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Compound Evidence InstituteEvidence synthesis · established 2023Graded assessments of compounds, trials, methods and supply
Document set current to 30 July 2026
Compound monograph · §4

Survodutide — safety

Adverse events as reported, contraindications, warnings, and an explicit statement of what the safety evidence does not establish.

Document identifier
CEI-MN-013/4
Series
Compound monograph
Version
3.1
Published
19 Nov 2025
Last reviewed
19 Nov 2025
Next review
19 Nov 2027
Identifier
10.71829/cei.mono.13
Certainty
Moderate
Cycle
2025 Q4

§4Safety

§4.1Adverse events reported in controlled trials

Table 4. Adverse events for Survodutide as reported in the trial safety tables the Institute holds. Percentages are of randomised participants in the stated trial and arm.

EventActive, %Comparator, %Difference, ppSource
Nausea52.018.0+34.0Phase 2 obesity, highest dose
Vomiting37.04.0+33.0Phase 2 obesity
Constipation29.010.0+19.0Phase 2 obesity
Increased heart rateDose-dependent, attributed to the glucagon arm
Discontinuation for adverse events25.05.0+20.0Phase 2 obesity, highest dose
A difference column is computed by the Institute from the two reported percentages and is not itself a published figure. Confidence intervals for adverse-event differences are not reported in the contributing trials and are not constructed here.
Gastrointestinal adverse eventsProportion of participants reaching each categorical response threshold, by arm.EventActiveComparatorNausea52.0 %18.0 %Vomiting37.0 %4.0 %Constipation29.0 %10.0 %
Figure 4. Gastrointestinal adverse events for Survodutide as reported in the contributing safety tables. Incidences of this kind are dose- and titration-rate-dependent and attenuate with continued exposure in most but not all participants.

§4.2Contraindications

  • Not established — investigational

§4.3Warnings and precautions

  • Gastrointestinal discontinuation at the highest doses studied was high
  • Heart-rate increase attributable to glucagon receptor agonism
  • Glucagon-driven hepatic glucose output requires monitoring in any glycaemic indication

§4.4What this section does not establish

Related assessments: tolerability of incretin receptor agonists · acute pancreatitis · the rodent thyroid C-cell signal.[1,2]

References cited on this page

References are numbered in order of first citation in this document. Each superscript in the text links to its entry below.

  1. le Roux CW, Steen O, Lucas KJ, Startseva E, Unseld A, Hennige AM. Glucagon and GLP-1 receptor dual agonist survodutide for obesity: a randomised, double-blind, placebo-controlled, dose-finding phase 2 trial. The Lancet Diabetes & Endocrinology 2024;12(3):162–173. doi:10.1016/S2213-8587(23)00356-X · PMID 38330977
  2. Sanyal AJ, Bedossa P, Fraessdorf M, Neff GW, Lawitz E, Bugianesi E, Anstee QM, Hussain SA, Newsome PN, Ratziu V, Hosseini-Tabatabaei A, Schattenberg JM. A phase 2 randomized trial of survodutide in MASH and fibrosis. New England Journal of Medicine 2024;391(4):311–319. doi:10.1056/NEJMoa2401755 · PMID 38847460

Identifiers are reproduced only where the Institute holds them. Where a digital object identifier or PubMed identifier is not shown, the Institute has recorded the journal and year and has not constructed an identifier.

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