MEDICAL DISCLAIMER: Educational research guidelines only. Lyophilized peptides are investigational chemical compounds and are NOT approved for human consumption, diagnosis, or therapy. Consult a licensed physician before any research application.
Ecnoglutide Dosage Chart, Schedule & Reconstitution Protocol
Quickstart Highlights
Ecnoglutide (XW003) is a long-acting GLP-1 receptor agonist engineered for cAMP bias: it strongly activates the cAMP second-messenger pathway (EC50 about 0.018 nM) while causing little receptor internalization, a profile intended to sustain insulin secretion and amplify weight loss (PMID 37364710). It is a human GLP-1 analog stabilized by an Ala8Val swap and an 18-carbon fatty-diacid chain that binds albumin, giving a 124-138 hour half-life and once-weekly subcutaneous dosing. Across phase 2-3 trials, weekly doses of 0.4-1.2 mg lowered HbA1c by up to about 2.4% in type 2 diabetes, while 2.4 mg drove roughly 13% placebo-adjusted body-weight loss in obesity (PMID 39333121, 40555243). Dosing starts at 0.3 mg weekly and titrates upward about every four weeks to limit gastrointestinal side effects. China's NMPA approved ecnoglutide in 2026; it is not approved by the FDA or EMA, and the reconstitution figures here are educational only.
Reconstitute: Add 2 mL bacteriostatic water → 5 mg/mL concentration.
Typical dose: 0.6-2.4 mg (600-2400 mcg) SC once weekly, 0.3 mg start
Easy measuring: At 5 mg/mL, 1 unit = 0.01 mL = 0.0500 mg (50 mcg) on a U-100 insulin syringe.
Storage: Lyophilized powder stored frozen at −20 °C; reconstituted solution refrigerated at 2-8 °C and used within ~28 days. Protect from light; do not freeze the reconstituted solution or expose it to heat.
Half-life: Approximately 124-138 hours (about 5-6 days) at steady state, enabling once-weekly dosing
Route: Subcutaneous injection once weekly (abdomen, thigh, or upper arm), with stepwise dose titration
Status: Approved in China (NMPA, 2026) for type 2 diabetes and weight management; NOT FDA/EMA approved, investigational elsewhere
About Ecnoglutide
Ecnoglutide (XW003) is a once-weekly, cAMP-biased GLP-1 receptor agonist, a fatty-acid-modified analog of human GLP-1 designed for long-acting glucose lowering and weight reduction [1]. Its real-world route is already subcutaneous injection, so the reconstitution figures below closely mirror the format used in its clinical trials and in the approved Chinese product, rather than being a stand-in for an oral or topical drug [3][4].\n\nThis guide models a 10 mg vial reconstituted with 2.0 mL of bacteriostatic water (5 mg/mL, 50 mcg per insulin-syringe unit) so the trial doses land on clean U-100 syringe marks: 0.3 mg is about 6 units, 0.6 mg about 12 units, 1.2 mg about 24 units, and 2.4 mg about 48 units. Protocols begin at 0.3 mg once weekly and step up roughly every four weeks to limit gastrointestinal side effects, reaching a maintenance dose tailored to the indication (around 0.6-1.2 mg for type 2 diabetes, up to 2.4 mg for weight management) [2][3][4].\n\nFrequency: Once weekly, on the same day each week, at any time of day with or without food. Ecnoglutide is not FDA- or EMA-approved; the Ecnoglutide dosage protocol below is an educational reference only, not medical advice.
Quick Protocol Navigation
Reconstitution Instruction & Mixing Step-by-Step
Lyophilized powder must be reconstituted carefully. Agitating peptide chains can shear disulfide bonds and render the peptide biologically inert.
Draw 2.0 mL of bacteriostatic water into a sterile syringe.
Inject the water slowly down the inner glass wall of the 10 mg Ecnoglutide vial; do not spray the stream directly onto the lyophilized cake, and do not shake.
Gently swirl or roll the vial until the solution is completely clear; this yields a 5 mg/mL concentration (50 mcg per insulin-syringe unit).
