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Research use only · common protocol

Survodutide 10 mg vial dosage

A 10 mg Survodutide vial mixed with 1 mL of bacteriostatic water gives 10 mg/mL, so 3.5 mg is 35 units (0.35 mL) on a U-100 insulin syringe. At 3.5 mg a dose, one vial holds 2 doses.

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The common Survodutide protocol is 0.6-6 mg, once weekly, starting around 0.6 mg; the phase 2 trial titrated over about 20 weeks to a 2.4-4.8 mg maintenance dose, while the published phase 3 SYNCHRONIZE-1 trial randomizes to a higher 3.6 or 6.0 mg maintenance target using a slower, flexible up-titration - common practice, not a dose established in trials. Evidence, side effects and legal status are on the full Survodutide dosing page.

Survodutide 10 mg vial at a glance

Vial
10 mg of Survodutide per vial
Common dose
0.6-6 mg
How often
once weekly, starting around 0.6 mg; the phase 2 trial titrated over about 20 weeks to a 2.4-4.8 mg maintenance dose, while the published phase 3 SYNCHRONIZE-1 trial randomizes to a higher 3.6 or 6.0 mg maintenance target using a slower, flexible up-titration
Mixing example
1 mL bacteriostatic water = 10 mg/mL; 1 unit = 100 mcg
Doses per vial
16 at 600 mcg · 2 at 3.5 mg · 1 at 6 mg
Route
Subcutaneous injection

What Survodutide is

Class:
Synthetic dual GLP-1/glucagon receptor agonist peptide
Also called:
BI 456906
Used for:
An investigational injectable peptide, not approved for any use. Its sponsor, Boehringer Ingelheim, is studying it in Phase 3 trials for chronic weight management and, in a separate programme, for MASH (metabolic dysfunction-associated steatohepatitis). It is also sold directly to consumers as a research chemical outside those trials.
Human evidence:
Moderate human evidence. Two Phase 3, randomised, double-blind, placebo-controlled trials are registered and completed per ClinicalTrials.gov: SYNCHRONIZE-1 (weight loss without diabetes; primary completion 2 December 2025, study completion 20 February 2026) and SYNCHRONIZE-CVOT (cardiovascular safety, completed 30 June 2026), both sponsored by Boehringer Ingelheim. SYNCHRONIZE-1 is published in the New England Journal of Medicine (2026): among 725 adults, average weight fell 12.2% on survodutide up to 3.6 mg and 13.0% on up to 6.0 mg at 76 weeks, against 5.4% on placebo. SYNCHRONIZE-CVOT results were not published in a source this page checked, and no regulator has yet reviewed or approved survodutide for any indication.
US status:
Research use only. Not approved by FDA or any other regulator for any indication. It remains an investigational drug inside company-sponsored trials. Outside those trials it is sold to consumers as a "research use only" peptide, the same grey-market pattern FDA has documented for compounded semaglutide and tirzepatide. Australian status was not independently confirmed this session.

The full picture, with every study: Survodutide guide.

Units per dose: Survodutide 10 mg vial

Water addedConcentration1 unit =600 mcg3.5 mg6 mg
1 mL10 mg/mL100 mcg6 units35 units60 units
1.5 mL6.67 mg/mL66.67 mcg9 units52.5 units90 units
2 mL5 mg/mL50 mcg12 units70 unitsover 100 units

U-100 insulin syringe (100 units = 1 mL), to the nearest half unit. Water volumes are examples. Other numbers: dosage calculator.

Every dose from 600 mcg to 6 mg, in units

With 1 mL of water in a 10 mg vial (10 mg/mL). Every dose across the common range, so you can read off any dose. The sources give a range, not a week-by-week schedule.

DoseDraw on a U-100 syringeVolumeDoses per vial
600 mcg6 units0.06 mL16
1 mg10 units0.1 mL10
2 mg20 units0.2 mL5
3 mg30 units0.3 mL3
4 mg40 units0.4 mL2
5 mg50 units0.5 mL2
6 mg60 units0.6 mL1

How many doses a 10 mg vial holds

DoseDoses per vialWeeks per vial
600 mcg1616
3.5 mg22
6 mg11

Weeks per vial at the common frequency (once weekly, starting around 0.6 mg; the phase 2 trial titrated over about 20 weeks to a 2.4-4.8 mg maintenance dose, while the published phase 3 SYNCHRONIZE-1 trial randomizes to a higher 3.6 or 6.0 mg maintenance target using a slower, flexible up-titration). Doses per vial do not depend on how much water you add.

