Also known as: BI 456906 · Surv
Updated 42 sources
Every Survodutide protocol on file, 10 in all, labelled by where each number came from. 2 have titration steps, each step is worked out in U-100 units for a 6 mg vial + 1 mL water.
Who: Adults with obesity or overweight in the 76-week SYNCHRONIZE-1 (725 people, no diabetes) and SYNCHRONIZE-2 (752 people, type 2 diabetes) trials.
Timing: Sites could pause 1 to 2 doses, delay a step, or drop one dose level for 2 to 4 weeks when stomach side effects were hard to handle.
Note: The global step schedule is published only as a trial figure. The Chinese sister trial's written schedule is the next entry.
Who: Chinese adults with obesity in the phase 3 SYNCHRONIZE-CN trial, as set out in its design paper.
Timing: The 3.6 mg arm stops climbing at 3.6 mg. Doses could be cut between weeks 16 and 28 if diet advice, symptom medicine and a short pause did not settle side effects.
| When | Dose | U-100 units (6 mg vial + 1 mL water) |
|---|---|---|
| Weeks 1 to 4 | 0.3 mg | 5 units · 0.05 mL |
| Weeks 5 to 8 | 0.6 mg | 10 units · 0.1 mL |
| Weeks 9 to 12 | 1.2 mg | 20 units · 0.2 mL |
| Weeks 13 to 16 | 2.4 mg | 40 units · 0.4 mL |
| Weeks 17 to 20 | 3.6 mg | 60 units · 0.6 mL |
| Weeks 21 to 76 | 4.8 mg | 80 units · 0.8 mL |
Who: 387 adults with a BMI of 27 or more and no diabetes, in 12 countries.
Timing: Weight loss at 46 weeks by planned dose: 6.2% at 0.6 mg, 12.5% at 2.4 mg, 13.2% at 3.6 mg, 14.9% at 4.8 mg, vs 2.8% on placebo. People who stayed on 4.8 mg lost 18.7%.
Note: The fast 2-week steps drove most stomach side effects, so phase 3 slowed the climb.
Who: A dosing guide's own schedule for a 10 mg vial mixed with 2 mL. It climbs faster than phase 3, which slowed the steps to cut side effects.
| When | Dose | U-100 units (6 mg vial + 1 mL water) |
|---|---|---|
| Weeks 1 to 2 | 0.6 mg | 10 units · 0.1 mL |
| Weeks 3 to 4 | 1.2 mg | 20 units · 0.2 mL |
| Weeks 5 to 6 | 1.8 mg | 30 units · 0.3 mL |
| Weeks 7 to 8 | 2.4 mg | 40 units · 0.4 mL |
| Weeks 9 to 10 | 3.6 mg | 60 units · 0.6 mL |
| Weeks 11 to 12 | 4.8 mg | 80 units · 0.8 mL |
| Weeks 13 to 16 | 6 mg | 100 units · 1 mL |
Who: 411 adults with type 2 diabetes on metformin, BMI 25 to 50.
Timing: Survodutide at 1.8 mg weekly or more cut more weight than open-label semaglutide 1.0 mg, which gave 5.3%.
Who: Adults with type 2 diabetes on metformin in the same 16-week phase 2 trial.
Timing: The 1.8 mg twice-weekly arm gave the trial's largest weight loss, 8.7% at 16 weeks. Later trials kept once-weekly dosing.
Who: 293 adults with biopsy-confirmed MASH and fibrosis stage F1 to F3.
Timing: MASH improved without worse fibrosis in 47%, 62% and 43% of the 2.4, 4.8 and 6.0 mg groups, vs 14% on placebo.
Who: 216 adults with obesity and at-risk MASLD, in the United States and Spain.
Timing: Doses could drop to a floor of 2.4 mg. Weight loss at 48 weeks: 12.2% on the efficacy estimand and 8.7% on the treatment-regimen estimand, vs 1.0% and 1.4% on placebo.