Store refrigerated at 2-8 °C and draw the prescribed units per weekly dose: 0.3 mg ≈ 6 units, 0.6 mg ≈ 12 units, 1.2 mg ≈ 24 units, 2.4 mg ≈ 48 units.
Inject subcutaneously once weekly into the abdomen, thigh, or upper arm, rotating sites; ecnoglutide's real-world route is already subcutaneous, so these figures mirror the approved once-weekly injection format.
Interactive Ecnoglutide Syringe Calculator
Currently visualizing the 10 mg vial reconstituted with 2 mL bacteriostatic water. Adjust the target dose to dynamically render syringe units.
Reconstitution Calculation: 10mg dry powder in 2mL water yields 5.00 mg/mL. To evaluate a 250mcg dose, pull to 5.0 units (5 syringe ticks).
U-100 Syringe Representation
Educational reference visual. Assumes standard U-100 insulin syringe where 1.0 mL volume = 100 units.
Titration & Dose Escalation Schedules
| Phase | Dose per injection | Units (per injection) |
|---|---|---|
| Weeks 1-4 — initiation (0.3 mg) | 300 mcg | 6 units (0.06 mL) |
| Weeks 5-8 — first step-up / lower T2D maintenance (0.6 mg) | 600 mcg | 12 units (0.12 mL) |
| Weeks 9-12 — higher maintenance (1.2 mg) | 1200 mcg (1.2 mg) | 24 units (0.24 mL) |
| Week 13+ — top weight-management maintenance (2.4 mg) | 2400 mcg (2.4 mg) | 48 units (0.48 mL) |
Administration guidelines: Refer to guidelines | 2 mL Reconstitution
Research Supplies Quantity Planner
Scientific mathematical planning of syringes, bacteriostatic water and dry vials needed for extended research blocks using the 10 mg vial.
Peptide Vials (Ecnoglutide, 10 mg each):
- check8-week course ≈ 2 vials (a reconstituted 10 mg vial covers about 4 weekly doses before the ~28-day use-by)
- check12-week course ≈ 3 vials
- check16-week course ≈ 4 vials
- checkHigher 2.4 mg maintenance uses more drug per dose, but ~4 weekly doses still fit within a 10 mg vial
Insulin Syringes (U-100):
- checkOnce-weekly dosing: 1 syringe per injection
- check8 weeks ≈ 8 syringes; 12 weeks ≈ 12 syringes; 16 weeks ≈ 16 syringes
- checkUse a fresh U-100 syringe for each weekly dose and never reuse needles
Bacteriostatic Water (30 mL bottles): Use 2 mL per 10 mg vial for reconstitution.
- check8 weeks (≈2 vials) ≈ 4 mL, well under one 30 mL bottle
- check12 weeks (≈3 vials) ≈ 6 mL
- check16 weeks (≈4 vials) ≈ 8 mL, one 30 mL bottle covers a full course
Alcohol Swabs:
- check1-2 swabs per dose (vial septum + injection site)
- check8 weeks ≈ 16-24 swabs; 12 weeks ≈ 24-36 swabs
- check16 weeks ≈ 32-48 swabs; keep extras for re-swabbing the multi-dose vial
Mechanism of Action (MOA)
Ecnoglutide is a peptide analog of human glucagon-like peptide-1 (GLP-1) assembled from only natural amino acids. Two engineered features define it: an alanine-to-valine substitution at position 8 (Ala8Val), which shields the molecule from rapid cleavage by dipeptidyl peptidase-4 (DPP-4), and an 18-carbon fatty-diacid chain conjugated to the lysine-30 side chain, which lets the peptide bind reversibly to serum albumin and circulate for days [1]. Like all GLP-1 receptor agonists it activates the GLP-1 receptor, a class B G-protein-coupled receptor expressed on pancreatic beta cells and on appetite-regulating neurons in the hypothalamus and hindbrain.\n\nWhat distinguishes ecnoglutide is biased agonism. In vitro it is an extremely potent stimulator of the Gs-adenylate cyclase-cyclic AMP (cAMP) pathway (EC50 of roughly 0.018 nM) yet only weakly drives receptor internalization (EC50 greater than 10 μM) [1]. Because reduced internalization keeps more receptor available at the cell surface, the cAMP signal is sustained rather than rapidly desensitized. This is hypothesized to enhance glucose-dependent insulin secretion and amplify the weight-lowering and glycemic effects relative to less biased analogs; in rodent models ecnoglutide produced greater glucose lowering and weight loss than semaglutide [1]. Downstream, cAMP and protein kinase A potentiate glucose-stimulated insulin release, suppress inappropriate glucagon secretion, slow gastric emptying, and act centrally to reduce appetite and food intake, together lowering HbA1c and body weight [2][3].