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The common Survodutide protocol

Dose0.6-6 mg per injection
How oftenonce weekly, starting around 0.6 mg; the phase 2 trial titrated over about 20 weeks to a 2.4-4.8 mg maintenance dose, while the published phase 3 SYNCHRONIZE-1 trial randomizes to a higher 3.6 or 6.0 mg maintenance target using a slower, flexible up-titration
RouteSubcutaneous injection
CycleNo cycle length is stated consistently by the sources
BreakNo break length is stated consistently by the sources
Sources agree?Partly - the sources differ, and the ranges above cover them

Common practice from the vendors and clinics that publish it, not a dose tested in trials. Where it comes from: [1], [2]. I do not give week-by-week titration: none of these sources states one.

Supplies for four weeks with 10 mg vials

Counted for the low and high ends of the common protocol over four weeks, since the sources give no fixed cycle length, mixing each vial with 1 mL of water. One new syringe per injection.

PlanInjections10 mg vialsInsulin syringesBacteriostatic waterAlcohol swabs
600 mcg, 1×/week, 4 weeks4141 mL (1 × 10 mL bottle)10 (1 × 100-pack)
6 mg, 1×/week, 4 weeks4343 mL (1 × 10 mL bottle)14 (1 × 100-pack)

Arithmetic on the protocol and this vial size. Swabs: two per vial mixed (both stoppers) and two per injection (vial stopper and skin). An opened multi-dose vial has a use-by date (see storage), which on a slow schedule can matter more than the dose count. Plan your own numbers with the protocol builder.

How to mix a 10 mg Survodutide vial

For this vial: 1 mL of bacteriostatic water makes 10 mg/mL, so 3.5 mg is 35 units (0.35 mL) on a U-100 insulin syringe. Pick a different volume from the units table if you want bigger or smaller draws; the number of doses stays the same.

  1. Wipe the rubber stoppers of both the peptide vial and the bacteriostatic water vial with an alcohol swab and let the alcohol dry. [3][4]
  2. With a new sterile needle and syringe, draw up the amount of bacteriostatic water you have chosen for the dilution. [3][4][5]
  3. Inject the water into the peptide vial by aiming the stream against the inside glass wall, which helps prevent foaming. [6]
  4. Swirl or roll the vial gently until the powder has fully dissolved; do not shake it. Do not inject the solution if it is cloudy or has particles in it. [3][4][6]
  5. Label the vial with the date and time it was mixed, the amount of water added and how long it can be used after mixing. [3]
  6. Store the mixed vial in the refrigerator at 2-8°C (36-46°F) and do not freeze it. [6]

Step by step with pictures: how to reconstitute peptides. About the water itself: bacteriostatic water.

Storing Survodutide vials

  • Freeze-dried (lyophilized) peptide keeps far longer than peptide in solution; peptide suppliers advise storing the powder at -20°C away from bright light. [7]
  • Protect peptide vials from heat and light. [7][8]
  • Avoid repeated freeze-thaw cycles; a prescription peptide label also says not to freeze a vial once it has been mixed. [6][7]
  • Once a multi-dose vial, such as bacteriostatic water, has been opened (needle-punctured), date it and discard it within 28 days unless its manufacturer states another date. [9][10]

More detail: peptide storage and shelf life.

Injecting safely

  • Clean the injection site with an alcohol swab and let the skin dry completely before injecting. [11][12]
  • Pinch up a fold of skin and fat (not muscle) and insert the needle at a 45- to 90-degree angle: 90 degrees where there is enough fatty tissue, 45 degrees where there is little. [11][12][13]
  • Pulling back on the plunger (aspiration) is not necessary for a subcutaneous injection, because the chance of the needle being in a blood vessel is small. [11]
  • Inject slowly, at roughly 10 seconds per mL. [11]
  • Common sites are the belly, the thigh and the upper arm; rotate sites, keeping each injection at least 1 inch (2.5 cm) from the last. [6][11][12]

Hygiene and warning signs

  • Use a new sterile needle and syringe for every injection and every time you enter a vial; never reuse them. [5][9][12]
  • Never share needles, syringes or pens with anyone, even if the needle is changed; unsafe injection practices spread hepatitis B, hepatitis C and HIV. [5][8][9]
  • Put used needles and syringes in a sharps disposal container straight away (FDA-cleared if possible), never loose in the trash, recycling or toilet, and dispose of the container following your community's guidelines. [14][15]
  • Contact a health care provider if the injection site shows signs of infection, such as redness, swelling, red streaks or a fever. [12]

Where to inject: subcutaneous injection sites.

How Survodutide works

  • Survodutide (BI 456906) is a peptide that activates both the glucagon receptor and the GLP-1 receptor. A C18 fatty acid is attached so that it lasts long enough for once-weekly dosing. [16]
  • In mice, it lowered body weight more than the highest effective doses of semaglutide. The researchers attributed this to two effects together: burning more energy and eating less. [16]
  • Human and mouse tissue studies found the glucagon receptor barely detectable in two brain areas that control appetite, while the GLP-1 receptor was present. In mice, the appetite-lowering effect appeared to come from GLP-1 receptor activity; a glucagon-only agonist did not reduce food intake but still lowered body weight. [17]

What the Survodutide research found

Human evidence: moderate human evidence. Each result says what was studied.

