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Drug companion protocol

Mazdutide

Prescription only
GLP-1 / glucagon dual receptor agonist

A dual GLP-1 / glucagon receptor agonist under clinical development for weight management and metabolic disease.

Quickstart Highlights

Drug class
GLP-1 / glucagon dual receptor agonist
Route
Subcutaneous injection
Schedule
Weekly subcutaneous injection
Evidence score
42

Quickstart highlights

  • ๐Ÿ’‰Subcutaneous injection
  • ๐Ÿ”ฌGLP-1 / glucagon dual receptor agonist
  • ๐Ÿ“‹Prescription required

How this works

Mechanism of action and pharmacokinetic profile from published data.

Mazdutide (also known as IBI362 or OXM3) is a dual GLP-1 / glucagon receptor agonist. Like retatrutide, it activates the glucagon receptor โ€” which promotes energy expenditure, fat oxidation, and liver-fat reduction โ€” alongside the GLP-1 receptor for appetite suppression and insulin regulation. Mazdutide is in clinical development primarily in China (Innovent Biologics), with Phase 3 trials underway in China and Phase 2 data published in the Lancet Diabetes & Endocrinology for type 2 diabetes.

Time to peak (Tmax)
~48โ€“72 hours after subcutaneous injection.
Clearance
Proteolytic degradation; full clearance characterisation is ongoing in Phase 3.
Elimination half-life
Approximately 3.5โ€“4 days based on Phase 2 data; supports once-weekly or less-frequent dosing.
Bioavailability
Published from Phase 2 investigational data in Chinese populations; not yet on a product label for other regions.

Clinical Benefits & Side Effects

Observed outcomes, adverse effects, and lifecycle considerations from published trial data.

Benefits

Week 0

Investigational status

Mazdutide is approved in China and in Phase 3 trials there; it remains investigational elsewhere. Dosing, escalation, and monitoring are trial-protocol-specific.

Week 1

First injection โ€” taking the first step

You've taken a big step by starting your first injection. This week is all about getting familiar with the process and listening to your body. You may not notice much change yet โ€” that's completely normal at this early, low starting dose.

Week 2

Body begins adjusting to the medication

Some people start to notice mild nausea, especially after eating or in the hours following their injection. You might also feel a little more full than usual at mealtimes. These early signals are signs your body is responding โ€” go gently with yourself.

Week 3

Navigating nausea and early side effects

Nausea, tiredness, or loose stools are commonly reported around this time and can feel discouraging. Most people find these symptoms are manageable and begin to ease with small, simple meals. Hang in there โ€” this phase is temporary for most people.

Week 4

Completing your first month โ€” finding your rhythm

You've made it through your first month โ€” that's worth acknowledging! Side effects may still be present but often start to settle. The scale may not have shifted much yet, and that's okay; your body is still adjusting to the medication.

Week 5

Dose may increase โ€” appetite changes ahead

Depending on your prescriber's plan, your dose may be increased around this point. With a higher dose, you might notice a more noticeable reduction in appetite or earlier feelings of fullness at meals. Follow your prescriber's instructions closely during this escalation phase.

Week 6

Appetite suppression becoming more noticeable

Many people report that food simply doesn't feel as appealing this week, or that they feel satisfied with much smaller portions. It's important to still eat regular, balanced meals โ€” your body needs consistent fuel even when hunger signals are quieter.

Week 7

Energy and mood may start to stabilise

As your body adapts to the higher dose, energy levels often begin to even out. Some people experience a second wave of nausea with dose escalation โ€” eating slowly, avoiding rich foods, and staying well hydrated can help manage this.

Side effects

โ—ฆNausea(mild-to-moderate)

Common; most frequent at 6 mg

โ—ฆVomiting(mild)

Reported

โ—ฆDiarrhoea(mild)

Reported

โ—ฆDecreased appetite(mild)

Common; generally expected

โ—ฆInjection-site reaction(mild)

Reported; generally mild

Lifecycle factors

Mazdutide is investigational outside China

Phase 3 trials are underway in China and some early Phase 2 data are international; the drug does not have TGA, FDA, MHRA, or EMA approval. Any questions about access or participation should go to your trial site.

Glucagon co-activation distinguishes this class

The glucagon receptor component of dual GLP-1/glucagon agonists like mazdutide and retatrutide is thought to increase energy expenditure โ€” a mechanism not present in pure GLP-1 agonists. Phase 2 data suggest this may be particularly effective for liver-fat reduction (NASH/MAFLD).

