18 fatty acid as a half-life extending principle to support once-weekly dosing in humans (PMID 36356832). PubChem lists it under CID 171378821 with the molecular formula C192H289N47O61, a molecular weight of 4232, and CAS number 2805997-46-8. You can place it beside the other compounds in our peptide library.

It is modelled on oxyntomodulin, a natural gut peptide that activates both the glucagon and GLP-1 receptors (PMID 36356832). Engaging both receptors is the reported difference from a GLP-1-only agonist such as semaglutide: in the preclinical work the weight effect was attributed to both increased energy expenditure and reduced food intake (PMID 36356832). Boehringer Ingelheim funded the obesity, MASH and diabetes trials cited here and is the lead sponsor on 25 of the 26 registered survodutide studies.

No regulator has approved survodutide, in Vietnam or in any other market that this research reached; the phase 3 primary report published in 2026 still describes it as investigational (PMID 42253238). There is no US prescribing information, because DailyMed returned zero records on both of its search endpoints against a database published on 2026-09-04. The one documented regulatory step is a US FDA Breakthrough Therapy designation, announced in October 2024, for adults with noncirrhotic MASH and moderate or advanced fibrosis; a Breakthrough Therapy designation speeds review and is not an approval.

How It Works

Dual receptor agonism: survodutide activates both the glucagon receptor (GCGR) and the GLP-1 receptor, which is the design that defines the molecule (PMID 42253238). That second receptor is what separates it from GLP-1-only agonists.

Two sides of the energy balance: in preclinical mouse work the weight effect was attributed to increased energy expenditure together with reduced food intake, not to reduced intake alone (PMID 36356832).

Once-weekly design: it is an acylated peptide that carries a C18 fatty acid as a half-life extending principle to support once-weekly dosing in humans (PMID 36356832). No numeric half-life, in hours or days, was stated in the abstracts collected for this page.

How target engagement was measured in animals: glucose tolerance, food intake and gastric emptying for the GLP-1 receptor, and liver nicotinamide N-methyltransferase mRNA plus circulating biomarkers such as amino acids and fibroblast growth factor-21 for the glucagon receptor (PMID 36356832).

What the Trials Measured

Weight change in obesity without diabetes: in the phase 3 SYNCHRONIZE-1 trial, mean body weight change at week 76 was -12.2% at the 3.6 mg dose and -13.0% at the 6.0 mg dose, versus -5.4% with placebo (trial dose, not a recommendation, PMID 42253238).
Dose-dependent weight change in the earlier phase 2 obesity trial: mean change at week 46 ran from -6.2% at 0.6 mg to -14.9% at 4.8 mg, versus -2.8% with placebo (trial dose, not a recommendation, PMID 38330987).
MASH: in a phase 2 trial in biopsy-confirmed MASH with fibrosis F1 to F3, histologic improvement in MASH without worsening of fibrosis occurred in 47% at 2.4 mg, 62% at 4.8 mg and 43% at 6.0 mg, versus 14% with placebo, and the response was not monotonic with dose (trial dose, not a recommendation, PMID 38847460).
Type 2 diabetes: in a 16-week phase 2 trial on background metformin, the largest once-weekly HbA1c reduction was -1.71% from a baseline of 8.07% (trial result, PMID 38095657).
Cross-trial ranking: in a network meta-analysis of 29 MASH randomised controlled trials, survodutide ranked second of all agents for MASH resolution without worsening fibrosis, behind pegozafermin and ahead of tirzepatide (meta-analysis, PMID 39903735).

