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.
Pemvidutide Dosage Chart, Schedule & Reconstitution Protocol
Quickstart Highlights
Pemvidutide (ALT-801) is an investigational balanced (1:1) GLP-1/glucagon dual receptor agonist for obesity and metabolic liver disease, given once weekly by subcutaneous injection. The GLP-1 arm suppresses appetite and slows gastric emptying while the glucagon arm raises energy expenditure and hepatic fat oxidation, an approach designed to mimic diet plus exercise (PMID 39002641). In the 48-week Phase 2 MOMENTUM obesity trial, weekly doses of 1.2, 1.8, and 2.4 mg produced mean weight loss of 10.3%, 11.2%, and 15.6% versus 2.2% with placebo, and Phase 2 MASH/MASLD studies showed liver-fat reductions of roughly 56-78%. Trial doses are 1.2-2.4 mg weekly, with only the 2.4 mg arm requiring a short titration. Pemvidutide is not approved by any regulator and remains in clinical development; the reconstitution figures here are an educational reference, not medical advice.
Reconstitute: Add 2 mL bacteriostatic water → 5 mg/mL concentration.
Typical dose: 1.2-2.4 mg once weekly (subcutaneous)
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 and protected from light; once reconstituted, the solution is refrigerated at 2-8 °C and used within about 4 weeks. Avoid repeated freeze-thaw cycles and do not shake.
Half-life: Long-acting, supports once-weekly subcutaneous dosing; albumin-binding EuPort domain extends exposure over multiple days (precursor co-agonist ~52 h in vivo).
Route: Subcutaneous injection once weekly (abdomen, thigh, or upper arm), matching the clinical trial route.
Status: Investigational; NOT FDA- or EMA-approved. In Phase 2/2b trials for obesity and MASH. Research and educational use only.
About Pemvidutide
Pemvidutide (ALT-801) is an investigational balanced (1:1) GLP-1/glucagon dual receptor agonist developed for obesity and metabolic liver disease, given as a once-weekly subcutaneous injection [1][2]. Unlike GLP-1-biased dual agonists, pemvidutide activates both receptors with roughly equal potency, the GLP-1 arm curbing appetite and the glucagon arm raising energy expenditure and hepatic fat oxidation [4][8]. In Phase 2 trials the studied Pemvidutide dosage was 1.2 mg, 1.8 mg, or 2.4 mg weekly, with only the 2.4 mg arm requiring a short 4-week titration [2]. Its real-world clinical route is subcutaneous injection, so the reconstitution figures below match how the compound is actually delivered.\n\nThis guide models a 10 mg vial reconstituted with 2.0 mL of bacteriostatic water (5 mg/mL, or 50 mcg per insulin-syringe unit) so the trial doses fall in a clean, measurable range on a U-100 syringe: 1.2 mg ≈ 24 units (0.24 mL), 1.8 mg ≈ 36 units (0.36 mL), and 2.4 mg ≈ 48 units (0.48 mL). A practical educational titration starts at 1.2 mg to gauge gastrointestinal tolerability, then steps up toward the 2.4 mg target dose that drove the largest weight loss in MOMENTUM [2].\n\nFrequency: Once weekly, on the same day each week, injected subcutaneously into the abdomen, thigh, or upper arm with site rotation. Pemvidutide is NOT FDA- or EMA-approved and is presented here for educational and research purposes only.
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 wall of the 10 mg pemvidutide vial; do not aim the stream directly at the lyophilized powder, and never shake the vial.
Gently swirl or roll the vial until the solution is completely clear; the result is a 5 mg/mL concentration (50 mcg per insulin-syringe unit).
Store the reconstituted vial refrigerated at 2-8 °C and draw the prescribed number of units per weekly dose (1.2 mg ≈ 24 units, 1.8 mg ≈ 36 units, 2.4 mg ≈ 48 units on a U-100 syringe).
Inject subcutaneously into the abdomen, thigh, or upper arm, rotating sites weekly; inject slowly and steadily and wait a few seconds before withdrawing the needle. Do not aspirate.