Store your medication correctly in the Australian climate

Australian summers can get extremely hot, and heat can degrade injectable medications quickly. Always store your pen in the fridge (typically **2โ€“8ยฐC**) and never leave it in a hot car, direct sunlight, or a warm bathroom cabinet. If you're travelling, use a medical-grade insulated travel pouch designed for injectable pens โ€” these are available at most Australian pharmacies.

Important note

This content is intended for therapeutic educational purposes only and does not constitute medical advice, diagnosis, or treatment. All information presented is based on published clinical trial data. Always follow your prescriber's instructions.

Nutrition & practical guidance

Food, hydration, and adherence tips compiled from trial data and clinical companion content.

Food and hydration

โœ… Prefer

Lean protein (chicken breast, canned tuna, eggs, legumes)Lean proteinNon-starchy vegetables (zucchini, spinach, broccoli, capsicum)Non-starchy vegetablesWholegrains (rolled oats, brown rice, grainy bread)Low-fat dairy or fortified plant alternatives (Greek yoghurt, reduced-fat milk)Low-GI carbohydratesSoft, mild fruits (banana, melon, tinned peaches in juice)

โš ๏ธ Limit

High-fat mealsRefined sugars and sweetsHigh-fat takeaway and fried foods (hot chips, fried chicken, pastries)Sugary drinks and fruit juices

Adherence tips

administration

Rotate your injection sites consistently

Always rotate between recommended injection areas โ€” typically the abdomen (at least 5 cm from your belly button), front of the thigh, or upper arm. Rotating sites within each area each week helps prevent lumps or skin irritation building up at one spot. Keep a simple note on your phone or a sticky note on your pen to track where you last injected.

administration

Let your pen reach room temperature before injecting

Injecting medication that's straight from the fridge can sting more and feel uncomfortable. Take your pen out of the fridge **15โ€“30 minutes before** your scheduled injection and let it warm to room temperature. Never use a microwave or warm water to heat it โ€” just leave it on the bench. Follow your prescriber's instructions for storage between uses.

timing

Pick an injection day you can stick to every week

Choose a day of the week that works for your schedule โ€” such as Sunday morning before breakfast or Wednesday evening โ€” and stick to it. Consistency in timing supports steady medication levels in your body. Set a recurring weekly reminder on your phone so it becomes as automatic as charging your phone.

timing

Consider injecting on a day before a lighter schedule

Some people feel slightly fatigued or nauseous in the 12โ€“24 hours after their injection, especially in the early weeks. If possible, schedule your injection on a day before a lighter day โ€” for example, Friday evening if you have a quieter Saturday. This gives your body time to adjust without impacting a busy work day.

nutrition

Liver-fat reduction context

If you are in a mazdutide trial partly because of non-alcoholic fatty liver disease, your trial team may monitor liver enzymes and imaging. A low-fat, low-fructose dietary pattern is broadly recommended alongside pharmacotherapy for liver-fat reduction.

hydration

Start every morning with a full glass of water

Before coffee, before breakfast โ€” drink a full 250โ€“300 mL glass of water as the very first thing you do each morning. This simple habit kick-starts your hydration for the day and can help reduce that early-morning nausea some people experience. Keep a glass or water bottle on your bedside table the night before as a visual cue.

hydration

Sip water steadily โ€” don't gulp large amounts at once

Drinking large quantities of water quickly can actually worsen nausea and feelings of bloating when your stomach is already sensitive. Instead, aim to **sip steadily throughout the day** โ€” a few mouthfuls every 15โ€“20 minutes. A 750 mL drink bottle is a practical tool for keeping track without counting glasses.

nutrition

Prioritise protein at every meal, even small ones

When your appetite is reduced, it's easy to eat very little overall โ€” but insufficient protein can lead to muscle loss over time. Aim to include a palm-sized serve of protein at each meal: eggs at breakfast, canned tuna or legumes at lunch, and chicken or tofu at dinner. Even small amounts of protein at each sitting add up and matter.

nutrition

Eat smaller meals more frequently to manage nausea

Rather than three large meals, try shifting to **4โ€“5 smaller eating occasions** across the day, especially in the first eight weeks. An empty stomach can sometimes make nausea worse, while overfilling it definitely will. Think of it as keeping the tank topped up rather than filling it to the brim.

mindset

Track non-scale victories alongside your weight

The number on the scale is only one small measure of progress โ€” and it can be frustratingly slow in the early weeks. Keep a short weekly note (even in your phone's notes app) of other changes: energy levels, how your clothes feel, how far you walked, how you slept. These 'non-scale victories' often tell a much richer story of what's actually changing in your body.