Doses Used in the Trials

Phase	Dose	Frequency	Duration
Phase 3, obesity without diabetes (SYNCHRONIZE-1)	Adjusted up to 3.6 mg or 6.0 mg (trial dose, not a recommendation, PMID 42253238)	Once weekly, subcutaneous, plus lifestyle counselling	76 weeks, n=725 (PMID 42253238)
Phase 2 dose-finding, obesity without diabetes	0.6, 2.4, 3.6 or 4.8 mg (trial dose, not a recommendation, PMID 38330987)	Once weekly, subcutaneous (20 weeks escalation, 26 weeks maintenance)	46 weeks, n=386 treated (PMID 38330987)
Phase 2, MASH with fibrosis F1 to F3	2.4, 4.8 or 6.0 mg (trial dose, not a recommendation, PMID 38847460)	Once weekly, subcutaneous (24 weeks rapid escalation, 24 weeks maintenance)	48 weeks, n=293 treated (PMID 38847460)
Phase 2, type 2 diabetes on metformin	Up to 0.3, 0.9, 1.8 or 2.7 mg once weekly, or 1.2 or 1.8 mg twice weekly (trial dose, not a recommendation, PMID 38095657)	Once weekly or twice weekly, subcutaneous, versus open-label semaglutide up to 1.0 mg (trial dose, not a recommendation, PMID 38095657)	16 weeks, n=413 randomised (PMID 38095657)
Phase 3 cardiovascular safety (SYNCHRONIZE-CVOT)	Dose not stated in the abstract (PMID 39453356)	Once weekly, subcutaneous, versus placebo	Event-driven; registry lists n=5531, completed (ClinicalTrials.gov NCT06077864)
Preclinical anti-obesity pharmacology	Dose not stated in the abstract (animal study, mice, route not stated, PMID 36356832)	Acute and subchronic dosing regimens	Mice, including GLP-1R knockout and reporter mice (PMID 36356832)

These figures are the doses used in the cited trials, quoted for education. There is no approved survodutide label to summarise. They are not a recommendation or a personal protocol; any dose, schedule, or decision to use a compound belongs with a licensed prescriber.

Side Effects

Most commonly reported (gastrointestinal)

⚠Gastrointestinal symptoms were the most common adverse events and were typically mild to moderate. In phase 3 obesity they occurred in 80.9% at 3.6 mg and 89.7% at 6.0 mg, versus 47.9% on placebo (PMID 42253238).
⚠In phase 2 MASH, nausea was reported in 66% versus 23% on placebo, diarrhea in 49% versus 23%, and vomiting in 41% versus 4% (PMID 38847460).
⚠In phase 2 obesity, adverse events occurred in 91% of survodutide recipients versus 75% on placebo, and were primarily gastrointestinal in 75% versus 42% (PMID 38330987).
⚠In phase 2 type 2 diabetes, adverse events were reported in 77.8% of survodutide participants, mainly gastrointestinal, versus 52.5% on placebo and 52.0% on open-label semaglutide (PMID 38095657).

Serious events, deaths and retention

•Serious adverse events occurred in 8% with survodutide versus 7% with placebo in the phase 2 MASH trial, so the serious-event rate did not separate from placebo (PMID 38847460).
•No deaths were reported in the phase 3 obesity trial (PMID 42253238).
•Retention belongs next to the tolerability figures: only 60.4% completed the 46-week phase 2 obesity trial (PMID 38330987).
•The trialists reported that dose-related gastrointestinal adverse events could be mitigated with slower dose escalations (PMID 38095657).

Cautions and What Is Not Established

✕Survodutide is investigational and unapproved, so there is no approved label that defines who should not use it (PMID 42253238); nothing collected for this page shows a product authorised for sale in Vietnam or in any market this research reached.
✕The phase 2 obesity trial enrolled adults aged 18 to 75 with a BMI at or above 27; both obesity trials excluded people with diabetes (PMID 38330987, PMID 42253238).
✕No safety data for pregnancy, breastfeeding, children or specific drug interactions appears in the trial abstracts collected for this page; a gap in the data is not the same as evidence of safety.

Where the Evidence Stands

Phase 2

Completed phase 2 trials read out weight change in obesity, liver histology in MASH, and HbA1c in type 2 diabetes (PMID 38330987, PMID 38847460, PMID 38095657).

