GLORY-1, 4 mg
Trial- Dose
- 4 mg
- How often
- Once weekly
- How long
- 48 weeks
2 mg for 4 weeks, then 4 mg. Mean loss 11.0% vs a 0.3% gain on placebo, counting everyone who started.
Draw 40 units10 mg + 1 mL
Approved drugGLP-1 / glucagon dual agonist
Mazdutide
IBI362, LY3305677; Xinermei (China)
- Common dose
- 2 → 4–6 mg weekly
- Cycle
- Continuous
- Vial sizes
- 10 mg
- Typical draw
- 20 units10 mg with 1 mL, 2 mg
A once-weekly injectable peptide modeled on oxyntomodulin, a gut hormone, that activates both the GLP-1 and glucagon receptors. It curbs appetite and lowers blood sugar, and in trials it also cut liver fat.
Evidence. Approved only in China, as Xinermei (Innovent, under license from Lilly): for long-term weight management in June 2025 and for type 2 diabetes in September 2025. In GLORY-1 (610 adults, 48 weeks) weight fell 11.0% on 4 mg and 14.0% on 6 mg vs a 0.3% gain on placebo. A 9 mg dose was filed in China in November 2025, and Lilly has tested doses up to 16 mg in the US.
Status
- Approval
- Not approved in the US or EU. Approved in China (NMPA) as Xinermei: June 27, 2025 for long-term weight management in adults (BMI 28 or more, or 24 or more with a weight-related condition) and September 19, 2025 for type 2 diabetes. A 9 mg dose for moderate to severe obesity was submitted in China in November 2025.
- Sport (WADA 2026)
- Not banned in sportNot named on the 2026 list. China approved it in 2025, so the S0 rule for drugs with no government approval no longer applies, and no other section covers GLP-1 or glucagon agonists. WADA’s 2026 Monitoring Program tracks only semaglutide and tirzepatide in this class.
Sport status follows the WADA Prohibited List in force since January 1, 2026; athletes should confirm with their anti-doping organization. Checked October 5, 2026. Status of every compound.
How it works
Mazdutide is a modified copy of oxyntomodulin, a gut hormone, with a fatty-acid chain that lets it be given weekly. It switches on the GLP-1 receptor, which curbs appetite and raises insulin when blood sugar is high, and the glucagon receptor, which acts mainly on the liver and is expected to raise energy use. In trials it lowered weight, blood sugar and liver fat.
TrialMainly from studies in people.
Not known
How much the glucagon action adds in people is unclear. Glucagon can speed the heart: in Phase 2, heart rate rose about 9 beats per minute on the top dose vs 5 on placebo, and long-term heart effects are unknown.
Protocol
Trial
GLORY-1, NEJM 2025
2 mg once weekly for 4 weeks, then 4 mg. The 6 mg group took 4 mg for 4 weeks before moving to 6 mg. Innovent describes its regimen in China as 2 mg, 4 mg, then 6 mg.
Trial
GLORY-2, JAMA 2026
9 mg once weekly, reached in two steps (3 mg, then 6 mg, then 9 mg), in adults with a BMI of 30 or more: 16.65% mean loss at 60 weeks vs 1.50% on placebo.
Trial
Hsia 2026
US phase 2: 10 or 16 mg once weekly, starting at 1.5 mg and stepping up every 4 weeks. At 32 weeks weight fell 15.6% and 18.1% vs 0.9% on placebo; 20% stopped 16 mg because of side effects.
- Frequency
- Once weekly
- Route
- Subcutaneous injection
- Cycle
- Continuous in trials (24–60 weeks); long-term use in China.
Continuous, shown over 26 weeks
Common protocols
The ways Mazdutide is most often run, each tagged with where it comes from.
GLORY-1, 6 mg
Trial- Dose
- 6 mg
- How often
- Once weekly
- How long
- 48 weeks
2 mg, then 4 mg, 4 weeks each, then 6 mg. Mean loss 14.0%; 49.5% lost at least 15%.
