Carl read the papersWhat it actually is
Mazdutide is a synthetic peptide that switches on two receptors at once: GLP-1, the appetite and blood sugar receptor semaglutide uses, and glucagon, a receptor that does most of its work in the liver. Eli Lilly developed it and licensed the China rights to Innovent, which ran the big trials.
China's regulator approved it for chronic weight management in June 2025 and for type 2 diabetes in September 2025. It is not approved in the US, Europe or South Africa. Lilly has also tested it in the US, at much higher doses than the Chinese label uses.
How it’s thought to work
- GLP-1 receptor agonism — Same receptor as semaglutide: fuller sooner, less interest in food, better blood sugar after meals.
- Glucagon receptor agonism — Glucagon acts directly on the liver, pushing it to burn fat and make less of it. That is the case for pairing it with GLP-1.
- Liver fat — In GLORY-1, people who started with at least 10% liver fat cut it by about 66% on 4 mg and 80% on 6 mg by week 48, against 5% on placebo, per Innovent.
- Weekly dosing — One injection a week, stepped up every 4 weeks to the maintenance dose.
What the research says
Solid and growing, with one catch: nearly all of it comes from China. GLORY-1 (phase 3, 610 adults, 48 weeks) found weight change of -11.0% on 4 mg and -14.0% on 6 mg against +0.3% on placebo. GLORY-2 pushed the dose to 9 mg in adults with a BMI of 30 or more and got -16.7% at 60 weeks against -1.5%. Two diabetes trials (DREAMS-1 and -2) beat placebo and dulaglutide on blood sugar and weight. Lilly's own US phase 2 went up to 16 mg and reached -18.1% at 32 weeks, but 1 in 5 people on that dose stopped because of side effects.
- GLORY-1 (phase 3, n=610, 48 wks): -11.0% on 4 mg, -14.0% on 6 mg, +0.3% on placebo.
- GLORY-2 (phase 3, n=461, 60 wks): -16.7% on 9 mg vs -1.5% on placebo; vomiting in 53% vs 1%.
- DREAMS-2 (type 2 diabetes): beat dulaglutide 1.5 mg on HbA1c and on weight.
- US phase 2 (Lilly, n=179): -18.1% at 32 wks on 16 mg; 20% on that dose stopped for side effects.
Reported protocols
These are the doses the peptide community actually reports running (Reddit & forums), alongside published research — logged for education, not as a recommendation to use.
| Parameter | Commonly reported range |
|---|---|
| Label dose (China) | 2, 4 or 6 mg once weekly; the approved pen covers all three. The GLORY-1 schedule behind the approval: 2 mg for 4 weeks, then 4 mg; for 6 mg, another 4 weeks at 4 mg first. A prescription medicine in China. |
| Higher-dose trials | 9 mg (GLORY-2) and up to 16 mg in Lilly's US phase 2, which climbed in 4-week steps (1.5, 3, 6, 9, 12, 16 mg). Not on any label. |
| Community dose | One long forum thread (a handful of users): starts between 0.25 and 1.5 mg weekly, settling between 2 and 5 mg, often on top of tirzepatide or retatrutide |
| Frequency | Once weekly |
| Route | Subcutaneous |
| Community tip | Two users said 2 to 2.5 mg already cut their hunger hard, and one backed down from 2.5 to 2 mg. Higher is not automatically better: the 16 mg trial arm lost 1 in 5 people to side effects. |
Common use cases
| Goal | Community protocol notes |
|---|---|
| Chronic weight management | the approved Chinese indication, 4 or 6 mg weekly |
| Type 2 diabetes with excess weight | approved in China; beat dulaglutide on HbA1c and weight |
| Fatty liver alongside weight loss | liver fat fell sharply in GLORY-1; not an approved liver indication |
Mixing it (reconstitution)
Freeze-dried peptides must be reconstituted with bacteriostatic water before they can be measured. Carl’s calculator turns “mg in the vial + ml of water + target dose” into “units on the syringe” — and tells you how long the vial lasts.
→ Open the Reconstitution Calculator
Injection & handling
Subcutaneous, once weekly, rotating between abdomen, thigh and upper arm. The trial schedule behind the Chinese approval steps up every 4 weeks (2 mg, then 4 mg, then 6 mg if used), and Lilly's higher-dose US trial kept the same 4-week steps. Stomach side effects are the main complaint in every mazdutide trial and climb with dose, so stopping at the lowest dose that works is the sensible habit. The approved Chinese multi-dose pen keeps for up to 12 weeks at 2 to 8 C once opened; reconstituted research powder has no such data, so keep it cold.
Stacks it appears in
- With tirzepatide — The most common forum pattern: a low mazdutide dose added to a tirzepatide maintenance dose. No trial has tested it.
- With retatrutide — Also reported. Retatrutide already hits GLP-1 and glucagon (plus GIP), so this doubles up on receptors rather than adding a new one.
Sources
- GLORY-1, NEJM 2025 (PMID 40421736)
- GLORY-2, JAMA 2026 (PMID 42251595)
- DREAMS-2 vs dulaglutide, Nature 2026 (PMID 41407860)
- DREAMS-1 vs placebo, Nature 2026 (PMID 41407859)
- Lilly US phase 2 up to 16 mg, Lancet Diabetes Endocrinol 2026 (PMID 42628555)
- GLORY-1 arms, ClinicalTrials.gov NCT05607680
- Innovent press release: NMPA approval for chronic weight management (27 Jun 2025)
- Innovent press release: NMPA approval for type 2 diabetes (Sep 2025)
- Xinhua: NMPA approves mazdutide multi-dose pen (May 2026)
- Retatrutide phase 2, NEJM 2023 (PMID 37366315)
- Pemvidutide MASLD trial, J Hepatol 2025 (PMID 39002641)
- JAMA news 2026: unapproved GLP-1 drugs retatrutide and zenagamtide (PMID 42853576)
- GLP-1 Forum, 'Any Experiences with Maz?' thread (pages 1-3)
- SAHPRA, Peptide Products: Public Information (published 26 May 2026)
- WADA 2026 Prohibited List (S0 non-approved substances; S6.B specified stimulants)
- Lilly US phase 2 arms, ClinicalTrials.gov NCT06124807
