- Onset
- Appetite effects build as the dose rises over a months-long escalation; grey-market users often feel little below about 1 mg, while some report more energy from the first dose.
- Lasts
- Once-weekly injection; some users note a heart-rate bump for one to two days after each dose.
- Access
- Grey market
- Cost / month
- ≈ €36–140
- researchers' estimate; no listing to price
24 user reports
Glowing 1Positive 13Mixed 5Nothing 1Negative 3Bad reaction 1r/survodutide· · 11 upvotesOriginal ↗
I have lost 110 pounds on Survodutide. It’s works great. I started April 2024 at 307 and now weigh 197. I’m in a trial for people with kidney and cardiovascular disease.
GlowingInjection · about 15 months
clinical-trial participant (trial in people with kidney and cardiovascular disease); fatigue described in a follow-up comment
r/survodutide· · 19 upvotesOriginal ↗
Yesterday had noticeable energy increase. Today a slight increase. Less hungry than I if I was just on tirz.
Positive0.3 mg rising to 0.6 mg/week · Injection
on max-dose tirzepatide; could not tolerate retatrutide (anxiety, impending doom)
r/survodutide· · 4 upvotesOriginal ↗
I started my Survodutide journey in February and I’ve never had the incredible weight loss so many demonstrate online. I’ve been steadily losing 1lb a month, nothing more.
NothingInjection · 7 months
blinded clinical-trial participant, believes they are on drug
- Strict case
- Unapproved drug bought as grey-market vials, usually stacked on tirzepatide: the GLP-1 class's pancreatitis, gallbladder and dehydration-kidney routes, a glucagon-driven heart-rate rise whose cardiovascular safety trial is still running, and GI effects harsh enough that about one in five phase 3 participants stopped.
- Users report
- Twenty-four first-hand reports: six from clinical-trial participants and the rest mostly grey-market survo added to tirzepatide ('ghetto reta'). Trial participants describe 28 kg over 20 months and 110 lb over about 15 months, but also a 3-month stall with hair thinning and one near non-responder. Stackers report stalls broken, recomposition, better liver numbers and more energy, and several say it did not raise their heart rate as retatrutide did. Complaints are GI (one quit over unrelenting diarrhoea at 2.4 mg), fatigue at higher doses, sugar cravings during the first weeks, insomnia, a 10 bpm rise for two days after each dose, and one allergic reaction with eyelid swelling. Many grey-market reports are confounded by tirzepatide. Felt nothing: 1 of 24 reports (a blinded trial participant losing about 1 lb a month) saw little; another with heavy prior GLP-1 tolerance said it 'helped a little'..
- Best effects
- Weight loss of 12-13% at 76 weeks in phase 3 (up to 16.6% in those who stayed on drug) · liver fat cut by 30% or more in 84% vs 24% on placebo; MASH improvement in up to 62% vs 14% · visceral-fat, triglyceride and blood-pressure reductions · appetite and food-noise suppression, often with more energy
- Downsides
- GI effects in 81-90% in phase 3 (vs 48% on placebo), leading 18-20% to stop · fatigue, especially at higher doses · sugar cravings for the first weeks · constipation or diarrhoea · insomnia and a higher resting heart rate in some users
- Watch
- Pancreatitis, gallbladder disease and dehydration-related kidney injury: GLP-1 class harms with label warnings on approved agonists · Heart-rate rise from glucagon-receptor agonism; a dedicated cardiovascular outcomes trial (SYNCHRONIZE-CVOT) has not reported · Thyroid C-cell tumours in rodents for the GLP-1 agonist class (boxed warning on semaglutide, tirzepatide and mazdutide) · Stacking on tirzepatide adds a second GLP-1 agonist in a combination never trialled · Grey-market vials of unknown dose, purity and sterility
- Evidence
- Human RCTs — Phase 2 in obesity (n=387) and biopsy-proven MASH (n=293); phase 3 SYNCHRONIZE-1 (n=725), SYNCHRONIZE-2 (n=752) and SYNCHRONIZE-MASLD (n=216) published in 2026; cardiovascular and MASH outcome trials running; approved nowhere and no filing announced
- Caveat
- SYNCHRONIZE-1's placebo group lost 5.4%, partly because about 15% of them obtained GLP-1 drugs outside the trial, and a rigid dose escalation may have inflated GI dropouts, so the true effect and tolerability sit somewhere between the headline numbers. Users' belief that survodutide does not raise heart rate rests on anecdote; the glucagon arm raises it in the class.
- Typical use
- Trials: slow weekly escalation (20-24 weeks in phase 2) to 3.6 mg or 6.0 mg in phase 3 (phase 2 tested 0.6-4.8 mg). Grey-market users: start 0.2-0.3 mg, usually 1-2.5 mg weekly beside tirzepatide. Users report 120–290 mcg/day (median 250 mcg, n=6).
- Getting it
- Unapproved; obtainable legitimately only in clinical trials. Grey-market vials (mostly 10 mg) are bought for tirzepatide stacks, often via Telegram groups.
- Stacked with
- Tirzepatide: The 'ghetto reta' stack adding glucagon agonism; the dominant grey-market use, never trialled. · cagrilintide: Occasionally added for appetite, or kept on when switching from retatrutide. · retatrutide: Not combined; users switch to survodutide when retatrutide raises their heart rate or causes anxiety.