Draw 60 units10 mg + 1 mL
GLORY-2, 9 mg
Trial- Dose
- 9 mg
- How often
- Once weekly
- How long
- 60 weeks
Two steps up from 3 mg (3, 6, then 9 mg) in adults with a BMI of 30 or more. Mean loss 16.65% vs 1.50% on placebo. Filed for approval in China in November 2025.
Draw 90 units10 mg + 1 mL
US phase 2, up to 16 mg
Trial- Dose
- 10 or 16 mg
- How often
- Once weekly
- How long
- 48 weeks
Started at 1.5 mg with 4-week steps. At 32 weeks: 15.6% (10 mg) and 18.1% (16 mg) vs 0.9% on placebo; 20% stopped 16 mg for side effects.
GLORY-1 step-up (6 mg group)
| Period | Dose | Draw at 10 mg/mL |
|---|---|---|
| Weeks 1–4 | 2 mg | 20 units (0.20 mL) |
| Weeks 5–8 | 4 mg | 40 units (0.40 mL) |
| Week 9 on | 6 mg | 60 units (0.60 mL) |
Units assume a 10 mg vial mixed with 1 mL. Use the calculator for other vial sizes. The 4 mg group stayed at 4 mg from week 5. Innovent describes its regimen in China as 2 mg, 4 mg, then 6 mg.
Taking it
Where it goes
Injected under the skin once a week in trials. The belly, thigh or upper arm are the usual sites, rotated each week.
If you miss a dose
No English-language label or published trial rule. Common practice is to take the next dose on schedule without doubling up. For comparison, the Wegovy label restarts at a lower dose after 2+ missed doses.
What to expect
- Weeks 1–8
The dose steps up from 2 mg. Stomach side effects peak during the step-ups and are mostly mild to moderate (DREAMS trials).
Trial - Week 32
GLORY-1: 10.1% loss on 4 mg and 12.6% on 6 mg vs a 0.5% gain on placebo. In type 2 diabetes, 48.0% on 6 mg reached both HbA1c under 7% and 10% weight loss vs 21.0% on semaglutide 1 mg (DREAMS-3).
Trial - Week 48
GLORY-1: 11.0% and 14.0% vs a 0.3% gain; 35.7% and 49.5% lost at least 15%.
Trial - Week 60 (9 mg)
GLORY-2: 16.65% vs 1.50% on placebo; 84.3% lost at least 5%.
Trial
Side effects and what to do
Nausea 31%, diarrhea 27%, vomiting 24% at 6 mg (DREAMS-3; semaglutide 1 mg: 13%, 22%, 9%)
Mostly mild to moderate and worst during step-ups. Smaller meals help; ongoing vomiting needs medical advice.
Vomiting 53%, nausea 47%, diarrhea 39% at 9 mg (GLORY-2; placebo 1%, 3%, 7%)
Higher doses bring more GI effects. Stay hydrated; heavy fluid loss can strain the kidneys.
Stopping for side effects: 0.5–1.5% at 4–6 mg (GLORY-1; placebo 1.0%), 2.9% at 9 mg (GLORY-2), 20% at 16 mg (US phase 2)
Tolerability falls as the dose rises.
Low blood sugar with other diabetes drugs (no severe episodes in DREAMS-1 or -2; mild to moderate ones about as common as on dulaglutide)
Take extra care with insulin or a sulfonylurea, and check glucose more often while the dose rises.
Stop and get medical help
Severe belly pain that won’t go away, signs of allergy, a racing heart at rest or fainting, or dehydration (dizziness, very little urine). Get medical help.
Who should avoid it
Mazdutide is approved outside the US, but its label couldn’t be checked, so these come from its trials and from precautions based on how it works. Most important first.
- History of medullary thyroid cancer or MEN 2
- TrialExcluded from the trials, including a family history; MEN 2 is an inherited tumor syndrome. Approved GLP-1 drugs such as semaglutide are ruled out for this group because of thyroid C-cell tumors in rodents.