Interactive Pemvidutide 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) |
|---|---|---|
| Initiation (Weeks 1-4): 1.2 mg/week | 1200 mcg (1.2 mg) | 24 units (0.24 mL) |
| Titration (Weeks 5-8): 1.8 mg/week | 1800 mcg (1.8 mg) | 36 units (0.36 mL) |
| Target / Maintenance (Weeks 9+): 2.4 mg/week | 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 (Pemvidutide, 10 mg each):
- check8-week course: about 2 vials (weekly doses ramping from 1.2 mg to 1.8 mg; a reconstituted vial is used within ~4 weeks).
- check12-week course: about 3 vials (titration through 1.2, 1.8, then 2.4 mg weekly).
- check16-week course: about 4 vials (maintenance at 2.4 mg weekly through the later weeks).
Insulin Syringes (U-100):
- check8-week course: about 10 syringes (1 weekly injection plus spares).
- check12-week course: about 15 syringes (1 weekly injection plus spares).
- check16-week course: about 20 syringes (1 weekly injection plus spares).
Bacteriostatic Water (30 mL bottles): Use 2 mL per vial for reconstitution.
- check8-week course: about 4 mL total (2 vials) — one 30 mL bottle is ample.
- check12-week course: about 6 mL total (3 vials) — one 30 mL bottle is ample.
- check16-week course: about 8 mL total (4 vials) — one 30 mL bottle is ample.
Alcohol Swabs: Clean the vial stopper and injection site before each use.
- check8-week course: about 20-30 swabs (vial stopper plus skin per weekly injection).
- check12-week course: about 30-45 swabs.
- check16-week course: about 40-60 swabs.
Mechanism of Action (MOA)
Pemvidutide (ALT-801) is a synthetic lipidated peptide engineered as a balanced (1:1) co-agonist of the glucagon-like peptide-1 receptor (GLP-1R) and the glucagon receptor (GCGR) [4][8]. It carries an 18-carbon diacid fatty-acid chain attached through a novel glycosidic linkage, part of Altimmune's proprietary EuPort domain. This lipid tail drives reversible binding to serum albumin, which extends the molecule's plasma half-life enough to support once-weekly dosing and slows its entry into the systemic circulation, a feature thought to blunt peak-related gastrointestinal side effects [2][8].\n\nThe therapeutic rationale is to engage two complementary metabolic axes simultaneously. GLP-1R activation in the hypothalamus and gut reduces appetite and caloric intake, slows gastric emptying, and enhances glucose-dependent insulin secretion. GCGR activation in hepatocytes and adipose tissue increases resting energy expenditure, accelerates hepatic lipid oxidation, and promotes lipolysis. Altimmune frames this as mimicking the combined effects of diet (the GLP-1 \"eat less\" signal) and exercise (the glucagon \"burn more\" signal). The balanced ratio is deliberate: in head-to-head preclinical work, 1:1 agonism produced greater weight loss and superior hepatic fat clearance than GLP-1-biased designs, while the glucagon component directly reduces intrahepatic triglyceride content, explaining the unusually large liver-fat reductions seen in MASLD/MASH trials [4][5][6].\n\nPharmacokinetics and route: pemvidutide is administered subcutaneously into the abdomen, thigh, or upper arm. The albumin-binding EuPort domain confers a long, multi-day effective exposure that underpins weekly dosing; the precursor surfactant-conjugated co-agonist demonstrated a half-life of roughly 52 hours in vivo, and the marketed candidate maintains overall exposure comparable to other long-acting incretin agents while showing lower peak concentrations [6][8]. A distinguishing clinical feature is the high proportion of lean-mass preservation: in the MOMENTUM obesity program, a large share of weight lost was fat mass, an outcome attributed to the glucagon-driven energy-expenditure mechanism [2].\n\nDownstream effects extend beyond weight. In Phase 2 trials pemvidutide lowered serum triglycerides and total cholesterol, modestly reduced systolic blood pressure, and produced large relative reductions in liver fat content (up to ~78%), with the higher MASH doses also driving MASH resolution and fibrosis improvement [1][2][4][5]. Notably, because the glucagon arm can transiently raise glucose, the obesity program used non-diabetic populations and reported no clinically meaningful increase in fasting glucose or HbA1c at the studied doses [2].\n\nRegulatory status: pemvidutide is investigational. It is not approved by the FDA, EMA, or any other regulator, and the subcutaneous reconstitution scheme on this page is an educational measurement convention, not a clinically validated prescribing instruction [7][8].
