An investigational once-weekly injection that switches on the GLP-1 and glucagon receptors in equal measure. It is being developed mainly for MASH, a fatty liver disease with inflammation, and for alcohol use disorder; it also lowered weight in trials.
Evidence. Investigational (Altimmune). In the phase 2b IMPACT trial (212 adults with MASH and F2–F3 liver scarring), MASH cleared without worse scarring in 52–58% vs 20% on placebo at 24 weeks, counting everyone randomized, but scarring didn’t improve more than on placebo. A 48-week obesity trial (MOMENTUM, 391 adults) reported 10.3–15.6% weight loss vs 2.2% in a 2023 company release; a phase 3 MASH trial began in July 2026, and it isn’t approved anywhere.
What it’s used for
None of these uses is approved. Uses tested in people come first, then claims that rest on animal studies or user reports.
MASH, fatty liver with inflammation
TrialPromising: in IMPACT (212 adults with MASH and F2–F3 scarring), MASH cleared without worse scarring in 52–58% vs 20% on placebo at 24 weeks, but scarring didn’t improve more than on placebo.
Liver fat in fatty liver disease (MASLD)
TrialPositive: in a 12-week trial of 94 adults, liver fat fell 47–69% vs 4% on placebo; in a 24-week extension (64 people) it fell 56–76% vs 14%.
Weight loss in obesity
TrialPromising but unpublished: in MOMENTUM (391 adults without diabetes), weight fell 10.3–15.6% vs 2.2% on placebo at 48 weeks, per Altimmune’s 2023 release. No obesity phase 3 has been announced.
Alcohol use disorder
TrialPromising: in RECLAIM (100 adults with a BMI over 25), heavy drinking days fell by 4.2 a week vs 2.75 on placebo over 24 weeks, per a July 2026 company release; not yet published.
Alcohol-related liver disease
TrialUnproven: RESTORE, a 48-week placebo-controlled trial in about 120 adults, finished enrolling in July 2026; results are expected in the second half of 2027.
Keeping muscle during weight loss
TrialUnproven: Altimmune reported that 25.5% of the weight lost in MOMENTUM was lean mass (press release, March 2024). No head-to-head comparison with other weight-loss drugs has been published.
Not approved anywhere. FDA has granted Breakthrough Therapy designation for MASH, based on 24-week IMPACT data, and Fast Track designations for MASH and alcohol use disorder. The phase 3 MASH trial (PERFORMA) began in July 2026; Altimmune expects its 52-week results in 2029.
US compounding
Never nominated for FDA’s 503A or 503B bulk lists: it isn’t in Categories 1–3 (503A list updated May 14, 2026), and it isn’t part of any approved drug, so it doesn’t qualify for US compounding.
European Union
No marketing authorization.
United Kingdom
No marketing authorization (MHRA).
Canada
No marketing authorization; no pemvidutide product is listed in Health Canada’s Drug Product Database.
Australia
No marketing authorization, and pemvidutide isn’t named in the Poisons Standard (October 2026).
Sport (WADA 2026)
Likely banned in sportNot named on WADA’s 2026 list, but its S0 rule bans drugs with no current human approval anywhere, at all times.
Category 2 is FDA’s list of bulk substances that may present significant safety risks in compounding. The 503A bulks list adds substances that pharmacies may compound with. Advisory committee votes are advice; FDA makes the final decision. 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 outside the US checked October 7, 2026 against EMA, MHRA, Health Canada and TGA records. By country: EU, UK, Canada, Australia. Status of every compound.
How it works
Pemvidutide binds and switches on two receptors in roughly equal measure: GLP-1, which curbs appetite and slows stomach emptying, and glucagon, found mainly in the liver, where it speeds fat burning and slows fat making. An attached fatty-acid sugar group makes it cling loosely to albumin, a blood protein, and slows its release from under the skin, so it can be given once a week. In a 12-week trial, liver fat fell by up to 69% while weight fell about 4%.
TrialMainly from studies in people.
Not known
No trial has compared it with a GLP-1-only drug, so how much the glucagon action adds in people is unproven. Effects on liver scarring, heart outcomes and safety beyond 48 weeks are unknown; the phase 3 trial reports from 2029.