- Past pancreatitis or gallbladder disease
- TrialExcluded from the trials (gallbladder disease in Phase 2). Both are listed risks of approved GLP-1 drugs such as semaglutide.
- Depression or a past suicide attempt
- TrialGLORY-1 excluded moderate to severe depression, severe mental illness and any past suicide attempt. Phase 2 found no link with depression scores, but these groups weren’t studied.
- Heart disease or a fast or irregular heartbeat
- TrialPhase 2 excluded heart attack, heart failure, serious rhythm problems and a resting pulse over 100. Heart rate rose more than on placebo at the top dose.
- Pregnancy or breastfeeding
- PrecautionNo human safety data exist.
- Anyone relying on product quality
- PrecautionOutside China it isn’t approved, so vials sold online have no regulated standard for identity, purity or sterility, and none has been tested in a trial.
Interactions
No interaction studies have been published, and China’s product label, the only one, wasn’t available to review.
Trial: seen in human studies, or a group those studies left out. Precaution: follows from how it works or from a related drug, and hasn’t been tested. This isn’t a complete list: a pharmacist or doctor can check a specific medicine or condition.
Tracking and pairing
Worth tracking
- Blood sugar if you use insulin or a sulfonylurea
- Kidney function if vomiting or diarrhea is heavy
- Resting heart rate
- Lipids and liver enzymes (both improved in trials)
Often paired with
Usually run on its own.
Human studies
5 key published human studies, with how many people took part. Animal studies aren’t listed here.
-
Weight fell 11.0% and 14.0% vs a 0.3% gain on placebo in Chinese adults with overweight or obesity; 35.7% and 49.5% lost at least 15%.
- Design
- Randomized double-blind placebo-controlled trial (phase 3)
- Dose
- 4 or 6 mg weekly
- Length
- 48 weeks
Ji et al., N Engl J Med 2025 (GLORY-1), PMID 40421736
-
Weight fell 16.65% vs 1.50% on placebo in Chinese adults with a BMI of 30 or more; vomiting 53.1% vs 1.3%, and 2.9% stopped for side effects vs 0%.
- Design
- Randomized double-blind placebo-controlled trial (phase 3)
- Dose
- 9 mg weekly
- Length
- 60 weeks
Gao et al., JAMA 2026 (GLORY-2), PMID 42251595
-
HbA1c fell 1.61 and 1.66 points vs 1.36 with dulaglutide in type 2 diabetes on metformin-based treatment; weight fell 6.6% and 8.5% vs 2.8%.
- Design
- Randomized trial vs dulaglutide (phase 3)
- Dose
- 4 or 6 mg weekly vs dulaglutide 1.5 mg
- Length
- 28 weeks
Guo et al., Nature 2025 (DREAMS-2), PMID 41407860
-
HbA1c fell 1.58 and 2.02 points vs 0.25 on placebo in type 2 diabetes treated with diet and exercise only; weight fell 5.5% and 7.3% vs 1.2%.
- Design
- Randomized double-blind placebo-controlled trial (phase 3)
- Dose
- 4 or 6 mg weekly
- Length
- 24 weeks, plus 24-week extension
Zhu et al., Nature 2025 (DREAMS-1), PMID 41407859
-
At 32 weeks weight fell 7.3%, 15.6% and 18.1% vs 0.9% on placebo in US adults without diabetes; 20% stopped 16 mg because of side effects.
- Design
- Randomized double-blind placebo-controlled trial (phase 2)
- Dose
- 3 rising to 6 mg, 10 mg or 16 mg weekly
- Length
- 48 weeks
Hsia et al., Lancet Diabetes Endocrinol 2026, PMID 42628555
Limits of the evidence
The Phase 3 trials enrolled only Chinese adults and lasted 24–60 weeks; the largest, GLORY-1, had 610 people. Outside China, one US Phase 2 trial of 179 adults has been published, and no heart outcome trial has reported. The higher doses tested in the US aren’t approved anywhere, and research vials haven’t been tested.
