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Comparison

Survodutide vs Retatrutide

Survodutide vs Retatrutide: dual GLP-1 + glucagon vs triple GLP-1 + GIP + glucagon. Two Phase 3 glucagon-arm compounds, weighed on obesity and fatty-liver disease (MASH).

The verdict

Both put glucagon to work, just to different degrees. Survodutide (Boehringer Ingelheim) is a dual GLP-1 plus glucagon agonist in Phase 3, with a strong liver angle and FDA Breakthrough Therapy status for MASH. Retatrutide (Lilly) adds GIP for a triple mechanism and owns the biggest weight-loss numbers in the class. Neither is approved. If maximum trial weight loss is the metric, Retatrutide leads; Survodutide is the more interesting one for fatty-liver disease, where its data stands out. Both are investigational, so this is a which-to-watch, not a which-to-buy.

№ 024
Survodutide
Fat LossEvidence: Moderate

Survodutide is Boehringer Ingelheim's dual agonist (GLP-1 + glucagon), a competitor to Retatrutide. Stronger fat-burn signal than the GLP-1-only drugs because it activates glucagon, which boosts metabolic rate. Phase 2 data is promising. Once-weekly.

Onset
80
Documentation
95
Side intensity
82
Popularity
55
№ 003
Retatrutide
Fat LossEvidence: Moderate

Retatrutide is the newest weight-loss compound in development at Eli Lilly. It's a stronger cousin of Tirzepatide (Mounjaro / Zepbound) and pulls bigger weight loss in trials, often 20%+ of body weight. One injection per week. Side effects are real, especially in the first few weeks.

Onset
80
Documentation
95
Side intensity
100
Popularity
90
Side-by-side
Field
Left
Right
Category
Fat Loss
Fat Loss
Half-life
~6 days
~6 days
Route
Subcutaneous
Subcutaneous
Schedule
Once weekly
Once weekly
Cycle length
Open-ended, titrate over months
Open-ended, titrate over 4-6 months
Dose
Start 0.3 mg sub-q weekly. Titrate over 4-week steps up to 6.0 mg in trials.
Start 2mg sub-q weekly. Titrate by 2mg every 4 weeks based on tolerance. Trials went up to 12mg; most users plateau benefit at 8-12mg.
FDA
Investigational. Phase 3 trials by Boehringer Ingelheim and Zealand Pharma (co-developers).
Investigational. In Phase 3 trials with Eli Lilly. Not yet approved.
WADA
Not listed
Not listed
Natty?
Not natty
Not natty
Prescribed
Not yet approved. Trial access only.
Not yet available by prescription. Trial-only access through Lilly's clinical program.
Top side effects
Nausea (especially titration steps); Diarrhea or constipation; Mild fatigue
Nausea (especially first 2 weeks of each titration step); Vomiting; Constipation or diarrhea

Which one should you pick?

Pick Survodutide if users plateaued on glp-1-only drugs or people targeting >15% body weight loss.

Pick Retatrutide if people plateaued on tirzepatide or users targeting >15% body weight loss.

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