Clinical Trial Efficacy Highlights
- starThe 48-week Phase 2 MOMENTUM obesity trial randomized 391 adults with overweight or obesity (without diabetes) 1:1:1:1 to weekly pemvidutide 1.2, 1.8, or 2.4 mg or placebo; mean weight loss at week 48 was 10.3%, 11.2%, and 15.6% versus 2.2% with placebo, with over 50% of the 2.4 mg arm losing at least 15% and over 30% losing at least 20% of body weight [2][3].
- starIn MOMENTUM, the 2.4 mg dose reduced serum triglycerides by about 34.9% (vs +7.3% on placebo), total cholesterol by about 15.1%, and systolic blood pressure by roughly 4.6 mmHg, with no significant change in fasting glucose or HbA1c in the non-diabetic population [2][3].
- starA 12-week Phase 2 MASLD trial (Harrison et al., Journal of Hepatology 2025) tested weekly pemvidutide 1.2, 1.8, and 2.4 mg and found relative liver-fat reductions of 46.6%, 68.5%, and 57.1% respectively versus 4.4% with placebo (p<0.001), with 55.6% of the 1.8 mg group normalizing liver fat to 5% or less [1].
- starA 24-week randomized MASLD trial (Browne et al., JHEP Reports 2025) reported relative liver-fat reductions of 56.3% (1.2 mg), 75.2% (1.8 mg), and 76.4% (2.4 mg) versus 14.0% placebo (p<0.001), alongside body-weight reductions of 5.1-6.2% versus 1.4% placebo [5].
- starIn the Phase 2b IMPACT MASH trial (212 patients with biopsy-confirmed F2-F3 fibrosis), 24-week MASH resolution without worsening of fibrosis was achieved in 59.1% (1.2 mg) and 52.1% (1.8 mg) of pemvidutide-treated participants versus 19.1% on placebo (p<0.0001), with fibrosis improvement in roughly 32-35% of treated patients [4].
- starPreclinical work (Nestor et al., Scientific Reports 2022) in a biopsy-confirmed diet-induced obese mouse model of NASH showed ALT-801 reduced body weight, hepatic steatosis, inflammation, and fibrosis, supporting the balanced GLP-1/glucagon design that distinguishes pemvidutide from GLP-1-biased agents [6].
- starAn ADA Scientific Sessions presentation (abstract 334-OR) reported that pemvidutide, as a balanced 1:1 GLP-1/glucagon agonist, induced rapid and marked weight loss in people with overweight or obesity without the need for dose titration at lower doses, consistent with the EuPort domain's slow-entry pharmacokinetics [9].
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: in the MOMENTUM obesity trial nausea occurred in about 51.5% and vomiting in about 27.8% of the 2.4 mg arm, predominantly mild to moderate and most pronounced during dose escalation [2][3].
- warningTreatment discontinuation for adverse events was higher than placebo, about 19.6% on 2.4 mg versus 6.2% on placebo, largely driven by gastrointestinal intolerance; slower titration is used to mitigate this [2][3].
- warningBecause the glucagon component can transiently raise blood glucose, fasting glucose and HbA1c are monitored; in the non-diabetic obesity population no clinically meaningful glucose increase was reported, but this remains a class consideration for the glucagon arm [2].
- warningModest heart-rate elevation is a recognized incretin/glucagon class effect; the MOMENTUM program reported no major adverse cardiac events and no arrhythmia imbalance, but cardiovascular monitoring continues in later trials [2][3].
