GLP-1 & metabolic · Treatment of obesity and type 2 diabetes
Mazdutide
1.5 → 6 mg weekly, titrated
Dual GLP-1/glucagon receptor agonist (LY3305677/IBI362) discovered in 2018, combining GLP-1 and glucagon signaling for stronger metabolic effects than single-receptor drugs. In Phase 3 trials for obesity and type 2 diabetes, showing notable weight loss and glycemic improvement.
Reconstitution
| Vial | 1 mL water | 2 mL water |
|---|---|---|
| 10 mg | 10 mg/mL | 5 mg/mL |
- Use bacteriostatic water as the diluent.
- Add the water slowly, letting it run down the inside wall of the vial rather than onto the powder.
- Swirl gently to mix, then leave it to dissolve. Do not shake.
- Give it a few minutes. The finished solution should be clear and colourless.
Protocol
Route: Subcutaneous
Standard titration (once weekly, subcutaneous)
- Weeks 1 to 4: 1.5 mg
- Weeks 5 to 8: 3 mg
- Weeks 9 to 12: 4.5 mg
- Week 13 onward: 6 mg as the maintenance dose
- (A simpler 2 mg, then 4 mg, then 6 mg version on the same 4-week steps is also used.)
Watch fasting glucose early
- Because of the glucagon side of this drug, a small temporary rise in fasting blood sugar in the first 1 to 2 weeks is normal and usually settles by week 3 to 4
- A persistent rise means slow the titration down
Dosing detail
- Start at 1.5 mg and step up every 4 weeks. Going too fast is the top reason people quit, almost always from nausea.
- Maintenance is commonly 6 mg weekly. China approved it at 4 mg and 6 mg in 2025 (brand name Xinermei), and a higher 9 mg dose (titrated 3, 6, 9) is under review there for severe obesity.
- Some step down to 4.5 mg or 3 mg once at goal to hold results with fewer side effects.
- One consistent day per week. Half-life is about 6.5 days.
Duration
- Titrate over 12 to 16 weeks, then maintain. Like the other GLP-1 class drugs, stopping tends to bring weight back.
Notes
- A GLP-1 / glucagon dual agonist, so appetite suppression plus a metabolic bump are the headline effects.
- Inject subcutaneously and rotate sites.
- GI effects are dose-related and ease with slow titration.
Storage and handling
- Keep the powdered (lyophilized) vial in a cool, dark place. Refrigerate it for longer-term storage before mixing.
- Once reconstituted and refrigerated at 2–8 °C away from light, use the vial within 90 days.
- Do not freeze a reconstituted vial, and keep it away from heat and sunlight.
- If the solution turns cloudy, develops floating particles, or shows any other sign of degradation, stop using that vial.