Who: Self-reported use outside trials. One tracking site sums community reports as 0.3 to 6 mg weekly with 300 mcg as a common first dose; r/Survodutide posts mostly start at 0.3 or 0.6 mg and settle between 1 and 2.8 mg. No consensus protocol exists.
Note: A 0.3 mg start matches the first step of SYNCHRONIZE-CN, and posters say they copied it from the trials. Most Reddit logs are survodutide added to tirzepatide; see the next entry.
Who: People already on tirzepatide who hit a weight-loss plateau, as posted on r/Survodutide. Doses below are survodutide only; tirzepatide stays at 5 to 15 mg in these posts.
Note: No trial has tested survodutide with tirzepatide. Both act on GLP-1, so stomach effects stack: posters report vomiting or diarrhea after climbing to about 2.4 mg on top of tirzepatide.
Doses shown are what sources report, labelled by origin. Not medical advice.
| Water | Strength | 0.3 mgdose, units | 4.8 mgdose, units | 6 mgdose, units |
|---|---|---|---|---|
| 5 mg vial | ||||
| 1 mLCompetitor guide† | 5 mg/mL | 60.06 mL | 960.96 mL | 1201.2 mL2 draws |
| 2 mLCompetitor guide† | 2.5 mg/mL | 120.12 mL | 1921.92 mL2 draws | 2402.4 mL3 draws |
| 6 mg vial | ||||
| 1 mLCompetitor guide | 6 mg/mL | 50.05 mL | 800.8 mL | 1001 mL |
| 2 mLCompetitor guide | 3 mg/mL | 100.1 mL | 1601.6 mL2 draws | 2002 mL2 draws |
| 10 mg vial | ||||
| 1 mLCompetitor guide | 10 mg/mL | 30.03 mL | 480.48 mL | 600.6 mL |
| 2 mLCompetitor guide | 5 mg/mL | 60.06 mL | 960.96 mL | 1201.2 mL2 draws |
| 20 mg vial | ||||
| 2 mLCommunity-reported | 10 mg/mL | 30.03 mL | 480.48 mL | 600.6 mL |
Doses shown are what sources report, labelled by origin. Not medical advice.
Calculate with this peptideYour vial, your water, your dose: Survodutide in syringe units, with the math shown.Diluent: Bacteriostatic water
Water volumes sources use: 1 mL, 2 mL
Run the water down the vial wall, then swirl gently. Do not shake. Every trial used pre-filled syringes, so no trial ever mixed survodutide from powder. At 5 mg/mL a 6.0 mg dose is 1.2 mL, more than a 1 mL insulin syringe holds; one guide splits it into two shots or uses a larger syringe.
SYNCHRONIZE-1 and -2 stepped people up to 3.6 mg or 6.0 mg once a week and held that dose to week 76. Phase 2 tested 0.6 to 4.8 mg for obesity and 2.4 to 6.0 mg for MASH. The MASLD trial used 6.0 mg with a floor of 2.4 mg if people needed to step down.
The Chinese phase 3 trial wrote it out: 0.3 mg, then 0.6, 1.2, 2.4, 3.6 and 4.8 mg, moving up every 4 weeks. Phase 2 climbed every 2 weeks over 20 weeks, which caused more stomach trouble, so phase 3 slowed down and allowed pauses and one-step dose cuts.
In SYNCHRONIZE-1 (no diabetes), average loss at 76 weeks was 12.2% at 3.6 mg and 13.0% at 6.0 mg, vs 5.4% on placebo, counting everyone who started. For people who stayed on treatment it was up to 16.6% vs 3.2%. With type 2 diabetes (SYNCHRONIZE-2) it was 8.2% and 9.8% vs 3.9%.
Guides use 1 or 2 mL. With 2 mL you get 5 mg/mL, so each unit on a U-100 insulin syringe is 50 mcg. With 1 mL you get 10 mg/mL, so each unit is 100 mcg. More water makes small doses easier to measure.
21 sources, each checked by date. Record updated Oct 24, 2026. Numbers are restated in our own words and labelled by where they came from.
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