Mixing your vial
| Vial | Water | Common dose | Draw | Strength | Action |
|---|---|---|---|---|---|
| 10 mg | 1 mL | 2 mg | 20 units (0.20 mL) | 10 mg/mL |
In China it comes in a single-use injection device with a hidden needle. Research vials are mixed with bacteriostatic water; with 1 mL in a 10 mg vial, each 10 units holds 1 mg.
Dose chart
10 mg vialSyringe units for common doses at different water volumes. Select a cell to open it in the calculator.
| Dose | Water added | ||
|---|---|---|---|
| 1 mL | 2 mL | 3 mL | |
| 2 mg | |||
| 4 mg | |||
| 6 mg | |||
| 9 mg | |||
U-100 insulin syringe: 100 units is 1 mL. Draws over 100 units show in mL. Faded values are under 2 units, which is hard to measure. Check that your vial holds the larger volumes.
Datasheet
- Half-life
- about 9 days TrialSingle 2 mg subcutaneous dose in Chinese adolescents with obesity (phase 1b); the authors report the same profile as in adults.
- Type
- Peptide, 34 amino acids
- Molecular weight
- 4,563.1 g/mol
- Formula
- C210H322N46O67
- Sequence
- HXQGTFTSDYSKYLDEKKAKEFVEWLLEGGPSSG-NH2X = Aib; Lys20 carries a C20 fatty diacid through a γGlu–2×OEG linker
- Storage before use
- Freezer for long-term storage; keep the vial sealed, dry and out of light.
- After mixing or opening
- Fridge (2–8 °C) after mixing; use within about 4 weeks.
- Half-life: Gong et al., ADA 2026 abstract 1133-OR (Diabetes 2026, suppl. 1), doi:10.2337/db26-1133-or; no PMID
- Molecule: KEGG D12225 (sequence, formula, MW 4563.07); Lys20 side chain as drawn in PubChem CID 167312357
- Storage: Community Common practice for research vials; the storage rules on the Chinese Xinermei label weren’t available in English
Every compound side by side: the half-life chart and the storage chart.
Cautions
- Approved only in China; the US and EU haven’t reviewed it.
- Nausea, vomiting and diarrhea are common and rise with dose: at 9 mg, 53% vomited and 47% had nausea vs 1% and 3% on placebo (GLORY-2).
- At 6 mg, nausea (31%) and vomiting (24%) were more common than on semaglutide 1 mg (13% and 9%) in DREAMS-3.
- The phase 3 trials were all in China and lasted 24 to 60 weeks; rare and long-term risks aren’t known yet.
Questions
What is mazdutide?
A once-weekly injectable peptide modeled on oxyntomodulin, a gut hormone, that activates both the GLP-1 and glucagon receptors. It curbs appetite and lowers blood sugar, and in trials it also cut liver fat.
How does mazdutide work?
Mazdutide is a modified copy of oxyntomodulin, a gut hormone, with a fatty-acid chain that lets it be given weekly. It switches on the GLP-1 receptor, which curbs appetite and raises insulin when blood sugar is high, and the glucagon receptor, which acts mainly on the liver and is expected to raise energy use. In trials it lowered weight, blood sugar and liver fat. How much the glucagon action adds in people is unclear. Glucagon can speed the heart: in Phase 2, heart rate rose about 9 beats per minute on the top dose vs 5 on placebo, and long-term heart effects are unknown.
Is mazdutide FDA-approved?
Not approved in the US or EU. Approved in China (NMPA) as Xinermei: June 27, 2025 for long-term weight management in adults (BMI 28 or more, or 24 or more with a weight-related condition) and September 19, 2025 for type 2 diabetes. A 9 mg dose for moderate to severe obesity was submitted in China in November 2025.
What is the usual mazdutide dose?
