Mazdutide and survodutide are the two glucagon and GLP-1 receptor dual agonists furthest along in trials, and the comparison readers search for is mostly a dose question: where each ladder starts, how fast it climbs, and whether a milligram of one means anything for the other. This page sets the two trial records side by side, works the units at the research-vial concentrations, and reports the only comparative evidence there is, which is indirect. It states no preference between them and recommends no amount.
Each compound has its own page with its full trial record: mazdutide dosage and survodutide dosage. Each against the GLP-1/GIP drugs: mazdutide vs tirzepatide and survodutide vs tirzepatide. The compounds are covered in Medibact's Mazdutide guide and Survodutide guide.
Two molecules, one receptor pair
| Mazdutide | Survodutide | |
|---|---|---|
| Codes | IBI362, LY3305677 | BI 456906 |
| Developer | Innovent Biologics, with Eli Lilly | Boehringer Ingelheim |
| Receptors | glucagon + GLP-1 | glucagon + GLP-1 |
| Molecular weight (PubChem, read 2026-10-15) | 4,476 | 4,232 |
| Dosing in trials | once weekly, subcutaneous | once weekly, subcutaneous |
| Approval | China, NMPA: weight management June 2025, type 2 diabetes September 2025 | none |
| Drugs@FDA (read 2026-10-15) | no record | no record |
| PubMed records (title or abstract, 2026-10-15) | 55 | 91 |
The approval dates for mazdutide are from the 2025 profile in Drugs (PMID 41028652), as recorded on this site's mazdutide page. No head-to-head trial exists: the ClinicalTrials.gov search for both names returned zero studies on 2026-10-15, and every one of the 16 PubMed records that names both is a review or a meta-analysis.
The two dose ladders
Mazdutide's ladder is short and coarse. In GLORY-1 (NCT05607680, 610 Chinese adults, read 2026-10-15) the registry describes the 4 mg arm as 2 mg once weekly for 4 weeks, then 4 mg for 44 weeks, and the 6 mg arm as 2 mg for 4 weeks, 4 mg for 4 weeks, then 6 mg for 40 weeks. GLORY-2 gave 9 mg once weekly for 60 weeks (JAMA 2026, PMID 42251595, as recorded on the mazdutide page).
Survodutide's ladder is long and fine. The posted results of the phase 2 obesity trial (NCT04667377) describe 0.3 mg in weeks 1 and 2, then steps every two weeks through 0.6, 0.9, 1.2, 1.8, 2.4, 3.3 and 4.2 mg to 4.8 mg at week 17. The phase 3 SYNCHRONIZE trials escalate to 3.6 mg or 6.0 mg on a schedule their design paper describes as extended compared with phase 2, to reduce gastrointestinal symptoms, with interruption of one or two doses and, after reaching 3.6 mg and up to week 32, a delay or a one-level reduction for 2 to 4 weeks permitted (Wharton et al., Obesity 2025, PMC11664303, read 2026-10-15). The paper's weekly schedule is in a figure, not in its text, so it is not reproduced here.
| Mazdutide (GLORY-1) | Survodutide (phase 2 obesity) | |
|---|---|---|
| First dose | 2 mg | 0.3 mg |
| Step interval | 4 weeks | 2 weeks |
| Steps to the top dose | 2 (to 6 mg) | 8 (to 4.8 mg) |
| Week the top dose is reached | 9 | 17 |
| Phase 3 maintenance doses | 4 mg, 6 mg (GLORY-1); 9 mg (GLORY-2) | 3.6 mg, 6.0 mg (SYNCHRONIZE) |
The first doses differ almost sevenfold in milligrams, 2 mg against 0.3 mg. That says nothing about which is gentler: the milligrams belong to different molecules.
Why a milligram of one is not a milligram of the other
By molecular weight alone, a milligram of survodutide holds about 5.8% more molecules than a milligram of mazdutide (4,476 ÷ 4,232 = 1.058, arithmetic by this site). The larger difference is potency at the two receptors, which the trials express only through their doses: both programmes land their top phase 3 dose at 6 mg, but they reach it from starting points 0.3 mg and 2 mg apart, and the weight outcomes at those doses came from different trials. No source read for this page publishes a conversion between the two, and none exists in a label. A switch between them is a prescriber's question, not an arithmetic one.