\n\nPharmacokinetics support a true once-weekly regimen. After subcutaneous injection the albumin-bound peptide is absorbed slowly and cleared slowly, giving a steady-state elimination half-life of approximately 124-138 hours (about 5-6 days) in phase 1 work [1][4]. Steady state is reached after several weekly doses, which is why protocols titrate the dose upward in roughly four-week steps rather than all at once. As a peptide, ecnoglutide is not meaningfully absorbed by mouth, so the clinically studied and approved route is subcutaneous injection (an oral coformulation is in earlier development); the reconstitution scheme on this page therefore reflects the real administration route. A dedicated drug-interaction study found no clinically meaningful effect on warfarin or metformin exposure, so co-administration with those agents did not require dose adjustment [6].\n\nRegulatory status: ecnoglutide is not approved by the US FDA or the European EMA. China's National Medical Products Administration (NMPA) approved ecnoglutide injection in early 2026, first for adult type 2 diabetes and then for chronic weight management, making it the world's first approved cAMP-biased GLP-1 receptor agonist [7]. Outside China it remains investigational, and any material sold for laboratory use is not intended for human administration. The figures here are an educational reference, not a prescription.
Clinical Trial Efficacy Highlights
- starGuo and colleagues (2023, Molecular Metabolism) described ecnoglutide's design, a GLP-1 backbone built only from natural amino acids with an Ala8Val substitution and a C18 fatty-diacid at Lys30, and showed it potently stimulated cAMP (EC50 about 0.018 nM) with negligible receptor internalization (EC50 greater than 10 μM); in rodents it produced greater glucose lowering and weight loss than semaglutide, and phase 1 work established a 124-138 hour steady-state half-life supporting once-weekly dosing [1].
- starIn a 20-week phase 2 randomized, double-blind, placebo-controlled trial of 145 adults with type 2 diabetes (Zhu et al., 2024, Nature Communications), once-weekly ecnoglutide at 0.4, 0.8 and 1.2 mg reduced HbA1c from baseline by -1.81%, -1.90% and -2.39% respectively versus -0.55% for placebo (P < 0.0001); 71.9% of the 1.2 mg group reached HbA1c at or below 6.5% and 33.3% lost at least 5% of body weight, versus 9.1% and 3.0% on placebo [2].
- starThe phase 3 EECOH-1 trial (211 adults with type 2 diabetes across 32 Chinese centers) started ecnoglutide at 0.3 mg weekly and escalated every four weeks to maintenance doses of 0.6 mg (reached week 4) or 1.2 mg (reached week 8); at week 24 the placebo-adjusted HbA1c reductions were -1.09% and -1.56%, with body-weight reductions of about 3 kg [4].
- starIn a phase 3 obesity trial of 664 adults with overweight or obesity without diabetes across 36 Chinese centers (Ji et al., 2025, Lancet Diabetes & Endocrinology), once-weekly ecnoglutide produced week-40 body-weight reductions of -9.1% (1.2 mg), -10.9% (1.8 mg) and -13.2% (2.4 mg) versus +0.1% for placebo, with 77-87% of treated participants losing at least 5% of body weight [3].
- starThe 52-week phase 3 EECOH-2 trial compared ecnoglutide head-to-head against the established once-weekly agonist dulaglutide in metformin-treated type 2 diabetes and met its non-inferiority objective for glycemic control, supporting ecnoglutide's efficacy against an active comparator [5].