From human studies (GLORY-1, NEJM 2025): 2 mg once weekly for 4 weeks, then 4 mg. The 6 mg group took 4 mg for 4 weeks before moving to 6 mg. Innovent describes its regimen in China as 2 mg, 4 mg, then 6 mg. GLORY-2, JAMA 2026: 9 mg once weekly, reached in two steps (3 mg, then 6 mg, then 9 mg), in adults with a BMI of 30 or more: 16.65% mean loss at 60 weeks vs 1.50% on placebo. These are the amounts sources reference, not recommendations.
How much water do I mix mazdutide with?
There’s no single right amount, because the water only sets the strength. With 1 mL of bacteriostatic water in a 10 mg vial, the strength is 10 mg/mL, so 2 mg is 20 units on a U-100 insulin syringe. More water makes small doses easier to measure. The dose chart above shows other volumes.
Who should avoid mazdutide?
Mazdutide is approved outside the US, but its label couldn’t be checked, so these come from its trials and from precautions based on how it works. History of medullary thyroid cancer or MEN 2: Excluded from the trials, including a family history; MEN 2 is an inherited tumor syndrome. Approved GLP-1 drugs such as semaglutide are ruled out for this group because of thyroid C-cell tumors in rodents. Past pancreatitis or gallbladder disease: Excluded from the trials (gallbladder disease in Phase 2). Both are listed risks of approved GLP-1 drugs such as semaglutide. Depression or a past suicide attempt: GLORY-1 excluded moderate to severe depression, severe mental illness and any past suicide attempt. Phase 2 found no link with depression scores, but these groups weren’t studied. The “Who should avoid it” section lists 3 more groups.
What is the half-life of mazdutide?
About 9 days, measured in human studies. Single 2 mg subcutaneous dose in Chinese adolescents with obesity (phase 1b); the authors report the same profile as in adults.
How should mazdutide be stored?
Before mixing: Freezer for long-term storage; keep the vial sealed, dry and out of light. Fridge (2–8 °C) after mixing; use within about 4 weeks. This is common practice; no product label covers it.
Is mazdutide banned in sport?
No. Not named on the 2026 list. China approved it in 2025, so the S0 rule for drugs with no government approval no longer applies, and no other section covers GLP-1 or glucagon agonists. WADA’s 2026 Monitoring Program tracks only semaglutide and tirzepatide in this class.
Has mazdutide been studied in people?
Yes. The human studies section lists 5 published studies. The largest, from 2025, included 731 people. HbA1c fell 1.61 and 1.66 points vs 1.36 with dulaglutide in type 2 diabetes on metformin-based treatment; weight fell 6.6% and 8.5% vs 2.8%.
Sources
- Ji et al., mazdutide for obesity, GLORY-1 (NEJM 2025) PMID 40421736
- Gao et al., mazdutide 9 mg, GLORY-2 (JAMA 2026) PMID 42251595
- Shirley, Mazdutide: First Approval (Drugs 2025) PMID 41028652
- Innovent: China NMPA approvals for weight management (June 27, 2025) and type 2 diabetes (Sept 19, 2025)
For the protocol details
- US trial registry entry NCT05607680: GLORY-1 arm descriptions (step-up schedule)
- Luo et al., DREAMS-3: mazdutide 6 mg vs semaglutide 1 mg, ADA 2026 abstract 1226-OR (Diabetes 2026, suppl. 1) doi:10.2337/db26-1226-or
- Hsia et al., US phase 2 of mazdutide up to 16 mg (Lancet Diabetes Endocrinol 2026) PMID 42628555
- Innovent: mazdutide 9 mg application accepted by China’s NMPA (Nov 25, 2025)
For how it works, who should avoid it and the limits of the evidence
- GLORY-1 eligibility criteria (US trial registry entry) NCT05607680
- Ji et al., Phase 2 trial in Chinese adults with obesity (Nat Commun 2023) PMID 38092790
- Kushner and Michos, heart effects of glucagon and GLP-1 dual agonists, review (J Am Heart Assoc 2026) PMID 42535526
- Wegovy prescribing information, boxed warning and section 5, for class warnings (Novo Nordisk, DailyMed, rev. 06/2026)