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GLP-1 & metabolic · Treatment of obesity and type 2 diabetes

Survodutide

0.3 → 4.8 mg weekly, titrated

A dual glucagon/GLP-1 receptor agonist (BI 456906) from Boehringer Ingelheim and Zealand Pharma. It combines glucagon-driven energy expenditure with GLP-1-driven appetite suppression for weight management and metabolic dysfunction–associated steatohepatitis.

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Reconstitution

Concentration by vial size and water volume
Vial1 mL water2 mL water
10 mg10 mg/mL5 mg/mL
  1. Use bacteriostatic water as the diluent.
  2. Add the water slowly, letting it run down the inside wall of the vial rather than onto the powder.
  3. Swirl gently to mix, then leave it to dissolve. Do not shake.
  4. Give it a few minutes. The finished solution should be clear and colourless.

Protocol

Route: Subcutaneous

Standard titration (once weekly, subcutaneous)

  • Start at 0.3 mg once weekly and step up roughly every 2 to 4 weeks toward a working dose, climbing over 14 to 16 weeks
  • The Phase 2 obesity trial topped out at 4.8 mg weekly
  • Effects become noticeably stronger from 1.8 mg upward

Where most people land

  • 1.8 mg to 4.8 mg weekly is the working range
  • Do not skip steps; the glucagon and GLP-1 combination makes a fast ramp rough on the gut

Dosing detail

  • Start at 0.3 mg. This is a tolerance dose; real weight effect kicks in around 1.8 mg.
  • Step up gradually over 14 to 16 weeks. Steady-state at any dose takes about 5 weeks given the 7-day half-life.
  • Phase 2 went up to 4.8 mg weekly. Stay at the lowest dose that keeps you progressing.
  • One consistent day per week.

Duration

  • Titrate over roughly 4 months, then maintain. A plateau after 12 to 16 weeks at your target dose is normal, not failure.

Notes

  • A GLP-1 / glucagon dual agonist studied heavily for weight and metabolic effects.
  • Inject subcutaneously, rotate sites.
  • Nausea and fullness early on, easing as the body adjusts.

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.