Protocol
Trial
IMPACT, Lancet 2025
MASH: 1.2 or 1.8 mg once weekly from the first dose, with no step-up. At 24 weeks MASH cleared without worse scarring in 58% and 52% vs 20% on placebo, counting everyone randomized.
Trial
MOMENTUM, Altimmune 2023
Obesity: 1.2, 1.8 or 2.4 mg once weekly for 48 weeks; only 2.4 mg was reached by a 4-week step-up. Weight fell 10.3%, 11.2% and 15.6% vs 2.2% on placebo.
Trial
PERFORMA, RECLAIM, 2026
Current trials: 1.8 or 2.4 mg weekly in the phase 3 MASH trial, and 2.4 mg weekly in the alcohol trials (reached in two steps in RECLAIM).
Frequency
Once weekly
Route
Subcutaneous injection (trials)
Cycle
Continuous in trials (12–48 weeks).
Week 15913172125
Continuous, shown over 26 weeks
Common protocols
The ways Pemvidutide is most often run, each tagged with where it comes from.
MASH (IMPACT)
Trial
Dose
1.2 or 1.8 mg
How often
Once weekly
How long
48 weeks
Full dose from week 1, no step-up. At 24 weeks MASH cleared without worse scarring in 58% and 52% vs 20% on placebo; at 48 weeks weight was down 4.5% and 7.5% vs 0.2% (company release).
Obesity (MOMENTUM)
Trial
Dose
1.2, 1.8 or 2.4 mg
How often
Once weekly
How long
48 weeks
Adults without diabetes; 2.4 mg was reached after a 4-week step-up. Weight fell 10.3%, 11.2% and 15.6% vs 2.2% on placebo (company release; not published in a journal).
Phase 3 MASH (PERFORMA)
Trial
Dose
1.8 or 2.4 mg
How often
Once weekly
How long
Liver biopsies at 52 weeks; follow-up for about 5 years
About 1,800 adults with F2–F3 MASH, recruiting since July 2026. Altimmune expects 52-week results in 2029.
Alcohol use disorder (RECLAIM)
Trial
Dose
2.4 mg
How often
Once weekly
How long
24 weeks
Reached in two steps. Heavy drinking days fell by 4.2 a week vs 2.75 on placebo; 10% stopped for drug-related side effects vs none on placebo (company release, July 2026).
Taking it
Where it goes
Injected under the skin once a week in trials; published reports don’t name the sites used. Weekly injections are usually rotated between the belly, thigh and upper arm.
If you miss a dose
No published guidance. Common practice for weekly injections is to take the next dose on schedule without doubling up.
Fatty liver trial (94 adults): liver fat fell 47–69% vs 4% on placebo, and weight by up to 4.3%.
Trial
Week 24
IMPACT: MASH cleared without worse scarring in 52–58% vs 20% on placebo; weight fell 5.0–6.2% vs 1.0% (company release).
Trial
Week 48
MOMENTUM: weight fell 15.6% on 2.4 mg vs 2.2% on placebo, and 32% of those on 2.4 mg with data lost 20% or more (company release). IMPACT: weight fell 7.5% on 1.8 mg vs 0.2%.
Trial
Side effects and what to do
Nausea (MOMENTUM: 25.5%, 59.6% and 51.5% at 1.2, 1.8 and 2.4 mg vs 11.3% on placebo)
Most common at 1.8–2.4 mg. Most trials started at the full dose; only 2.4 mg was stepped up.
Vomiting (MOMENTUM: 6.1–27.8% vs 3.1% on placebo)
Ongoing vomiting can dehydrate; get medical advice and keep up fluids.
Stopping because of side effects (MOMENTUM: 19.2% at 1.8 mg and 19.6% at 2.4 mg vs 6.2% on placebo)
In IMPACT, at 1.2–1.8 mg, 0–1% stopped vs 2% on placebo.
Faster heart rate (MOMENTUM: up 3.1 and 2.5 beats a minute at 1.8 and 2.4 mg vs down 1.4 on placebo)
Small rise; blood pressure fell. Report palpitations or a racing pulse at rest.
