Survodutide

Dual GLP-1 and glucagon receptor agonist. Unlike tirzepatide’s GIP/GLP-1 dual agonism, survodutide pairs GLP-1 with glucagon — prioritizing hepatic lipid mobilization and thermogenesis over incretin potentiation. Glucagon receptor activation in hepatocytes drives fatty acid oxidation and reduces hepatic steatosis directly. The GLP-1 component provides appetite suppression and glucose-dependent insulin secretion to offset glucagon-driven hyperglycemia.

Half-life

~5-6 days (~130 hours, estimated from phase 2 PK)

Bioavailability

~80% (SC, estimated)

Route

subcutaneous

Evidence tier

T3 — Community / emerging

Optimization pillars

fat-loss · cellular-health

References

2 peer-reviewed

Dose ranges

Three tiers ordered by aggressiveness. Tier chips on every OPTIMIZE intervention let you filter the catalog by your evidence tolerance.

conservative

0.3–2.4 mg/week SC

Phase 2 titration (MASH indication)

moderate

4.8 mg/week SC

Phase 2 mid-dose cohort

aggressive

6 mg/week SC

Phase 2 high-dose cohort (maximum studied)

Monitoring

fasting-glucose
hba1c
fasting-insulin
homa-ir
lipid-panel
alt
ast
ggt
triglycerides
hs-crp
creatinine
egfr

Contraindications

medullary-thyroid-carcinoma
men2-syndrome
pancreatitis-history
severe-gastroparesis
hepatic-impairment-severe

References

PMID:37908901Survodutide for MASH — a randomised, double-blind, placebo-controlled, phase 2 trial — Lancet, 2024
PMID:37078536Efficacy and safety of survodutide for overweight and obesity — Lancet Diabetes Endocrinol, 2024

Notes

Survodutide occupies a different niche than tirzepatide. Where tirzepatide maximizes incretin synergy through GIP, survodutide targets the liver directly through glucagon. The MASH data is the signal worth watching. Phase 2 showed significant reductions in liver fat content and fibrosis improvement — outcomes that matter beyond the scale. The obesity cohort showed ~19% body weight reduction at the highest dose. Competitive with semaglutide, trailing tirzepatide, but the hepatic angle gives it a distinct clinical identity. If phase 3 MASH data holds, this becomes a liver drug that also causes weight loss — a completely different regulatory and commercial positioning than the incretin-first compounds.

This is not medical advice

Discuss with a licensed clinician before starting, stopping, or changing any compound. This page documents what the research literature describes — it is not a prescription.

See Survodutide in a protocol matched to you