- starA 2026 systematic review and meta-analysis pooling ecnoglutide's randomized trials concluded the drug consistently lowered HbA1c and body weight versus placebo, with a tolerability profile typical of the GLP-1 class and dominated by transient, mild-to-moderate gastrointestinal effects [8].
- starA dedicated open-label drug-interaction study found no clinically meaningful change in warfarin or metformin pharmacokinetics when co-administered with ecnoglutide, so no dose adjustment of those medications was required [6].
Side Effects & Tolerability Profile
Clinical subjects transiently report mild side effects. Slowly escalating the titration dose represents the single most effective intervention to limit side effects.
- warningGastrointestinal effects are the most common adverse events, including nausea, diarrhea, decreased appetite, vomiting and constipation; they are usually mild to moderate, transient, and most frequent during dose escalation [2][3][4].
- warningAsthenia (weakness/fatigue) and reduced appetite are also commonly reported, consistent with the appetite-suppressing action of the GLP-1 class [4].
- warningA minority of participants discontinued for adverse events (roughly 6% in the phase 3 obesity trial); slow, stepwise titration over four-week intervals improves tolerability [3].
- warningHypoglycemia risk rises when ecnoglutide is combined with insulin or sulfonylureas; because GLP-1 action is glucose-dependent, dose reductions of those background agents may be needed to avoid low blood sugar [2].
- warningGLP-1 receptor agonists as a class carry warnings for acute pancreatitis, gallbladder disease (cholelithiasis/cholecystitis), a modest rise in resting heart rate, and acute kidney injury from dehydration with severe vomiting or diarrhea; patients should stay hydrated and report severe abdominal pain.
- warningAs with other long-acting GLP-1 agonists, a contraindication based on a rodent thyroid C-cell tumor signal applies: it should be avoided in people with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 (MEN2); human relevance is unknown.
- warningEcnoglutide is a peptide and is not orally active, so it must be injected; injection-site reactions can occur, and sites should be rotated.
- warningRegulatory/research status: ecnoglutide is NOT approved by the FDA or EMA. It is approved only by China's NMPA (2026); elsewhere it is investigational, long-term safety outside the trial setting is not established, and material sold for laboratory use is not intended for human use [7].
Subcutaneous Injection Technique
Most research peptides require subcutaneous injection into fatty tissue. Never inject directly into a blood vessel or deep muscle tissue unless clinically detailed.
1. Site Selection
Common locations include the abdomen (2 inches from navel), outer upper arms, or thighs.
2. Sanitization
Thoroughly clean the selected site, stopper and vial top using 70% isopropyl alcohol prep swabs.
3. Angle & Push
Pinch the skin and insert the needle at a 45 to 90-degree angle. Depress plunger smoothly.
4. Site Rotation
Rotate injection sites continuously to avoid lipodystrophy or tissue scarring.
Frequently Asked Questions
What is the typical Ecnoglutide dosage?expand_more
In clinical trials the typical Ecnoglutide dosage starts at 0.3 mg subcutaneously once weekly and is escalated roughly every four weeks to limit gastrointestinal side effects. For type 2 diabetes, maintenance doses of about 0.4-1.2 mg once weekly were used (HbA1c fell most at 1.2 mg). For chronic weight management, maintenance doses ran higher, up to 1.8-2.4 mg once weekly, with 2.4 mg giving the largest weight loss. So the overall studied range is roughly 0.3 mg (start) to 2.4 mg once weekly, with the maintenance dose chosen for the indication.
Is Ecnoglutide FDA approved?expand_more
No. Ecnoglutide is NOT approved by the US FDA or the European EMA. China's National Medical Products Administration (NMPA) approved ecnoglutide injection in early 2026, first for adult type 2 diabetes and then for chronic weight management, making it the world's first approved cAMP-biased GLP-1 receptor agonist. Outside China it remains investigational, and any product sold for laboratory or research use is not intended for human administration. This page is educational only and not medical advice.