Diarrhea or constipation (24-week fatty liver trial: up to 33% and 20%, mostly mild)
Resolved without treatment in that small trial.
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.
Can it cause …?
The side effects people ask about most, answered one by one. Each answer says where it comes from.
Tiredness
Not reportedTiredness isn’t among the side effects reported so far from trials of up to 48 weeks, but full side-effect tables haven’t been published.
Headache
Not reportedHeadache isn’t among the side effects reported so far from trials of up to 48 weeks, but full side-effect tables haven’t been published.
Nausea or vomiting
TrialNausea 25.5–59.6% and vomiting 6.1–27.8% vs 11.3% and 3.1% on placebo in MOMENTUM (48 weeks, company release), highest at 1.8–2.4 mg.
Diarrhea or constipation
TrialIn a 12-week extension of a fatty liver trial (64 people), diarrhea hit 7–33% vs 21% on placebo and constipation 0–20% vs 5%, mostly mild.
Dizziness
Not reportedDizziness isn’t among the side effects reported so far from trials of up to 48 weeks, but full side-effect tables haven’t been published.
Trouble sleeping
Not reportedTrouble sleeping isn’t among the side effects reported so far from trials of up to 48 weeks, but full side-effect tables haven’t been published.
Hair loss
Not reportedHair loss isn’t among the side effects reported so far from trials of up to 48 weeks, but full side-effect tables haven’t been published.
Acne, rash or skin changes
Not reportedRash or injection-site reactions aren’t among the side effects reported so far from trials of up to 48 weeks; full tables haven’t been published.
Water retention or swelling
Not reportedSwelling or water retention isn’t among the side effects reported so far from trials of up to 48 weeks; full tables haven’t been published.
Joint or muscle pain
Not reportedJoint or muscle pain isn’t among the side effects reported so far from trials of up to 48 weeks; full tables haven’t been published.
Anxiety, low mood or irritability
Not reportedMood changes haven’t been reported so far. MOMENTUM excluded people with untreated depression or recent suicidal thoughts, so data in those groups are lacking.
Low or high blood sugar
TrialIn MOMENTUM (no diabetes), fasting glucose and HbA1c stayed about the same over 48 weeks, even though glucagon on its own raises blood sugar (company release).
Fast heartbeat or blood pressure changes
TrialMOMENTUM: heart rate rose 2.5–3.1 beats a minute at 1.8–2.4 mg vs a 1.4 fall on placebo, while systolic blood pressure fell; heart-rhythm events were similar to placebo.
More hunger
Not reportedMore hunger hasn’t been reported; weight fell 10.3–15.6% vs 2.2% over 48 weeks in MOMENTUM. Weight regain after stopping hasn’t been studied.
Liver strain
TrialLiver enzymes fell: ALT dropped about 37 IU/L vs 10 on placebo at 48 weeks in IMPACT (company release). No drug-induced liver injury has been reported.
Kidney problems
PrecautionKidney effects haven’t been reported. With related GLP-1 drugs, dehydration from vomiting or diarrhea has caused kidney injury, and vomiting hit up to 28% in MOMENTUM.
Cancer risk
PrecautionNo cancer signal has been reported in trials of up to 48 weeks. Approved GLP-1 drugs carry a warning about thyroid C-cell tumors seen in rodents.
Trial: reported in human studies. Precaution: a concern that follows from how it works or from a related drug, not measured. Not reported: studied in people and not reported. A side effect that hasn’t been reported can still happen, especially with long or high-dose use. Any of these across every compound: the side-effect finder.
Who should avoid it
No product label covers pemvidutide, so these come from human studies and from precautions based on how it works. Most important first.
History of pancreatitis
TrialPancreatitis in the past year excluded people from MOMENTUM. Pancreatitis, sometimes fatal, is a listed risk of approved GLP-1 drugs such as semaglutide.
History of medullary thyroid cancer or MEN 2
PrecautionApproved GLP-1 drugs are ruled out for this group because of thyroid C-cell tumors in rodents; no such data exist for pemvidutide. MEN 2 is an inherited tumor syndrome.
Slow stomach emptying or bowel disease
TrialMOMENTUM excluded conditions that affect stomach emptying or bowel habits. In that trial nausea hit up to 60% and vomiting up to 28% at the higher doses.
