Survodutide Reconstitution Calculator
Survodutide is not approved for human use anywhere. There is no prescribing information for it, so there is no boxed warning, no contraindication list, no drug-interaction table and no licensed maximum dose. It does have published human doses: every figure in the range table below was administered to people in a registered, published randomised trial, and each row names the trial it came from. The compound is a 29-amino-acid peptide derived from glucagon and re-engineered to also carry potent GLP-1 receptor activity, given once weekly by subcutaneous injection after a long escalation. Trial drug was a ready-made solution in a pre-filled syringe, so no reconstitution instruction has ever been published and no manufacturer storage conditions exist. Any lyophilised powder sold as survodutide or BI 456906 is not that drug, and its identity, purity and peptide content are unverified. The calculator above converts a vial size and a mixing volume into mg/ml and syringe units, which is arithmetic about a vial rather than a dose.
Curated by Dosavy from published literature and regulator labels. Published 11 September 2026, last reviewed 11 September 2026. No clinician reviews this page.
Enter a target dose above to see the draw.
What the evidence says
| Experience | Route | Range | Frequency |
|---|---|---|---|
| Beginner | Subcutaneous | 0.3–0.6 mg[1][2]Trial escalation entry point, not a maintenance target. The phase 1 cirrhosis study started at a single 0.3 mg subcutaneous dose and then escalated from 0.3 mg to 6.0 mg over 24 weeks; the phase 2 obesity trial's lowest maintenance arm was 0.6 mg once weekly, which produced a mean weight change of -6.2% at week 46 versus -2.8% on placebo. The phase 2 type 2 diabetes trial's lowest arm titrated up to 0.3 mg once weekly. These are protocol doses from registered trials, not a licensed starting regimen. | Once weekly |
| Intermediate | Subcutaneous | 2.4–3.6 mg[1][3][4]The mid maintenance doses, and the lower of the two doses taken into phase 3. In the phase 2 obesity trial, 2.4 mg gave -12.5% and 3.6 mg -13.2% mean weight change at week 46; in the phase 3 obesity trial, 3.6 mg once weekly gave -12.2% at week 76 versus -5.4% on placebo. 2.4 mg was also the lowest arm of the phase 2 MASH trial. Separately, the phase 2 type 2 diabetes trial studied a twice-weekly regimen (1.2 mg or 1.8 mg twice weekly) alongside once-weekly arms up to 2.7 mg; the twice-weekly schedule was not carried into later development, so nothing here licenses a twice-weekly interpretation of these numbers. | Once weekly |
| Advanced | Subcutaneous | 4.8–6 mg[1][3][5]The highest doses given to humans in the published trials: 4.8 mg was the top arm of the phase 2 obesity trial (-14.9% at week 46) and of a phase 1 multiple-rising-dose study, while 6.0 mg was the top arm of the phase 3 obesity trial and of the phase 2 MASH trial. Going higher bought little: 6.0 mg gave -13.0% versus 3.6 mg's -12.2% in phase 3, at the cost of gastrointestinal adverse events in 89.7% versus 80.9% of participants, and in MASH the histologic response was worse at 6.0 mg than at 4.8 mg. No published trial in this packet administered more than 6.0 mg once weekly. | Once weekly |
- BeginnerSubcutaneous
Once weekly
Trial escalation entry point, not a maintenance target. The phase 1 cirrhosis study started at a single 0.3 mg subcutaneous dose and then escalated from 0.3 mg to 6.0 mg over 24 weeks; the phase 2 obesity trial's lowest maintenance arm was 0.6 mg once weekly, which produced a mean weight change of -6.2% at week 46 versus -2.8% on placebo. The phase 2 type 2 diabetes trial's lowest arm titrated up to 0.3 mg once weekly. These are protocol doses from registered trials, not a licensed starting regimen.