Phase 3

SYNCHRONIZE-1 in obesity without diabetes reported results in 2026 (PMID 42253238). SYNCHRONIZE-CVOT, a cardiovascular safety trial that the registry lists as completed with n=5531 (ClinicalTrials.gov NCT06077864), had no outcome results in the sources collected here; only the design paper was retrieved (PMID 39453356).

Still open

Several phase 3 studies remain open in the registry, including LIVERAGE (n=1800) and LIVERAGE-Cirrhosis (n=1590) in MASH, and a phase 3 type 2 diabetes study that started on 2026-08-24.

Approval

No approval in any market that this research reached. A US FDA Breakthrough Therapy designation for MASH, announced in October 2024, speeds review but is not an approval.

Notes from Ho Chi Minh City

Survodutide is not a Ho Chi Minh City pharmacy drug, and it is worth being blunt about why. It is a Boehringer Ingelheim trial compound, not approved in Vietnam or in any market that this research reached, so there is no legitimate retail or clinic supply to point anyone toward. The on-site search at Long Châu returns zero products for the name. The searches at Pharmacity and An Khang could not be driven from this box, a client-side search in one case and a reset connection in the other, so they are recorded as unresolved rather than as an absence. Vietnamese-language searches for the name surface pages on semaglutide, liraglutide and the GLP-1 class in general, not survodutide. Anyone offering survodutide for sale here is not selling an approved product, and dose, route and whether to use any GLP-1 drug are decisions for a licensed prescriber.

Sourcing in Vietnam

Survodutide is investigational, with no approved product and no legitimate consumer supply in Vietnam or elsewhere, so there is no published price to quote: no published figure. The on-site search at Long Châu returned zero products for the name in its server-rendered results (fetched 2026-09-06). Pharmacity and An Khang could not be confirmed either way: their search is rendered client-side or the connection to this box was reset, which is a tooling limitation, not evidence that they do or do not list it. Registration with the Drug Administration of Vietnam (DAV) could not be established either, because the public portal loaded but its search cannot be driven without JavaScript. Nothing collected for this page shows survodutide approved in any market.

FAQ

Q: Is survodutide approved or available in Vietnam?

A: No. Survodutide is an investigational Boehringer Ingelheim compound, and nothing collected for this page shows it approved in any market (PMID 42253238). The on-site search at Long Châu returns zero products for the name. Pharmacity and An Khang could not be confirmed either way because of tooling limits, and registration with the Drug Administration of Vietnam could not be established from the public portal. There is no approved product to buy.

Q: What doses were used in the survodutide trials?

A: In the phase 3 SYNCHRONIZE-1 trial, survodutide was adjusted up to 3.6 mg or 6.0 mg once weekly by subcutaneous injection (trial dose, not a recommendation, PMID 42253238). The earlier phase 2 obesity trial used 0.6 to 4.8 mg (trial dose, not a recommendation, PMID 38330987) and the phase 2 MASH trial used 2.4 to 6.0 mg (trial dose, not a recommendation, PMID 38847460). These are trial doses, not a protocol; any dose is a decision for a licensed prescriber.

Q: How is survodutide different from semaglutide?

A: Survodutide activates both the glucagon receptor and the GLP-1 receptor, while semaglutide is a GLP-1 receptor agonist only (PMID 42253238, PMID 36356832). The two have not been compared head to head for weight loss in the evidence collected here. The one trial that included a semaglutide arm was a phase 2 type 2 diabetes study that capped semaglutide at 1.0 mg once weekly (a trial dose, not a recommendation), a diabetes dose that is below the obesity dose, so it is not a fair weight-loss comparison (PMID 38095657).

Q: What side effects were reported most often?

A: Gastrointestinal symptoms, typically mild to moderate, were the most common adverse events across the trials. Examples are nausea, diarrhea and vomiting in phase 2 MASH, at 66%, 49% and 41% versus placebo (PMID 38847460), and gastrointestinal events in 80.9% to 89.7% of participants in phase 3 obesity versus 47.9% on placebo (PMID 42253238). The trialists reported that these could be mitigated with slower dose escalation (PMID 38095657). This is trial data, not a personal safety profile.

