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Extensively Studied

Mazdutide

Dual GLP-1/Glucagon Receptor Agonist | Weight Loss & Diabetes

Mazdutide (IBI362/LY3305677) is a first-in-class dual glucagon-like peptide-1 (GLP-1) and glucagon receptor agonist, and a synthetic analog of oxyntomodulin. Unlike tirzepatide which targets GIP/GLP-1, mazdutide uniquely combines GLP-1's appetite suppression with glucagon's ability to stimulate thermogenesis and increase energy expenditure. Phase 3 trials (GLORY-1, GLORY-2) have demonstrated up to 20% weight loss, with recent head-to-head trials showing superiority over semaglutide for both glycemic control and weight reduction in patients with type 2 diabetes and obesity.

Daily dose

3-9mg weekly

Frequency

Once weekly

Cycle length

48-60+ weeks

Storage

2-8°C / -20°C (lyophilized)

Key benefits

Up to 20% body weight loss, superior glycemic control vs semaglutide, increased energy expenditure via glucagon receptor activation, improved cardiometabolic markers (BP, lipids, liver fat), once-weekly convenience

How it works

Dual agonist of GLP-1 and glucagon receptors. GLP-1 activation: stimulates insulin release, suppresses glucagon, slows gastric emptying, reduces appetite. Glucagon activation: increases energy expenditure and thermogenesis, improves hepatic fat metabolism.

Dosage protocols

Goal

Weight loss (3mg target)

Dose

1.5mg → 3mg (weeks 1-4 → 5+) · Once weekly

Route

SubQ injection

Goal

Weight loss (4.5mg target)

Dose

1.5mg → 3mg → 4.5mg · Once weekly

Route

SubQ injection

Goal

Weight loss (6mg target)

Dose

2mg → 4mg → 6mg · Once weekly

Route

SubQ injection

Goal

Maximum weight loss (9mg target)

Dose

3mg → 6mg → 9mg · Once weekly

Route

SubQ injection

Research indications

weight Loss

Severe Obesity ManagementGLORY-2 trial: 20.1% weight loss with 9mg dose over 60 weeks. 48.7% achieved ≥20% weight reduction
Metabolic Syndrome ImprovementSignificant reductions in waist circumference, blood pressure, triglycerides, LDL cholesterol, and uric acid
Liver Fat Reduction80.2% reduction in liver fat content in exploratory analysis, suggesting potential MASLD benefits

diabetes

Type 2 Diabetes ManagementHbA1c reductions of 1.41-2.03% across trials. Superiority vs semaglutide demonstrated in DREAMS-3
Dual Endpoint Achievement48% achieved both HbA1c <7.0% AND ≥10% weight loss vs 21% with semaglutide

cardiovascular

Blood Pressure ReductionConsistent reductions in systolic (-7.57 mmHg) and diastolic (-2.98 mmHg) blood pressure
Lipid Profile EnhancementImprovements in total cholesterol (-16.82%), triglycerides (-43.29%), and LDL (-17.07%)

Administration

injectable

Interactions

Avoid Combination
SemaglutideBoth are GLP-1 agonists - combining increases hypoglycemia and severe GI side effect risk. Head-to-head trials show mazdutide is superior; no benefit to combining
Avoid Combination
TirzepatideBoth target GLP-1 receptor - combining creates additive effects on GI symptoms and hypoglycemia risk without proven additional benefit
Avoid Combination
LiraglutideAnother GLP-1 agonist - dual therapy contraindicated due to additive receptor activation and adverse effect risk
Monitor Closely
InsulinMay require significant insulin dose reduction due to improved glucose control. Monitor blood glucose carefully to prevent hypoglycemia
Monitor Closely
SulfonylureasIncreased hypoglycemia risk when combined. Dose reduction of sulfonylureas may be necessary
Synergistic
MetforminComplementary mechanisms for diabetes management. Clinical trials allowed stable metformin use with mazdutide showing enhanced efficacy
Compatible
CJC-1295Growth hormone support may help preserve muscle mass during rapid weight loss phase
Compatible
IpamorelinMay help maintain metabolic rate and muscle preservation during caloric restriction
Compatible
BPC-157No known interactions, may support gut health and potentially reduce GI side effects
Monitor Timing
Oral ContraceptivesGLP-1 agonists may affect absorption of oral medications due to delayed gastric emptying. Take oral contraceptives 1 hour before or 4 hours after mazdutide
Monitor Timing
LevothyroxineDelayed gastric emptying may affect thyroid hormone absorption. Monitor thyroid function and adjust timing if needed

Safety notes

Start low, escalate gradually every 4 weeks

GI side effects common but typically improve over time

Monitor for pancreatitis symptoms

Caution with history of thyroid cancer

Adjust insulin/sulfonylurea doses to prevent hypoglycemia

Research studies

GLORY-1 Phase 3 Trial - NEJM (2025)

610 Chinese adults with obesity/overweight | 48 weeks | 4mg and 6mg doses

First Phase 3 weight management trial showing clinically meaningful weight reductions with once-weekly mazdutide. Both doses achieved significant weight loss vs placebo with favorable safety profile.

View study →

GLORY-2 Phase 3 Trial (2025)

462 Chinese adults with obesity (BMI ≥30) | 60 weeks | 9mg dose

High-dose 9mg mazdutide achieved 20.1% weight loss in non-diabetic participants vs 2.8% placebo. 48.7% achieved ≥20% weight reduction. No plateau observed through week 60.

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DREAMS-3 Phase 3 Trial - Head-to-Head vs Semaglutide (2025)

349 Chinese adults with T2D and obesity | 32 weeks | Mazdutide vs Semaglutide

Mazdutide showed superiority over semaglutide on primary endpoint - 48.0% vs 21.0% achieved HbA1c <7.0% AND ≥10% weight reduction (p<0.0001). Mean HbA1c reduction -2.03% vs -1.84%.

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Systematic Review & Meta-Analysis - Frontiers (2024)

7 RCTs | 680 participants | 4-24 weeks | Meta-analysis of efficacy and safety

Overall 6.22% greater weight reduction vs placebo. Non-diabetics: 8.44% reduction. Significant improvements in BP, cholesterol, triglycerides. GI side effects most common but transient.

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Phase 2 T2D Trial - Diabetes Care (2024)

Chinese adults with T2D | 20 weeks | 3mg, 4.5mg, 6mg doses vs placebo and dulaglutide

HbA1c reductions of 1.41-1.67% with mazdutide vs 0.03% placebo. Weight loss up to 7.1% vs 1.4% placebo. 54-73.5% achieved HbA1c <7.0% target.

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Phase 1b High-Dose Safety Trial - eClinicalMedicine (2022)

24 Chinese adults with overweight/obesity | 12 weeks | 9mg and 10mg doses

9mg and 10mg doses were well tolerated with favorable safety profile. 11.7% weight loss at 12 weeks in 9mg cohort. No serious adverse events reported.

View study →