How do you reconstitute Ecnoglutide for a dosing protocol?expand_more
For this educational model, a 10 mg vial is reconstituted with 2.0 mL of bacteriostatic water, giving a 5 mg/mL solution, which equals 50 mcg per unit on a U-100 insulin syringe. Add the water slowly down the vial wall, swirl gently until clear (do not shake), and refrigerate at 2-8 °C. Weekly doses then map to clean syringe marks: 0.3 mg = 6 units, 0.6 mg = 12 units, 1.2 mg = 24 units, and 2.4 mg = 48 units. Use the reconstituted vial within about 28 days.
What is the half-life of Ecnoglutide?expand_more
Ecnoglutide has a long elimination half-life of roughly 124-138 hours at steady state, or about 5-6 days. That long duration comes from its 18-carbon fatty-diacid chain, which binds serum albumin and slows clearance, and from the Ala8Val substitution that protects it from DPP-4. This pharmacokinetic profile is what allows true once-weekly subcutaneous dosing and is also why protocols titrate the dose in roughly four-week steps as steady state is reached.
What are the most common Ecnoglutide side effects?expand_more
Like other GLP-1 receptor agonists, the most common Ecnoglutide side effects are gastrointestinal: nausea, diarrhea, decreased appetite, vomiting and constipation. These are usually mild to moderate, tend to appear during dose escalation, and often ease over time. Asthenia (fatigue) is also reported. Class-level cautions include pancreatitis, gallbladder disease, a small heart-rate increase, and hypoglycemia when combined with insulin or sulfonylureas. It is contraindicated in people with a personal or family history of medullary thyroid carcinoma or MEN2.
Related Guides & Tools
Step-by-step references for reconstituting, measuring, and storing Ecnoglutide, plus the universal dosing calculator.
Academic References & Study Citations
Guo W, Xu Z, Zou H, et al. Discovery of ecnoglutide - A novel, long-acting, cAMP-biased glucagon-like peptide-1 (GLP-1) analog. Mol Metab. 2023 Sep;75:101762. View Scientific Paper →
Zhu D, Wang W, Tong G, et al. Efficacy and safety of GLP-1 analog ecnoglutide in adults with type 2 diabetes: a randomized, double-blind, placebo-controlled phase 2 trial. Nat Commun. 2024 Sep 27;15(1):8408. View Scientific Paper →
Ji L, Gao L, Xue H, et al. Efficacy and safety of a biased GLP-1 receptor agonist ecnoglutide in adults with overweight or obesity: a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Diabetes Endocrinol. 2025 Sep;13(9):777-789. View Scientific Paper →
Zhu D, Wang W, Tong G, et al. Efficacy and safety of cAMP signalling-biased GLP-1 analogue ecnoglutide monotherapy versus placebo in patients with type 2 diabetes (EECOH-1): a multi-centre, randomised, double-blind, placebo-controlled, phase 3 trial. Nat Commun. 2026 Jan 7;17(1):1420. View Scientific Paper →
Efficacy and safety of cAMP-biased GLP-1 receptor agonist ecnoglutide versus dulaglutide in patients with type 2 diabetes on metformin monotherapy (EECOH-2): a 52-week, multicentre, open-label, non-inferiority, randomised, phase 3 trial. Lancet Diabetes Endocrinol. 2025 Oct. View Scientific Paper →
Chen Z, Du C, Cai L, et al. No dose adjustment required for warfarin or metformin when coadministered with the novel GLP-1 receptor agonist ecnoglutide: an open-label, fixed-sequence, crossover study. Front Pharmacol. 2026;17:1816593. View Scientific Paper →
Sciwind Biosciences. Ecnoglutide Injection Approved by China's National Medical Products Administration (NMPA) for Adult Type 2 Diabetes [press release]. PR Newswire; 2026. View Scientific Paper →
Comparative Efficacy and Safety of Ecnoglutide in Type 2 Diabetes: A Systematic Review and Meta-Analysis. Endocrinol Diabetes Metab. 2026 May. View Scientific Paper →