What the trials found, side by side and not comparable
| Trial | Population | Duration | Dose | Weight change | Placebo |
|---|---|---|---|---|---|
| GLORY-1 (mazdutide) | 610 Chinese adults | 48 weeks | 4 mg / 6 mg | −11.00% / −14.01% | +0.30% |
| GLORY-2 (mazdutide) | 307 adults, BMI ≥30 | 60 weeks | 9 mg | −16.65% | −1.50% |
| SYNCHRONIZE-1 (survodutide) | 725 adults without diabetes | 76 weeks | 3.6 mg / 6.0 mg | −12.2% / −13.0% | −5.4% |
Figures as recorded on this site's mazdutide (2026-09-28) and survodutide (2026-09-26) pages from the NEJM 2025, JAMA 2026 and NEJM 2026 papers. The placebo groups alone differ by almost six percentage points, which is one reason the rows cannot be read across. Gastrointestinal effects run high in both: in GLORY-2, vomiting 53.1%, nausea 46.9% and diarrhoea 39.4% on 9 mg; in SYNCHRONIZE-1, gastrointestinal adverse events in 80.9% (3.6 mg) and 89.7% (6.0 mg) against 47.9% on placebo.
Two 2026 meta-analyses pool the class. The network meta-analysis of 14 randomised trials by Abulehia and colleagues (Endocrinology, Diabetes & Metabolism 2026, PMID 41787737) estimated weight change against placebo of −10.74 kg for survodutide and −6.47 kg for mazdutide and described mazdutide as having the most favourable tolerability of the agents analysed. A class meta-analysis of 19 trials (Amjad et al., Diabetes, Obesity and Metabolism 2026, PMID 42811393) found mazdutide and survodutide showing the largest effects among four dual agonists and called for longer head-to-head trials. Both are indirect comparisons across trials of different length and population.
Units at the trial doses
Research-market vials of both compounds are labelled 5, 10 and 15 mg. Units on a U-100 syringe = mg ÷ mg/mL × 100.
| Dose | Compound | 2.5 mg/mL | 5 mg/mL | 10 mg/mL | 15 mg/mL |
|---|---|---|---|---|---|
| 0.3 mg | survodutide first step | 12 | 6 | 3 | 2 |
| 0.6 mg | survodutide step | 24 | 12 | 6 | 4 |
| 2 mg | mazdutide first step | 80 | 40 | 20 | 13.3 |
| 2.4 mg | survodutide step | 96 | 48 | 24 | 16 |
| 3.6 mg | survodutide phase 3 | 144 | 72 | 36 | 24 |
| 4 mg | mazdutide phase 3 | 160 | 80 | 40 | 26.7 |
| 4.8 mg | survodutide phase 2 top | 192 | 96 | 48 | 32 |
| 6 mg | both phase 3 tops | 240 | 120 | 60 | 40 |
| 9 mg | mazdutide GLORY-2 | 360 | 180 | 90 | 60 |
Concentrations: 2.5 mg/mL is a 5 mg vial with 2 mL of water; 5 mg/mL a 5 mg vial with 1 mL or a 10 mg vial with 2 mL; 10 mg/mL a 10 mg vial with 1 mL; 15 mg/mL a 15 mg vial with 1 mL. Cells over 100 do not fit one syringe. The table shows the practical difference between the ladders: survodutide's first steps are a few units at the common concentrations, two or three marks on a 1 mL barrel at 10 mg/mL, while mazdutide's first step is already 20 units there. The mazdutide calculator and the survodutide calculator work any vial and volume.
What is not established
No head-to-head trial, so no direct answer to which works better or is tolerated better. No conversion between their doses. No survodutide approval anywhere, and mazdutide's approval is Chinese only; every mazdutide trial on this site's mazdutide page was run in Chinese adults (2026-09-28). SYNCHRONIZE-1 was listed as completed with no posted registry results on 2026-10-15, so its full dose-by-week data are not public. Decisions about either compound belong with a prescriber.
Sources and dates
Opened 2026-10-15: ClinicalTrials.gov v2 search for mazdutide AND survodutide (0 studies) and the records NCT05607680 (arm descriptions) and NCT06066515 (status, results flag); PubMed counts and abstracts through NCBI E-utilities (16 records naming both; PMIDs 41787737 and 42811393 read); PubChem properties for mazdutide and survodutide; Drugs@FDA through openFDA for both names (no record); the full text of Wharton et al., Obesity 2025 (PMC11664303) through the PMC BioC service. Trial outcome and approval figures are as read and cited on this site's mazdutide (2026-09-28) and survodutide (2026-09-26) pages. Unit and molecule-ratio arithmetic by this site. Corrections go to the contact page.