Availability in Vietnam

Survodutide is investigational, with no approved product and no legitimate consumer supply in Vietnam or anywhere else. The on-site search at Long Châu returns zero products for the name; availability at Pharmacity and An Khang could not be confirmed either way because of tooling limits. There is no published price to quote.

Back to the peptide library

Peptide library Peptides FAQ Semaglutide guide

Research & Sources

Survodutide Once Weekly for the Treatment of Adults with Obesity · New England Journal of Medicine (2026) (PMID: 42253238)
Phase 3 SYNCHRONIZE-1, obesity without diabetes, n=725, week 76. Funded by Boehringer Ingelheim; NCT06066515.
Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial · The Lancet Diabetes & Endocrinology (2024) (PMID: 38330987)
Phase 2 dose-finding, obesity without diabetes, n=386 treated, week 46. NCT04667377.
A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis · New England Journal of Medicine (2024) (PMID: 38847460)
Phase 2, biopsy-confirmed MASH with fibrosis F1 to F3, n=293 treated, 48 weeks. NCT04771273.
Dose-response effects on HbA1c and bodyweight reduction of survodutide, a dual glucagon/GLP-1 receptor agonist, compared with placebo and open-label semaglutide in people with type 2 diabetes: a randomised clinical trial · Diabetologia (2024) (PMID: 38095657)
Phase 2, type 2 diabetes on metformin, n=413 randomised, 16 weeks. Semaglutide arm open-label, capped at 1.0 mg once weekly. NCT04153929.
Survodutide for the Treatment of Obesity: Rationale and Design of the SYNCHRONIZE Cardiovascular Outcomes Trial · JACC: Heart Failure (2024) (PMID: 39453356)
Phase 3 cardiovascular safety design paper; dose not stated in the abstract; no outcome results in the sources collected. NCT06077864.
BI 456906: Discovery and preclinical pharmacology of a novel GCGR/GLP-1R dual agonist with robust anti-obesity efficacy · Molecular Metabolism (2022) (PMID: 36356832)
Preclinical pharmacology in mice; dose and route not stated in the abstract.
Comparison of pharmacological therapies in metabolic dysfunction-associated steatohepatitis for fibrosis regression and MASH resolution: Systematic review and network meta-analysis · Hepatology (2025) (PMID: 39903735)
Network meta-analysis of 29 MASH randomised controlled trials, n=9324.
PubChem Compound Summary: Survodutide, CID 171378821 · PubChem, NIH National Library of Medicine (2026) Link
Molecular formula C192H289N47O61, molecular weight 4232, CAS 2805997-46-8, synonym BI-456906. Fetched 2026-09-06.
DailyMed drug name and label search for survodutide, zero records · DailyMed, NIH National Library of Medicine (2026) Link
Zero records on both the drugnames and spls endpoints against a database published 2026-09-04. No US prescribing information exists. Fetched 2026-09-06.
FDA grants breakthrough designation to survodutide for treatment of MASH · Healio (2024) Link
US FDA Breakthrough Therapy designation for noncirrhotic MASH with moderate or advanced fibrosis, announced October 2024. A designation, not an approval.
ClinicalTrials.gov registry, intervention survodutide, 26 studies · ClinicalTrials.gov, NIH (2026) Link
26 registered studies, 25 led by Boehringer Ingelheim, spanning phase 1 to phase 3. Fetched 2026-09-06.

Important Disclaimer

Educational content only. Not medical advice. Survodutide is an investigational compound; nothing collected for this page shows it approved in any market, including by the Drug Administration of Vietnam (DAV) or the Ministry of Health of Vietnam (Bộ Y Tế). The on-site search at Long Châu returns zero products for the name, while availability at Pharmacity and An Khang could not be confirmed either way from this research. Consult a licensed physician before any use.