Survodutide vs Retatrutide
Verdict: Retatrutide wins on weight loss (~24% vs ~19% in their respective phase 2 trials), but survodutide has the more striking liver data — 83% of MASH patients improved without fibrosis worsening — and is being developed as a liver drug first. Choose the comparison by the problem: fat mass favors retatrutide, fatty liver is where survodutide's evidence is strongest. Both are unapproved and in phase 3.
Side by side
| Survodutide | Retatrutide | |
|---|---|---|
| Typical dose | 600 mcg–6 mg | 1 mg–12 mg |
| Frequency | 1x weekly, titrated up over ~20 weeks | 1x weekly, titrated up |
| Administration | subcutaneous injection | subcutaneous injection |
| Common vials | 5 mg, 10 mg | 5 mg, 10 mg, 20 mg, 30 mg |
| Typical mix | 10 mg + 2 ml water | 10 mg + 2 ml water |
| Units for typical dose | 48 units (2.4 mg) | 40 units (2 mg) |
Same glucagon idea, different partner
Both compounds bet on glucagon agonism for energy expenditure and liver-fat clearance. Survodutide pairs it only with GLP-1; retatrutide adds GIP, which appears to amplify weight loss and improve GI tolerability per unit of effect — the tirzepatide lesson applied to a triple agonist.
Titration is where they diverge in practice
Survodutide's phase 2 protocol climbed 0.6 → 1.2 → 2.4 → 3.6 → 4.8 mg with fast escalation, and discontinuation from nausea was high — later trials slowed the ramp. Retatrutide's ramp runs 1 → 2 → 4 → 8 → 12 mg over months. Starting doses differ by roughly 2×, so dose numbers must never be carried between them.
Evidence status
Survodutide: phase 3 SYNCHRONIZE (obesity) and LIVERAGE (MASH) programs ongoing. Retatrutide: phase 3 TRIUMPH program across obesity, diabetes, sleep apnea and osteoarthritis. Neither has approval anywhere; both are years from a pharmacy shelf.
Can you stack them?
Not stacked with each other or with other incretin drugs. Both protocols emphasize protein, lifting and slow titration over any add-on peptide.
More comparisons
Educational comparison based on commonly published research protocols — not medical advice or an endorsement of any compound.