- IntermediateSubcutaneous
Once weekly
The mid maintenance doses, and the lower of the two doses taken into phase 3. In the phase 2 obesity trial, 2.4 mg gave -12.5% and 3.6 mg -13.2% mean weight change at week 46; in the phase 3 obesity trial, 3.6 mg once weekly gave -12.2% at week 76 versus -5.4% on placebo. 2.4 mg was also the lowest arm of the phase 2 MASH trial. Separately, the phase 2 type 2 diabetes trial studied a twice-weekly regimen (1.2 mg or 1.8 mg twice weekly) alongside once-weekly arms up to 2.7 mg; the twice-weekly schedule was not carried into later development, so nothing here licenses a twice-weekly interpretation of these numbers.
- AdvancedSubcutaneous
Once weekly
The highest doses given to humans in the published trials: 4.8 mg was the top arm of the phase 2 obesity trial (-14.9% at week 46) and of a phase 1 multiple-rising-dose study, while 6.0 mg was the top arm of the phase 3 obesity trial and of the phase 2 MASH trial. Going higher bought little: 6.0 mg gave -13.0% versus 3.6 mg's -12.2% in phase 3, at the cost of gastrointestinal adverse events in 89.7% versus 80.9% of participants, and in MASH the histologic response was worse at 6.0 mg than at 4.8 mg. No published trial in this packet administered more than 6.0 mg once weekly.
Published ranges, reported as the literature states them and numbered to the sources at the foot of this page. Not a recommendation.
Survodutide at a glance
- Category
- GLP-1
- Half-life
- Not established
- Routes
- Subcutaneous
- Regulatory status
- Not approved
- Also sold as
- BI 456906, glucagon/GLP-1 dual agonist, GCGR/GLP-1R dual agonist
Mechanism
A 29-amino-acid peptide derived from glucagon and re-engineered to carry potent GLP-1 receptor activity, so it is a dual glucagon receptor (GCGR) and GLP-1 receptor agonist. The GLP-1 arm suppresses appetite and delays gastric emptying; the glucagon arm is intended to increase energy expenditure and drive hepatic fat mobilisation, which is why the compound is being developed for MASH and MASH-related cirrhosis as well as obesity. A C18 diacid mediates albumin binding and prolongs the half-life enough for once-weekly subcutaneous dosing. It contains no GIP activity, so it is not the same class as tirzepatide or retatrutide.
Reconstitution
There is no approved presentation and no published reconstitution instruction. Trials used a pre-filled syringe of ready-made solution. Any lyophilised powder sold as 'survodutide' or 'BI 456906' has unverified identity, purity and peptide content, so the milligram figures from the trials below cannot be assumed to describe what is in such a vial.
Storage
No approved product and therefore no manufacturer storage instructions exist. Trial material was supplied as a solution for injection in a pre-filled syringe under sponsor-controlled conditions; nothing in this packet establishes stability conditions for material obtained outside a trial.
Frequency in practice
Once weekly by subcutaneous injection, after a long dose-escalation period, 16 to 24 weeks in the published trials, which is markedly slower than approved GLP-1 titrations.
Regulatory
Investigational. Survodutide (BI 456906, Boehringer Ingelheim with Zealand Pharma) is not approved by the FDA, the EMA or Swissmedic for any indication. It has completed phase 2 trials in obesity, type 2 diabetes and MASH, has published phase 3 obesity results (SYNCHRONIZE), and has ongoing phase 3 programmes in MASH/cirrhosis (LIVERAGE) and cardiovascular outcomes.
What to know before anything else
Not approved for human use anywhere. There is no prescribing information, so there is no boxed warning, no contraindication list, no drug-interaction table and no approved maximum dose. The doses below are trial protocol doses, not a licensed regimen.
Material sold as 'survodutide' or 'BI 456906' outside a clinical trial is not the trial drug. Identity, purity, peptide content and sterility are unverified.
