Pemvidutide
Altimmune's GLP-1 + glucagon dual agonist. Phase 2 data shows weight loss alongside meaningful liver-fat reduction (NASH/MASH applications). Direct competitor to Retatrutide and Survodutide.
Pemvidutide: Altimmune's GLP-1 + glucagon dual agonist. Phase 2 data shows weight loss alongside meaningful liver-fat reduction (NASH/MASH applications). Direct competitor to Retatrutide and Survodutide. Pemvidutide is Altimmune's competitor to Retatrutide and Survodutide, a GLP-1 + glucagon dual agonist.
Pemvidutide is Altimmune's competitor to Retatrutide and Survodutide, a GLP-1 + glucagon dual agonist. The interesting thing about Pemvidutide is it shows real liver-fat reduction in addition to weight loss, making it a NASH/MASH drug candidate too. Phase 2 in development.
Who it's for
- โTrial participants in NASH/MASH or obesity studies
- โPatients with metabolic-syndrome plus liver involvement
- โFollowers of Altimmune's pipeline
What to expect
- Week 1
Appetite drops. Mild nausea. Slight body-temp uptick from glucagon arm.
- Week 4
First titration step. Weight loss tracking.
- Week 8
Phase 2 showed liver-fat reduction beginning to compound.
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How it works (mechanism)
GLP-1 + glucagon dual agonist with structural design favoring liver-fat reduction alongside weight loss, making it a NASH/MASH candidate as well as obesity.
Dosing protocol
Stacks well with
Side effects
When NOT to use
- โ MTC / MEN-2 history
- โ Pancreatitis history
- โ Severe cardiovascular disease
- โ Pregnancy / nursing
Bloodwork to monitor
- โข Lipid panel
- โข ALT/AST
- โข Liver imaging if NASH context
- โข A1C
Common mistakes
- โข Treating elevated HR as caffeine sensitivity
- โข Titrating too fast
- โข Not getting baseline liver imaging if NASH-related
What it actually is
Pemvidutide is an investigational weekly GLP-1 and glucagon dual agonist from Altimmune, developed with liver disease as much as weight loss in view. It is not approved anywhere. It sits in the same class as survodutide and, like it, has published randomised phase 2 data in metabolic liver disease โ which is a stronger position than most unapproved compounds in this catalog.
The GLP-1 arm reduces appetite and slows gastric emptying. The glucagon arm raises energy expenditure and drives the liver to mobilise and oxidise stored fat, which is why this class targets MASH directly rather than only through weight loss. Pemvidutide's balance between the two receptors is tuned differently from survodutide's, and the glucagon component is also why resting heart rate rises and why severe cardiovascular disease is a listed caution.
Forms, and which is which
Phase 2b trials in MASH and in obesity have reported. Identity, dose and monitoring are known only here.
Verdict: The only defensible access.
No approved product exists to compare against, so identity, potency and sterility cannot be verified.
Verdict: Unverifiable contents outside any lawful route.
The other GLP-1 and glucagon dual agonist, also unapproved, also with NEJM-published phase 2 MASH data.
Verdict: The same mechanism from a different company.
Adds GIP to the same two receptors, with larger reported weight loss and phase 3 data now reporting.
Verdict: Further along, and also unapproved.
What it is claimed to do, graded
A randomised phase 2b trial published in the Lancet in 2025 plus a randomised study in J Hepatol. For an unapproved compound this is a solid evidence position.
Demonstrated in the randomised MASLD study, which is the mechanism the glucagon arm predicts.
Reported in the phase 2 programme, and the published base is smaller than the liver work.
A claim made for the class based on the glucagon arm's effect on energy expenditure. Not established by a head-to-head trial.
The glucagon arm raises resting heart rate, and severe cardiovascular disease is a listed caution rather than a resolved question.
Grades describe how much human evidence exists for that specific claim, not whether it will work for you or whether it is safe.
Pros and cons
- โข Randomised phase 2b evidence published in the Lancet and J Hepatol
- โข Targets liver disease directly rather than only through weight loss
- โข Weekly dosing
- โข A genuinely different balance from the GLP-1-only drugs
- โข Not approved anywhere; access is trial-only
- โข Raises resting heart rate through the glucagon arm
- โข Nausea and gastrointestinal effects are common at titration steps
- โข Glucagon activation can raise blood glucose, complicating use in diabetes
- โข Nothing sold outside a trial can be verified
When to stop
- โข Resting heart rate climbing and staying up, or palpitations at rest
- โข Severe persistent abdominal pain radiating to the back
- โข Vomiting that prevents keeping fluids down
- โข A new neck lump, hoarseness or difficulty swallowing
- โข Pregnancy
Interactions
The GLP-1 arm lowers glucose and the glucagon arm raises it, making the net effect less predictable than with a GLP-1-only drug.
No added benefit, multiplied gastrointestinal effects.
Compounds the glucagon-driven heart rate increase.
Delayed gastric emptying can alter absorption. No approved interaction labelling exists.
General weight-loss guidance, not a pemvidutide trial finding.
Is this for you?
- โข Participation in an authorised clinical trial is the only context in which this is lawfully available
- โข Anyone following the dual-agonist programmes in metabolic liver disease
- โข You want an approved medicine
- โข You have severe cardiovascular disease or an arrhythmia
- โข Personal or family history of medullary thyroid carcinoma or MEN-2
- โข You are pregnant or nursing
The one number
Sources for the claims above
- The dual GLP-1-glucagon agonist pemvidutide in MASH, a phase 2b trial
- Safety and efficacy of weekly pemvidutide versus placebo in metabolic dysfunction
- Effect on MASLD, a randomised trial
Drug & supplement interactions
- โ Same GLP/glucagon class warnings
- โ Trial-only, full interaction profile not yet published
Community patterns
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Common questions about Pemvidutide
Tracked alongside Pemvidutide
Same goal, different aisle โ each graded on its own evidence in the Pepdex catalog.
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Triple agonist (GLP-1 + GIP + glucagon) from Eli Lilly. In trials it outperforms Tirzepatide for weight loss.
Daily GLP-1 receptor agonist. FDA-approved 2010 (Victoza, T2D) and 2014 (Saxenda, obesity). The first wave of modern GLP-1 weight-loss therapy and direct predecessor to Semaglutide.