  • Human studyIn SYNCHRONIZE-1, a 76-week phase 3 randomised trial of 725 adults with obesity and no diabetes, body weight fell by 12.2% on survodutide up to 3.6 mg and 13.0% on up to 6.0 mg, against 5.4% on placebo. [18]
  • Human studyIn a 46-week phase 2 randomised dose-finding trial of 387 adults with a BMI of 27 or more and no diabetes, planned doses of 0.6 to 4.8 mg weekly lowered body weight by 6.2% to 14.9%, against 2.8% on placebo. Only 233 of the 386 treated participants (60.4%) completed the full treatment period. [19]
  • Human studyIn a 48-week phase 2 trial of 293 adults with biopsy-confirmed MASH (fatty liver inflammation) and fibrosis, the liver disease improved without worsening fibrosis in 47%, 62% and 43% of people on 2.4, 4.8 and 6.0 mg, against 14% on placebo. [20]
  • Human studyIn a 16-week phase 2 trial of 413 adults with type 2 diabetes on metformin, survodutide lowered HbA1c by up to 1.71% and body weight by up to 8.7%. Doses of 1.8 mg weekly or more lowered weight more than open-label semaglutide (5.3%). [21]

Survodutide side effects and risks

Survodutide has no regulator-reviewed label. The safety data come from trials funded by its sponsor, Boehringer Ingelheim.

  • Human studyIn SYNCHRONIZE-1, gastrointestinal symptoms (mostly mild to moderate) affected 80.9% of people on 3.6 mg and 89.7% on 6.0 mg, against 47.9% on placebo. No deaths were reported. [18]
  • Human studyIn the MASH trial, nausea (66% vs 23%), diarrhoea (49% vs 23%) and vomiting (41% vs 4%) were more common on survodutide than on placebo. Serious adverse events occurred in 8% on survodutide and 7% on placebo. [20]
  • Human studyIn the phase 2 obesity trial, 91% of survodutide recipients reported adverse events against 75% on placebo, mainly gastrointestinal (75% vs 42%). [19]
  • Human studyIn the phase 2 diabetes trial, 77.8% of people on survodutide reported adverse events, mainly gastrointestinal, against 52.5% on placebo and 52.0% on semaglutide. The authors suggested slower dose escalation could reduce these dose-related effects. [21]
  • Human studyIn a 16-week phase 1 study of Japanese men with overweight or obesity, 10 of 27 people on survodutide (37.0%) withdrew from dose escalation because of adverse events, mostly decreased appetite. [22]
  • Human studyA 2026 review of glucagon/GLP-1 dual agonists reports that survodutide and mazdutide generally raised heart rate by about as much as GLP-1-only drugs. Survodutide's cardiovascular safety is being tested in the SYNCHRONIZE-CVOT trial. [23]

Other things to know

  • Not approved anywhere. Nobody outside the sponsor-run trials has independently verified its safety or efficacy in humans, and its safety database is still accumulating.
  • The trials are testing a subcutaneous injectable peptide manufactured, dosed and quality-controlled by the sponsor. A "research use only" vial bought online is not that product, and has none of that oversight, purity testing or sterility control.
  • It combines two active hormone-receptor mechanisms (GLP-1 and glucagon) in one molecule. That dual action is also the stated reason Boehringer Ingelheim is testing it in liver disease - and it is a mechanism with no long-term, independently published human safety record outside the sponsor trials.
  • As a dual receptor agonist in the same broad drug class as approved GLP-1 medicines, expect a comparable gastrointestinal adverse-reaction pattern (nausea, vomiting, diarrhoea). In the published SYNCHRONIZE-1 trial, gastrointestinal symptoms, mostly mild to moderate, affected 80.9% of people on 3.6 mg and 89.7% on 6.0 mg, against 47.9% on placebo.
  • A research-labelled peptide sold for "laboratory use only" is, under reasoning FDA has applied to other unapproved peptides sold the same way, treated as intended for human use once it is marketed and sold with dosing information - a labelling convention, not a legal shield, and not the trial-grade product.

Reported side effects and what the studies measured: Survodutide side effects.

Where this vial size comes from

Survodutide is sold as a 10 mg vial by the pages below, each checked on the date shown. I list them as evidence that this size exists, not as a recommendation to buy from them.

  • Loti LabsvendorLists it as: "Survodutide 10mg" - ≥98% purity, lyophilized powder · checked 2026-09-28
  • MyGLP1StorevendorLists it as: "SURV" product details: "Quantity: 10mg per vial" · checked 2026-09-28

The doses come from the sourced common protocol on the Survodutide dosing page, and every number on this page is arithmetic on those doses and this vial size.

