Survodutide (10 mg Vial) Dosage Protocol
Survodutide (BI 456906) is an investigational dual GLP-1/glucagon receptor agonist under development for obesity and metabolic liver disease. Phase 2 trials showed 12.5–14.9% weight loss vs placebo over 46 weeks with weekly subcutaneous dosing.
⚡ Quickstart Highlights
Dosing & Reconstitution Guide
Route: Subcutaneous | Frequency: Once weekly | Half-life: ~5–7 days
Standard Approach (2 mL = 5.00 mg/mL)
Reconstituting with 2 mL bacteriostatic water produces a concentration of 5.00 mg/mL. Volume per dose changes with concentration; mg dose itself does not change between vial sizes.
| Phase / Protocol | Dose | U-100 Units | Volume | Doses per vial |
|---|---|---|---|---|
| Weeks 1–2 (titration) | 600 mcg | 12 units | 0.12 mL | 16 doses |
| Weeks 3–4 | 1.2 mg | 24 units | 0.24 mL | 8 doses |
| Weeks 5–6 | 1.8 mg | 36 units | 0.36 mL | 5 doses |
| Weeks 7–8 | 2.4 mg | 48 units | 0.48 mL | 4 doses |
| Weeks 9–10 | 3.6 mg | 72 units | 0.72 mL | 2 doses |
| Weeks 11–12 | 4.8 mg | 96 units | 0.96 mL | 2 doses |
| Week 13+ (target) | 6 mg | 120 units | 1.20 mL | 1 doses |
Reconstitution Steps
- Wipe the vial stopper and BAC water vial with alcohol; let dry.
- Draw 2 mL of bacteriostatic water into a sterile syringe.
- Inject slowly down the inside glass wall of the peptide vial. Do not aim at the powder.
- Gently swirl until fully dissolved. Do not shake.
- Label with reconstitution date. Refrigerate at 2–8°C; use within 30 days.
Supplies Needed
Estimates for an 8-week and 12-week cycle at 2.4 mg per dose, once weekly (1 dose/week).
| Item | 8-Week Cycle | 12-Week Cycle |
|---|---|---|
| Survodutide (10 mg) vials | 2 vials | 3 vials |
| Insulin syringes (U-100) | 8 | 12 |
| Bacteriostatic water (10 mL) | 1 × 10 mL | 1 × 10 mL |
| Alcohol swabs | 1 × 100-pack | 2 × 100-pack |
Protocol Overview
Survodutide is an investigational dual GLP-1/glucagon receptor agonist studied for obesity and metabolic liver disease. Phase 2 trials showed dose-dependent weight loss of 12.5–14.9% versus placebo over 46 weeks. Phase 3 SYNCHRONIZE trials are ongoing at doses up to 6 mg weekly.
The dual mechanism (GLP-1 satiety + glucagon energy expenditure) provides additive effects on body weight and liver fat beyond GLP-1 agonism alone.
Dosing Protocol
Weekly titration (subcutaneous, once weekly):
- Weeks 1–2 (titration): 0.6 mg (600 mcg) weekly.
- Weeks 3–4: 1.2 mg weekly.
- Weeks 5–6: 1.8 mg weekly.
- Weeks 7–8: 2.4 mg weekly.
- Weeks 9–10: 3.6 mg weekly.
- Weeks 11–12: 4.8 mg weekly.
- Week 13+ (target): 6.0 mg weekly maintenance.
Cycle: 12–16 weeks minimum. Phase 3 trials extend to 48–72 weeks.
Note on 6 mg dose: 6.0 mg = 1.20 mL, which exceeds a standard 1 mL U-100 insulin syringe. Use a 1 mL Luer-lock syringe or split into two injections at different sites.
Timing: Same day each week; rotate injection sites.
Storage Instructions
| State | Temperature | Duration |
|---|---|---|
| Lyophilized | −20°C (−4°F) | Up to 24 months, dry & dark |
| Reconstituted | 2–8°C (35–46°F) | Up to 30 days, protect from light |
Important Notes
How This Works
Survodutide activates both GLP-1 and glucagon receptors. The GLP-1 component enhances satiety and glycemic control, while the glucagon component increases energy expenditure and promotes hepatic lipid oxidation, providing additive effects on body weight and liver fat beyond GLP-1 alone.
Potential Benefits & Side Effects
Potential Benefits
- Phase 2 weight loss of 12.5–14.9% vs placebo over 46 weeks.
- Improved liver enzyme markers in NAFLD/NASH populations.
- Consistent efficacy across multiple randomized controlled trials.
Side Effect Profile
- GI effects: nausea, vomiting, diarrhea, constipation (most common during escalation).
- Gradual titration mitigates GI tolerability.
Lifestyle Factors
- Protein-forward diet to preserve lean mass.
- Combine resistance + aerobic training.
- Stay hydrated, especially during GI side effects.
Injection Technique
- Subcutaneous, once weekly.
- For 6 mg dose (>100 units), use 1 mL Luer-lock syringe or split into 2 injections.