Tolerability is the defining constraint on this molecule. In the phase 3 obesity trial gastrointestinal adverse events occurred in 80.9% of participants at 3.6 mg and 89.7% at 6.0 mg, versus 47.9% on placebo. In the phase 2 obesity trial only 60% of participants completed the 46-week treatment period, and in a phase 1 study in Japanese men 10 of the 27 given survodutide (37%) withdrew during dose escalation because of adverse events: 9 of them for decreased appetite alone.
The published trials escalate the dose over 16 to 24 weeks, far more slowly than an approved GLP-1 titration. Compressing that schedule is not supported by any published data and is the most likely way to reproduce the discontinuation rates above.
Glucagon receptor agonism is not shared with semaglutide or tirzepatide. It raises hepatic glucose output and energy expenditure, so its net effect on glycaemic control, heart rate and liver enzymes differs from a pure GLP-1 agonist and is not fully characterised outside trial monitoring.
Notably, the phase 2 MASH trial found a non-monotonic dose response: histologic improvement was better at 4.8 mg (62%) than at 6.0 mg (43%). 'More' was not simply 'better' even inside the studied range.
Every FDA-approved GLP-1 receptor agonist carries a boxed warning for rodent thyroid C-cell tumors and is contraindicated with a personal or family history of medullary thyroid carcinoma or MEN 2. No regulator has publicly adjudicated whether that class warning applies to survodutide.
No published pregnancy, lactation or paediatric data.
Reviewed interactions
These are the pairs Dosavy holds reviewed, cited data on. A combination that is not listed here has not been assessed, which is not the same as being safe.
- Dangerouswith Tirzepatide
Do not combine. Tirzepatide's label states that coadministration with any GLP-1 receptor agonist is not recommended, and survodutide is one. Survodutide is unapproved with no label of its own, so nothing on that side defines a maximum dose, and the glucagon-receptor arm it adds brings its own heart-rate effects on top of duplicated GLP-1 agonism.[6]
Both agonise the GLP-1 receptor; tirzepatide adds GIP-receptor agonism and survodutide adds glucagon-receptor agonism. The duplicated GLP-1 activity compounds the class's gastrointestinal effects and dehydration risk.
Survodutide questions
Is survodutide approved, and how good is the evidence behind these doses?
It is investigational, developed by Boehringer Ingelheim with Zealand Pharma as BI 456906, and not approved by the FDA, the EMA or Swissmedic for any indication. The evidence is nonetheless randomised. The sources below are a 2024 phase 2 double-blind, placebo-controlled dose-finding trial in obesity with 386 participants, a 2024 phase 2 randomised trial in MASH and fibrosis with 293, a 2024 phase 2 dose-response trial in type 2 diabetes with 413 that reported HbA1c falling by up to 1.71 percentage points, a 2024 phase 1 open-label pharmacokinetic and safety trial in cirrhosis, and a 2026 phase 3 double-blind, placebo-controlled obesity trial with 725. Phase 3 programmes in MASH and cirrhosis and in cardiovascular outcomes are still running.
How does survodutide work, and how is it different from tirzepatide or retatrutide?
It agonises two receptors, GLP-1 and glucagon. The GLP-1 arm suppresses appetite and delays gastric emptying, the arm every drug in this class shares. The glucagon arm is the addition, intended to raise energy expenditure and mobilise fat out of the liver, and it is why the compound is being developed for MASH and MASH-related cirrhosis as well as obesity. It carries no GIP activity at all, so it is not the same class as tirzepatide or retatrutide. A C18 diacid binds it to albumin and stretches the half-life enough for once-weekly dosing; no numeric half-life is recorded in this library's source packet, so this page does not state one.
How much weight did people lose on survodutide in the trials?
In the 2026 phase 3 obesity trial, mean body-weight change over 76 weeks was -12.2% on the lower of the two doses and -13.0% on the higher, against -5.4% on placebo. The 2024 phase 2 dose-finding trial ran 46 weeks and reported -6.2% on its lowest maintenance arm and -14.9% on its highest, against -2.8% on placebo. Those are trial averages, produced under trial monitoring and on the escalation schedules those protocols specified.