mindset

Be patient with the early weeks โ€” they're the hardest

The first four weeks are widely regarded as the most challenging part of starting a GLP-1-based medication. Side effects are at their most noticeable, results are least visible, and it can feel discouraging. Knowing this in advance can help you push through. Many people who persisted past week four report that things became significantly more manageable.

exercise

Start movement gently โ€” a 20-minute walk counts

You don't need to join a gym or start an intense program. In the early weeks, a 20-minute walk at a comfortable pace โ€” around the block or along a local path โ€” is genuinely beneficial and appropriate. As your energy and confidence grow, you can gradually increase duration or intensity. Any consistent movement is far better than none.

exercise

Add light resistance exercise to protect muscle

Because weight loss from any method can reduce muscle mass, adding some resistance-based movement โ€” like bodyweight squats, resistance bands, or light weights โ€” 2โ€“3 times per week is highly beneficial. It doesn't need to be intense; even a simple 15-minute home routine can make a meaningful difference. Chat with a qualified exercise professional for a plan suited to your current fitness level.

sleep

Protect your sleep โ€” it directly supports your results

Poor sleep increases hunger hormones and can make food cravings harder to manage โ€” working against the appetite changes you're trying to support with this medication. Aim for **7โ€“9 hours per night** and try to keep a consistent bedtime, even on weekends. If nausea is disrupting your sleep, try your injection earlier in the day and avoid eating within two hours of bed.

mindset

Communicate openly with your prescriber โ€” every concern counts

Your prescriber needs accurate information to support you well โ€” so don't hold back from telling them about side effects, how you're coping emotionally, or if something feels wrong. No concern is too minor to mention. Follow your prescriber's instructions about check-in appointments, and consider keeping a brief weekly log of symptoms to share at each visit.

Safety and interactions

Share this information with your prescriber for personalised care decisions.

Who should not take this

Mazdutide is investigational outside China; access is limited to clinical trial participants. Based on published trial exclusion criteria and the GLP-1/glucagon class: โ€ข Personal or family history of medullary thyroid carcinoma (MTC) or MEN2 โ€ข History of pancreatitis or unexplained persistent abdominal pain โ€ข Severe GI disease โ€ข Recent major cardiovascular events โ€ข Pregnancy or breastfeeding โ€ข Severe kidney or liver impairment No regulatory label exists outside trial contexts. Direct questions to your trial site.

Known interactions

  • Insulin and sulfonylureas
    significant

    GLP-1 agonism increases insulin secretion โ€” combining with other insulin-stimulating agents raises hypoglycaemia risk.

  • Oral contraceptives
    moderate

    GLP-1-mediated gastric slowing may affect oral contraceptive absorption.

  • Alcohol
    moderate

    Worsens nausea and GI effects; increases hypoglycaemia risk with co-administered glucose-lowering drugs.

Storage and handling

As an investigational biologic, storage is governed by the trial protocol or supplying pharmacy. GLP-1 family injectables in this class require refrigeration at 2โ€“8ยฐC and must not be frozen. Follow the instructions provided by your trial site.

Research evidence

Published studies connected to this peptide with dosage and outcomes context.

Efficacy and safety of mazdutide (IBI362) 4 mg and 6 mg in Chinese adults with type 2 diabetes and overweight or obesity: a randomised, double-blind, placebo-controlled, phase 2 trial

Human trial ยท 2023 ยท The Lancet Diabetes & Endocrinology ยท n=265 ยท Chinese adults with type 2 diabetes and BMI โ‰ฅ25, on stable metformin

265 adults were randomised to mazdutide 4 mg weekly, 6 mg weekly, or placebo for 24 weeks. HbA1c reductions were โˆ’1.46% and โˆ’1.81% for 4 and 6 mg respectively versus โˆ’0.22% for placebo. Body-weight reductions were โˆ’6.67% and โˆ’9.73% respectively. GI adverse events were the most common, generally mild-to-moderate.

Reported outcomes

  • weight_loss: Body-weight reductions of โˆ’6.67% at 4 mg and โˆ’9.73% at 6 mg weekly versus +0.05% for placebo. (Secondary)
  • hba1c_reduction: HbA1c reductions of โˆ’1.46% at 4 mg and โˆ’1.81% at 6 mg weekly versus โˆ’0.22% for placebo at 24 weeks. (Primary outcome)

Reported dosage

  • 4 mg ยท once weekly subcutaneous ยท 24 weeks โ€” Lower dose arm in the Phase 2 T2D trial.
  • 6 mg ยท once weekly subcutaneous ยท 24 weeks โ€” Higher dose arm; produced larger HbA1c and body-weight reductions.
DOI: 10.1016/S2213-8587(23)00091-8 โ†—

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