Questions

How much water do I add to a 10 mg Survodutide vial?
There is no single correct amount: water changes how many units a dose is, not how many doses the vial holds. With 1 mL the vial is 10 mg/mL and 3.5 mg is 35 units (0.35 mL) on a U-100 insulin syringe. The units table gives 1, 1.5, 2 mL.
How many doses are in a 10 mg Survodutide vial?
16 doses at 600 mcg, 2 doses at 3.5 mg, 1 dose at 6 mg.
How long does a 10 mg Survodutide vial last?
At 3.5 mg a dose and once weekly, about 2 weeks. How long a mixed vial keeps is a separate limit; see storage below.
How many 10 mg vials do I need for a 4-week run?
1 vial at 600 mcg 1 time a week for 4 weeks; 3 vials at 6 mg 1 time a week for 4 weeks.
What does 1 unit equal in a 10 mg Survodutide vial?
100 mcg with 1 mL, 66.67 mcg with 1.5 mL, 50 mcg with 2 mL of bacteriostatic water, on a U-100 syringe.

References (23 sources)

  1. [1] Diabetes, Obesity and Metabolism (Wiley, via PubMed Central): Published phase 3 SYNCHRONIZE-1 RCT: survodutide SC once weekly, randomized to 3.6 mg or 6.0 mg maintenance via flexible up-titration (assessed every 2-4 weeks during escalation), 76-week treatment period (publication, checked 2026-09-27)
  2. [2] Peptide Dosing Protocols: Phase 2 trial reporting: 0.6 mg weekly start, dose arms 0.6/2.4/3.6/4.8 mg, escalation over first 20 weeks then steady for 26 weeks (46 weeks total) (other, checked 2026-09-27)
  3. [3] OpenStax, Rice University: 12.3 Preparing Unit-Dose Packaged Medications - Clinical Nursing Skills
  4. [4] East Carolina University College of Nursing: Reconstitution of Medication
  5. [5] Centers for Disease Control and Prevention: Considerations for Blood Glucose Monitoring and Insulin Administration
  6. [6] DailyMed, National Library of Medicine: SEROSTIM (somatropin) for injection - prescribing information and instructions for use
  7. [7] GenScript: Peptide Storage and Handling Guidelines
  8. [8] DailyMed, National Library of Medicine: OZEMPIC (semaglutide) injection - prescribing information
  9. [9] Centers for Disease Control and Prevention: Preventing Unsafe Injection Practices
  10. [10] Pfizer: Bacteriostatic Water for Injection, USP - prescribing information
  11. [11] OpenStax, Rice University: 12.5 Administering Subcutaneous Injections - Clinical Nursing Skills
  12. [12] MedlinePlus, National Library of Medicine: Subcutaneous (SQ) injections
  13. [13] Centers for Disease Control and Prevention: Chapter 6: Vaccine Administration - Pink Book
  14. [14] US Food and Drug Administration: Best Way to Get Rid of Used Needles and Other Sharps
  15. [15] US Food and Drug Administration: DOs and DON'Ts of Proper Sharps Disposal
  16. [16] Zimmermann T, Thomas L, Baader-Pagler T et al. BI 456906: Discovery and preclinical pharmacology of a novel GCGR/GLP-1R dual agonist with robust anti-obesity efficacy. Mol Metab. 2022;66:101633.
  17. [17] Zimmermann T, Bleymehl K, Haebel P et al. Survodutide acts through circumventricular organs in the brain and activates neuronal regions associated with appetite regulation. Mol Metab. 2026;105:102326.
  18. [18] le Roux CW, Wharton S, Startseva E et al. Survodutide Once Weekly for the Treatment of Adults with Obesity. N Engl J Med. 2026;395(8):776-787.
  19. [19] le Roux CW, Steen O, Lucas KJ et al. Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial. Lancet Diabetes Endocrinol. 2024;12(3):162-173.
  20. [20] Sanyal AJ, Bedossa P, Fraessdorf M et al. A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis. N Engl J Med. 2024;391(4):311-319.
  21. [21] Blüher M, Rosenstock J, Hoefler J et al. Dose-response effects on HbA(1c) 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;67(3):470-482.
  22. [22] Yazawa R, Ishida M, Balavarca Y et al. A randomized Phase I study of the safety, tolerability, pharmacokinetics and pharmacodynamics of BI 456906, a dual glucagon receptor/glucagon-like peptide-1 receptor agonist, in healthy Japanese men with overweight/obesity. Diabetes Obes Metab. 2023;25(7):1973-1984.
  23. [23] Kushner PR, Michos ED. Cardiovascular Effects of Glucagon Receptor Signaling Alone and Combined With Glucagon-Like Peptide-1 Receptor Signaling in Multiagonists: A Narrative Review With a Translational Focus. J Am Heart Assoc. 2026;15(15):e049727.