Cirrhosis
TrialPeople with cirrhosis or its complications were excluded from IMPACT and from the phase 3 trial, so its effects in cirrhosis are unknown.
Depression or suicidal thoughts
TrialMOMENTUM excluded untreated depression and recent suicidal thoughts or behavior, so there are no data in these groups.
Pregnancy or breastfeeding
PrecautionNo human safety data exist; trials excluded pregnant and breastfeeding women and required birth control.
Anyone relying on product quality
PrecautionIt isn’t approved anywhere, so anything sold outside trials has no regulated standard for identity, purity or sterility, and none has been tested in a trial.
Interactions
No interaction results have been published, and no product label lists any. A 2022 study in 40 healthy volunteers tested its effect on metformin, atorvastatin, warfarin, digoxin and a birth-control pill; no results have been posted or published.
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. Every documented interaction, by medicine: drug interactions.
Special situations
What’s known about pregnancy, breastfeeding, kidney and liver problems, age and surgery. Where nothing has been studied, the row says so.
Pregnancy
PrecautionNo human data; trials excluded pregnancy and required birth control. Related approved drugs harmed fetal development in animal studies. A 2022 study of its effect on birth-control pills is unpublished.
Breastfeeding
PrecautionNo human data; trials excluded breastfeeding women, and it isn’t known whether pemvidutide passes into breast milk.
Kidney problems
PrecautionNo study in kidney impairment has been published. Vomiting or diarrhea can dehydrate and injure the kidneys, as with related drugs.
Liver problems
TrialStudied in fatty liver disease, including MASH with moderate to advanced scarring (F2–F3). People with cirrhosis were excluded from IMPACT and the phase 3 trial; a trial in alcohol-related liver disease is under way.
Older adults
PrecautionTrials enrolled adults up to age 75; no results by age have been published.
Children and teens
PrecautionNot studied in anyone under 18, and no trial in children or teens is registered.
Surgery and anesthesia
PrecautionNo data. Related GLP-1 drugs slow stomach emptying, and their labels warn that stomach contents can enter the lungs under anesthesia; tell the surgical team about any injected compound.
Trial: from human studies. Precaution: not studied, so the caution follows from how it works or from a related drug. Ages are given as approved or studied; this site never gives doses for children. Across every compound: pregnancy, breastfeeding, kidney disease, liver disease, older adults and surgery.
Tracking and pairing
Worth tracking
Resting heart rate
Kidney function if vomiting or diarrhea is heavy
Blood sugar with insulin or a sulfonylurea
Liver enzymes
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.
2025212 people
In MASH with F2–F3 scarring, MASH cleared without worse scarring in 58% and 52% vs 20% on placebo; scarring improved in 33% and 36% vs 28%, not significant.
In adults with obesity or overweight without diabetes, weight fell 10.3%, 11.2% and 15.6% vs 2.2% on placebo; 19% stopped for side effects at the two higher doses vs 6%.
Altimmune press release, November 2023 (NCT05295875); not published in a journal
202594 people
In fatty liver disease with overweight or obesity, liver fat fell 46.6%, 68.5% and 57.1% vs 4.4% on placebo; weight fell up to 4.3% at 1.8 mg.
Design
Randomized double-blind placebo-controlled trial
Dose
1.2, 1.8 or 2.4 mg weekly
Length
12 weeks
Harrison et al., J Hepatol 2025, PMID 39002641
202564 people
Liver fat fell 56.3%, 75.2% and 76.4% vs 14.0% on placebo, and weight 5.1%, 6.2% and 5.2% vs 1.4%.
Design
Double-blind placebo-controlled 12-week extension of the 12-week trial
Dose
1.2, 1.8 or 2.4 mg weekly
Length
24 weeks in total
Browne et al., JHEP Rep 2025, PMID 41113119
2026100 people
In alcohol use disorder with a BMI over 25, heavy drinking days fell by 4.20 a week vs 2.75 on placebo (p=0.0014), and weight fell 9.1% more than on placebo.
Registered trials that are still running, or that finished without published results, most important first. Checked on ClinicalTrials.gov, October 7, 2026.
