Home / Compounds / Survodutide
Survodutide
Dual GLP-1 and glucagon receptor agonist · No brand name. Development code BI 456906
- UK status
- Not licensed anywhere
- Availability
- Clinical trials only
- Evidence base
- Phase 3 ongoing
- Controlled drug
- No
Sequence
A modified peptide. Sequence not published in a form worth reproducing here.
The short version
What it does
In trials, reduces appetite and body weight, and is also being tested specifically for fatty liver disease rather than weight alone.
How it does it
Copies your gut's after-meal fullness signal, and also activates a second hormone system that raises the rate at which you burn energy. Eat less and spend more, from one weekly injection.
The catch
Not approved in any country. It is genuinely late-stage, with phase 3 trials involving thousands of people, but that means it is a real candidate rather than a real medicine.
Everything below goes into the detail, with sources.
Retatrutide and CagriSema get the attention. Survodutide is at a comparable stage of development, from a comparably serious manufacturer, and is being aimed at a target the others are not chasing as hard: the liver.
At a glance
- Compound type
- Peptide
- Drug class
- Dual GLP-1 and glucagon receptor agonist
- Development code
- BI 456906
- Originator
- Boehringer Ingelheim, with Zealand Pharma
- Route
- Injection under the skin, in trials
- Frequency
- Weekly, in trials
- Approval status
- None, anywhere in the world
- Phase 3 programme
- SYNCHRONIZE in obesity, LIVERAGE in the liver condition MASH
- In sport
- Unapproved, so would fall under WADA S0. Verify with UKAD.
01What it is
Survodutide activates two receptors: GLP-1, the one every drug in this class uses, and glucagon. Glucagon is the counterpart to insulin, and it raises blood glucose, which sounds like the last thing you would want in a metabolic drug.
The rationale is that glucagon also increases energy expenditure and acts directly on the liver to mobilise stored fat. Pair it with GLP-1, which suppresses appetite and offsets the glucose effect, and in principle you get reduced intake and increased output at once.
Retatrutide hits three receptors, GLP-1, GIP and glucagon. Survodutide hits two, GLP-1 and glucagon, skipping GIP. Both are betting on glucagon. More receptors is not automatically better, which is a point the coverage of this class routinely misses.
02How it came about
Survodutide is Boehringer Ingelheim's entry, developed with Zealand Pharma. Phase 2 results in obesity attracted attention for weight reductions comparable to the leading agents, and separately for effects on liver fat.
The phase 3 programme is substantial. SYNCHRONIZE-CVOT enrolled 5,531 participants with overweight or obesity plus cardiovascular disease, chronic kidney disease or multiple risk factors, and reached its completion date in March 2026. SYNCHRONIZE-JP, in Japan, has completed. Two further phase 3 trials, LIVERAGE and LIVERAGE-Cirrhosis, are recruiting specifically in MASH, the liver condition, including in people who already have cirrhosis.
03UK legal and licensing status
Survodutide has no marketing authorisation anywhere in the world. It cannot be lawfully prescribed or supplied for human use in the UK. The only lawful route to receiving it is enrolment in an authorised clinical trial, and several are running.
It is sold on the grey market, and at least one dosing-protocol site published a full survodutide protocol in June 2026. That is worth naming plainly: people are selling and self-administering a compound whose phase 3 safety data has not been published, let alone assessed by a regulator.
04How it works
- GLP-1 receptor. Glucose-dependent insulin release, slowed gastric emptying, reduced appetite. The familiar part.
- Glucagon receptor. Increased energy expenditure, and direct effects on the liver including mobilisation of stored liver fat.
- Once weekly by injection in the trials.
The liver effect is why the LIVERAGE trials exist. It is a different proposition from weight loss that happens to help the liver, and it is being tested as such.
05What it is not
Claims that attach themselves to this compound and do not hold up.
- Not licensed anywhere. No regulator has completed an assessment.
- Not a weaker retatrutide. Two receptors rather than three, aimed partly at a different target. Fewer receptors is not automatically less effective.
- Not safe to buy because the trials are large. Big phase 3 programmes mean the compound is being taken seriously. They do not mean the results are in.
06What the evidence shows
Phase 2 results in obesity reported substantial weight reduction and effects on liver fat. The phase 3 SYNCHRONIZE programme is the pivotal evidence, and SYNCHRONIZE-CVOT is the important one because cardiovascular safety outcome trials are how this class establishes that reducing weight does not cost you something elsewhere.
All of it is funded by Boehringer Ingelheim, which is normal for late-stage development and worth knowing.
The glucagon component is the open question across this whole sub-class. It raises blood glucose by design, and whether the GLP-1 component reliably offsets that in everyone, over years, is precisely what phase 3 and the cardiovascular outcome trial exist to find out.
No regulatory assessment anywhere, no SPC, no approved patient information, and no published long-term safety profile. The phase 3 liver trials are still recruiting, so the indication generating most of the interest is the least far along.
07Reported harms
Trial reporting has followed the class pattern, dominated by gastrointestinal effects. With no licence there is no authoritative frequency table and no Yellow Card coverage.
Grey-market product carries the usual unverifiable identity, purity, concentration and sterility problems, with the added issue that nobody outside the trials knows what a reasonable exposure even looks like.
08Interactions and cautions
No SPC, so no authoritative interaction list. The glucose effects of the glucagon component make combination with diabetes medication a genuine unknown rather than a theoretical one.
09Stopping
Not established outside trial conditions. No approved use exists, so there is no guidance on stopping.
10Monitoring
Trial participants are monitored closely, including for glucose and cardiovascular events. Nobody buying it online is monitored for anything.
11Questions worth asking
Take these to a doctor or pharmacist. A good clinician will not mind being asked, and the answers are specific to you in a way nothing on this page can be.
- Is there a UK trial recruiting that I could join? Be Part of Research lists them.
- Given this is years from a UK pharmacy, does a licensed option make sense now?
- If I have liver disease, has anyone actually investigated and staged it?
12Common questions
Is survodutide available in the UK?
No. It has no marketing authorisation anywhere in the world. The only lawful way to receive it is in an authorised clinical trial.
How does it compare to retatrutide and Mounjaro?
It cannot be compared reliably yet. Phase 2 figures looked competitive, but there are no published head-to-head trials against tirzepatide, and comparing across separately designed trials is unreliable.
Why is it being tested for liver disease?
Because the glucagon component acts directly on the liver and mobilises stored liver fat. Two phase 3 trials, LIVERAGE and LIVERAGE-Cirrhosis, are testing that specifically, including in people with established cirrhosis.
What does the glucagon part do?
Glucagon raises blood glucose, which sounds wrong for a metabolic drug. It also increases energy expenditure. The bet is that pairing it with GLP-1 offsets the glucose effect while keeping the energy expenditure benefit.
13Sources
Links go to the authoritative source. Where a document sits behind a paywall or moves around, the full citation is given so you can find it yourself.
- SYNCHRONIZE-CVOT trial record NCT06077864ClinicalTrials.gov
- LIVERAGE trial record NCT06632444ClinicalTrials.gov
- LIVERAGE-Cirrhosis trial record NCT06632457ClinicalTrials.gov
- Survodutide phase 2 resultsPubMed
- Be Part of ResearchNIHR
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