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Reviewed by MyPeptideMatch Editorial TeamLast reviewed February 2026Updated February 2026

Survodutide Dosing Protocol: 10 mg Vial — Week-by-Week Titration & Supplies

Complete titration schedule and reconstitution guide for survodutide (BI 456906) using the 10 mg compounded vial, based on Phase 2b OASIS trial data.

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Quickstart highlights

Survodutide (BI 456906, Boehringer Ingelheim) is a once-weekly dual GLP-1/glucagon receptor agonist.

  • Concentration: 5 mg/mL (10 mg vial + 2 mL bacteriostatic water).
  • At 5 mg/mL: 0.3 mg = 6 units, 0.9 mg = 18 units, 1.8 mg = 36 units, 3.6 mg = 72 units.
  • OASIS Phase 2b trial: 3.6 mg dose achieved 14.9% body weight reduction at 46 weeks.
  • One 10 mg vial provides approximately 2.8 maintenance doses at 3.6 mg/week.
  • Monitor liver enzymes monthly — glucagon agonism can transiently elevate ALT/AST.

Dosing table

For educational reference only. Your prescribing provider may adjust doses based on your clinical profile and response.

WeekDose (µg)UnitsFrequencyNotes
1-43006Once weekly0.3 mg starting dose — 6 units; assess GI tolerability before advancing
5-890018Once weekly0.9 mg — 18 units; step-3x increase typical of dual agonist titration
9-12180036Once weekly1.8 mg — 36 units; mid-dose assessment
13-16360072Once weekly3.6 mg maintenance — 72 units; highest dose from Phase 2b OASIS trial

Gradual approach

WeekDose (µg)UnitsNotes
1-83006Extend 0.3 mg phase to 8 weeks for sensitive patients
9-16900180.9 mg for 8 weeks before advancing to 1.8 mg

Reconstitution steps

  1. Draw 2 mL bacteriostatic water into a 3 mL syringe; inject slowly down the vial wall.
  2. Swirl gently until lyophilized powder dissolves completely; do not shake.
  3. Final concentration: 5 mg/mL (10 mg / 2 mL). At 5 mg/mL: 1 unit = 50 µg.
  4. Label with date and concentration; refrigerate at 2–8 °C immediately. Use within 28 days.

Supplies needed

8-week plan

  • 1 vial
  • 8 syringes
  • 2 mL bac water
  • 8 alcohol swabs

16-week plan

  • 1 vial
  • 16 syringes
  • 2 mL bac water
  • 16 alcohol swabs
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Protocol overview & cycle notes

Support weight loss and hepatic fat reduction through dual GLP-1/glucagon receptor agonism, titrating survodutide from 0.3 mg to 3.6 mg over 12 weeks per Phase 2b OASIS trial protocol.

Cycle length: 16 weeks on.

Off-cycle: 8 weeks off between cycles; monitor liver enzymes and body weight during off-cycle.

Storage & handling

Lyophilized: store below 25 °C. Reconstituted at 5 mg/mL: refrigerate 2–8 °C; use within 28 days. Protect from light. One 10 mg vial provides 16 doses at 0.3 mg, 11 doses at 0.9 mg, or ~2.8 doses at 3.6 mg maintenance.

Injection & tracking tips

  • Rotate injection sites weekly (abdomen, outer thigh, upper arm).
  • Hepatic side effects: survodutide's glucagon agonism increases liver enzyme activity — monitor ALT/AST monthly at doses ≥1.8 mg.
  • Inject at a consistent weekly time; survodutide's once-weekly design allows ±24-hour flexibility.

Tracking

Logging helps you and your provider spot patterns and adjust dose or timing.

  • Log body weight weekly; expect accelerated weight loss at 1.8–3.6 mg doses.
  • Record ALT/AST labs monthly — glucagon component may transiently elevate liver enzymes.
  • Track stool consistency and frequency; diarrhea is most common at dose increases.
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How this works & references

Survodutide (BI 456906, Boehringer Ingelheim) is a once-weekly dual GLP-1/glucagon receptor agonist. The OASIS Phase 2b trial (NCT04667377, n=387) demonstrated 14.9% body weight reduction at 46 weeks at the 3.6 mg dose. MASH (metabolic-associated steatohepatitis) Phase 3 trials are ongoing. The glucagon receptor component drives preferential visceral and hepatic fat reduction, while GLP-1 agonism controls appetite and insulin secretion.

Sources

Frequently asked questions

What distinguishes survodutide from semaglutide for weight loss?
Survodutide adds glucagon receptor agonism to GLP-1, targeting hepatic fat oxidation and thermogenesis — mechanisms that semaglutide does not activate. This produces greater visceral fat and liver fat reduction relative to total body weight loss. However, semaglutide has more Phase 3 efficacy data and is FDA-approved.
Is survodutide FDA-approved?
No — as of February 2026, survodutide is in Phase 3 trials for obesity and MASH. FDA approval is not expected before 2027. It is available as a compounded research peptide.
Why does survodutide titrate in such large steps (0.3 to 0.9 mg)?
The 3x dose escalation per step reflects Phase 2b titration design, which was tested in the OASIS trial. Slower titration (e.g., 0.3 → 0.6 → 0.9 mg) is more conservative and used in sensitive patients to minimize nausea and diarrhea.
Can survodutide help with fatty liver disease?
Yes — Phase 3 trials specifically target MASH/NASH. Phase 2b data showed significant liver fat reduction (MRI-PDFF) at 3.6 mg. This hepatic benefit is driven by glucagon receptor activation increasing hepatic fatty acid β-oxidation.
How many vials do I need for a 16-week cycle?
One 10 mg vial is typically sufficient for weeks 1–14 at the standard titration (total dose used: ~0.3×4 + 0.9×4 + 1.8×4 + 3.6×2 = 1.2 + 3.6 + 7.2 + 7.2 = 19.2 mg). A second vial is needed to complete the 3.6 mg maintenance phase beyond week 14.

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This content is for informational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any peptide therapy. Dosing and protocols may vary by formulation and prescriber.

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