Phase 3NCT07795164
PERFORMA: 1.8 or 2.4 mg vs placebo in about 1,800 adults with MASH and F2–F3 scarring, without cirrhosis: liver biopsy results at 52 weeks, then liver outcomes over about 5 years
Recruiting since July 2026; main results expected 2029, completion December 2032
Phase 2NCT05989711
IMPACT: 1.2 or 1.8 mg vs placebo for 48 weeks in 212 adults with MASH and F2–F3 scarring
Completed November 2025; 24-week results published, 48-week results only in a company release
Phase 2NCT06987513
RECLAIM: 2.4 mg vs placebo for 24 weeks in 100 adults with alcohol use disorder and a BMI over 25: heavy drinking days
Completed July 2026; positive results announced by Altimmune, not yet published or posted
Phase 2NCT07009860
RESTORE: 2.4 mg vs placebo for 48 weeks in 121 adults with alcohol-related liver disease: liver stiffness
Active, not recruiting; completion expected September 2027
Published human data cover 94 adults in 12–24-week fatty liver trials and 212 in IMPACT’s 24-week results; the 48-week obesity trial (MOMENTUM, 391 adults) and the alcohol trial are known only from company press releases. No trial has compared it with an approved GLP-1 drug, no finished trial ran beyond 48 weeks, and the phase 3 trial won’t report until 2029. Nothing is known about doses or products used outside trials.
How it’s supplied
Weekly injections of 1.2–2.4 mg in phase 2 and 3 trials; not sold. Injected under the skin once a week. Most trials started at the full dose; 2.4 mg was reached in steps. It’s available only in clinical trials, so the calculator and dose log don’t apply.
Datasheet
Half-life
No reliable value has been published.
Type
Peptide, 29 amino acids
Molecular weight
3,873.4 g/mol
Formula
C182H275N39O54
Sequence
HXQGTFTSDYSKYLDEKAAKEFIQWLLQT-NH2X = Aib, 2-aminoisobutyric acid; Lys17 carries an 18-carbon fatty acid chain attached through glucuronic acid, the EuPort glycolipid; a lactam bridge joins Glu16 and Lys20
Storage before use
No label or published storage data; trial supplies are handled by the sponsor.
After mixing or opening
Not applicable: no product is mixed or sold outside trials.
Molecule: KEGG D12861 (sequence, formula; MW 3873.36); FDA substance registry, UNII A35F525WBG (INN chemical name and modifications)
Storage:Community No approved label exists; no storage data have been published for this compound
No approved product exists, and it isn’t commonly sold as a research peptide; chemical suppliers list small amounts for laboratory use only. Anything sold for injection has no regulated standard for identity, purity or sterility.
Cautions
Investigational and not approved anywhere; long-term safety is still being studied.
In the 48-week obesity trial, 19% stopped because of side effects at 1.8 and 2.4 mg vs 6% on placebo (company release).
Nausea hit 52–60% and vomiting 27–28% at 1.8–2.4 mg vs 11% and 3% on placebo in that trial. In the MASH trial, at 1.2–1.8 mg, 0–1% stopped for side effects vs 2% on placebo.
Not sold as a regulated product: anything sold for injection has no standard for identity, purity or sterility.
Questions
What is pemvidutide?
An investigational once-weekly injection that switches on the GLP-1 and glucagon receptors in equal measure. It is being developed mainly for MASH, a fatty liver disease with inflammation, and for alcohol use disorder; it also lowered weight in trials.
How does pemvidutide work?
Pemvidutide binds and switches on two receptors in roughly equal measure: GLP-1, which curbs appetite and slows stomach emptying, and glucagon, found mainly in the liver, where it speeds fat burning and slows fat making. An attached fatty-acid sugar group makes it cling loosely to albumin, a blood protein, and slows its release from under the skin, so it can be given once a week. In a 12-week trial, liver fat fell by up to 69% while weight fell about 4%. No trial has compared it with a GLP-1-only drug, so how much the glucagon action adds in people is unproven. Effects on liver scarring, heart outcomes and safety beyond 48 weeks are unknown; the phase 3 trial reports from 2029.
Is pemvidutide FDA-approved?