Why do the trials escalate the dose over four to six months?
Because tolerability is the defining constraint on this molecule. The published protocols escalate over 16 to 24 weeks, markedly slower than an approved GLP-1 titration, and compressing that schedule is not supported by any published data. Even on those slow schedules the dropout rate is a headline finding rather than a footnote: in the 2024 phase 2 obesity trial only 60% of participants completed the 46-week treatment period, and in a phase 1 study in Japanese men, 10 of the 27 given survodutide, 37% of them, withdrew during dose escalation because of adverse events, 9 of those for decreased appetite alone.
What are the side effects, and does a higher dose work better?
Gastrointestinal adverse events dominate and they scale with dose. In the phase 3 obesity trial they occurred in 80.9% of the lower-dose group and 89.7% of the higher-dose group, against 47.9% on placebo. More was not simply better inside the studied range either: in the phase 2 MASH trial, histologic improvement was reported in 62% of the second-highest dose group and 43% of the highest, against 14% on placebo, a non-monotonic dose response. The glucagon arm also raises hepatic glucose output and energy expenditure, so the net effect on glycaemic control, heart rate and liver enzymes differs from a pure GLP-1 agonist and is not fully characterised.
Does a vial sold as BI 456906 contain what the trials used?
There is no basis to assume so. The trials used a ready-made solution for injection in a pre-filled syringe, prepared under sponsor-controlled conditions. There is no approved presentation, no published reconstitution instruction, and nothing establishing stability conditions for material obtained outside a trial, so no storage claim printed on such a vial has been tested for this peptide. Identity, purity, peptide content and sterility are all unverified.
Does the thyroid C-cell boxed warning apply to survodutide?
Nobody has ruled. Every FDA-approved GLP-1 receptor agonist carries a boxed warning for rodent thyroid C-cell tumors and is contraindicated with a personal or family history of medullary thyroid carcinoma or MEN 2, and no regulator has publicly adjudicated whether that class warning extends to survodutide. With no prescribing information there is no boxed warning and no contraindication list to consult, and no published pregnancy, lactation or paediatric data. Those are absences of assessment, not all-clears. The one combination this library holds cited data on is tirzepatide, recorded as dangerous: its label advises against coadministration with any GLP-1 receptor agonist, and survodutide is one.
Every number above, and where it came from
6 sources, numbered where they are used. Each one links to the paper or the label itself, not to a summary of it.
- [1]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 · Phase 2 randomised, double-blind, placebo-controlled dose-finding trial · n=386
- [2]Efficacy, tolerability and pharmacokinetics of survodutide, a glucagon/glucagon-like peptide-1 receptor dual agonist, in cirrhosis
Journal of Hepatology · 2024 · Phase 1 open-label pharmacokinetic and safety trial
- [3]Survodutide Once Weekly for the Treatment of Adults with Obesity
The New England Journal of Medicine · 2026 · Phase 3 randomised, double-blind, placebo-controlled trial · n=725
- [4]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 · Phase 2 randomised, double-blind, placebo-controlled, parallel-group trial · n=413
- [5]A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis
The New England Journal of Medicine · 2024 · Phase 2 randomised, double-blind, placebo-controlled trial · n=293
- [6]ZEPBOUND (tirzepatide) injection, for subcutaneous use: FDA prescribing information
2026 · FDA approved label
The rest of the math
- Reconstitution calculatorThe full version of the tool above, with syringe barrel sizes and IU conversion.
- Vial longevityHow many doses a vial holds and the date it runs out.
- Cost per doseVial price against doses drawn, so two vial sizes can be compared honestly.
- Half-life and decayFirst-order clearance, time to steady state, and what remains at a given hour.
- GLP-1 titration scheduleEscalation steps and week-by-week timing for GLP-1 receptor agonists.
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A calculator answers once and forgets. Dosavy keeps the concentration you mixed, the doses you actually took, and a reminder for the next one, with the same evidence labels you see on this page.