Not approved anywhere. FDA has granted Breakthrough Therapy designation for MASH, based on 24-week IMPACT data, and Fast Track designations for MASH and alcohol use disorder. The phase 3 MASH trial (PERFORMA) began in July 2026; Altimmune expects its 52-week results in 2029. Never nominated for FDA’s 503A or 503B bulk lists: it isn’t in Categories 1–3 (503A list updated May 14, 2026), and it isn’t part of any approved drug, so it doesn’t qualify for US compounding.
What is the usual pemvidutide dose?
From human studies (IMPACT, Lancet 2025): MASH: 1.2 or 1.8 mg once weekly from the first dose, with no step-up. At 24 weeks MASH cleared without worse scarring in 58% and 52% vs 20% on placebo, counting everyone randomized. Obesity: 1.2, 1.8 or 2.4 mg once weekly for 48 weeks; only 2.4 mg was reached by a 4-week step-up. Weight fell 10.3%, 11.2% and 15.6% vs 2.2% on placebo (MOMENTUM, Altimmune 2023). These are the amounts sources reference, not recommendations.
How is pemvidutide given?
Injected under the skin once a week. Most trials started at the full dose; 2.4 mg was reached in steps. It isn’t sold: it’s available only in clinical trials.
Who should avoid pemvidutide?
No product label covers pemvidutide, so these come from human studies and from precautions based on how it works. History of pancreatitis: Pancreatitis in the past year excluded people from MOMENTUM. Pancreatitis, sometimes fatal, is a listed risk of approved GLP-1 drugs such as semaglutide. History of medullary thyroid cancer or MEN 2: Approved GLP-1 drugs are ruled out for this group because of thyroid C-cell tumors in rodents; no such data exist for pemvidutide. MEN 2 is an inherited tumor syndrome. Slow stomach emptying or bowel disease: MOMENTUM excluded conditions that affect stomach emptying or bowel habits. In that trial nausea hit up to 60% and vomiting up to 28% at the higher doses. The “Who should avoid it” section lists 4 more groups.
How should pemvidutide be stored?
Before mixing: No label or published storage data; trial supplies are handled by the sponsor. Not applicable: no product is mixed or sold outside trials. This is common practice; no product label covers it.
Is pemvidutide banned in sport?
Probably. Not named on WADA’s 2026 list, but its S0 rule bans drugs with no current human approval anywhere, at all times.
Has pemvidutide been studied in people?
Yes. The human studies section lists 5 published studies. The largest, from 2023, included 391 people. In adults with obesity or overweight without diabetes, weight fell 10.3%, 11.2% and 15.6% vs 2.2% on placebo; 19% stopped for side effects at the two higher doses vs 6%.
How long has pemvidutide been studied in people?
Trial 48 weeks: MOMENTUM (391 adults with obesity) and IMPACT (212 adults with MASH). The phase 3 trial plans to follow about 1,800 adults for about 5 years.
Does pemvidutide come in other forms, like a pill or nasal spray?
Trial Only weekly injections under the skin have been tested. No tablet, nasal spray or patch form has been reported.
Can you drink alcohol while taking pemvidutide?
Trial In RECLAIM (100 adults with alcohol use disorder), heavy drinking days fell by 4.2 a week vs 2.75 on placebo over 24 weeks (company release). Heavy drinking can itself cause pancreatitis.
Can pemvidutide be taken with semaglutide or tirzepatide?
Precaution It already acts on the GLP-1 receptor, so adding semaglutide or tirzepatide would double up. No study has combined them; Wegovy’s label advises against using it with any other GLP-1 drug.
What happens if you take too much pemvidutide?
Precaution There’s no label and no published overdose data. Wegovy’s label says GLP-1 drug overdoses have caused severe nausea, vomiting and low blood sugar. Call Poison Help (1-800-222-1222), or emergency services for severe symptoms.
Sources
Noureddin et al., pemvidutide in MASH, IMPACT 24-week results (Lancet 2025) PMID 41237796
Harrison et al., 12-week trial in fatty liver disease (J Hepatol 2025) PMID 39002641
Browne et al., 24-week extension in fatty liver disease (JHEP Rep 2025) PMID 41113119