- warningInjection-site reactions (mild redness, induration) can occur with subcutaneous administration; rotating injection sites reduces incidence.
- warningDecreased appetite is the intended pharmacologic effect but can lead to reduced food and fluid intake; adequate hydration and nutrition should be maintained.
- warningContraindications and cautions mirror the incretin class: it should be avoided in people with a personal or family history of medullary thyroid carcinoma or MEN2, and pancreatitis remains a class-level concern to monitor, although no pancreatitis signal was reported in the published Phase 2 program.
- warningRegulatory/research status: pemvidutide is NOT approved by the FDA, EMA, or any regulator; it is an investigational drug in clinical trials, long-term human safety is not established, and the protocol here is for educational and research purposes only, not medical advice [4][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 Pemvidutide dosage?expand_more
In Phase 2 trials the Pemvidutide dosage was 1.2 mg, 1.8 mg, or 2.4 mg administered subcutaneously once weekly. The 1.2 and 1.8 mg doses were given without titration, while the 2.4 mg dose used a short 4-week titration. The 2.4 mg weekly dose produced the largest weight loss (about 15.6% at 48 weeks in MOMENTUM). These are investigational research doses, not an approved prescribing regimen.
Is Pemvidutide FDA approved?expand_more
No. Pemvidutide (ALT-801) is not approved by the FDA, the EMA, or any other regulatory agency. It is an investigational drug being studied in Phase 2/2b clinical trials for obesity and MASH. The FDA has cleared Investigational New Drug (IND) applications allowing clinical study, but that is not the same as marketing approval. All information here is for educational and research purposes only.
What is the half-life of Pemvidutide?expand_more
Pemvidutide is long-acting and designed for once-weekly subcutaneous dosing. Its EuPort domain incorporates an 18-carbon diacid fatty-acid chain that binds serum albumin, extending plasma exposure over multiple days; the precursor surfactant-conjugated co-agonist showed a half-life of roughly 52 hours in vivo, and the candidate maintains overall exposure comparable to other long-acting incretin agents while showing lower peak concentrations to improve tolerability.
How is Pemvidutide reconstituted and dosed on a U-100 syringe?expand_more
For this educational model, reconstitute a 10 mg vial with 2.0 mL of bacteriostatic water for a 5 mg/mL solution (50 mcg per insulin-syringe unit). Add the water slowly down the vial wall, swirl gently without shaking, and refrigerate. On a U-100 syringe, 1.2 mg is about 24 units (0.24 mL), 1.8 mg about 36 units (0.36 mL), and 2.4 mg about 48 units (0.48 mL).
How is Pemvidutide administered and can it be combined with other peptides?expand_more
Pemvidutide is given by subcutaneous injection once weekly into the abdomen, thigh, or upper arm, with site rotation. In trials it was studied as a single agent, not in combination. Because it already targets two receptors (GLP-1 and glucagon), stacking it with other incretin agonists is not supported by clinical evidence and would compound gastrointestinal and metabolic effects; no combination protocol is established.
Related Guides & Tools
Step-by-step references for reconstituting, measuring, and storing Pemvidutide, plus the universal dosing calculator.
Academic References & Study Citations
Harrison SA, Browne SK, Suschak JJ, et al. (2025) Effect of pemvidutide, a GLP-1/glucagon dual receptor agonist, on MASLD: a randomized, double-blind, placebo-controlled study. J Hepatol 82(1):7-17. PMID 39002641, DOI 10.1016/j.jhep.2024.07.006. View Scientific Paper →
Pemvidutide, a GLP-1/Glucagon Dual Receptor Agonist, in Subjects with Overweight or Obesity — A 48-Week, Placebo-Controlled, Phase 2 (MOMENTUM) Trial. Diabetes (2024) 73(Suppl 1):262-OR, ADA 84th Scientific Sessions. View Scientific Paper →
Altimmune, Inc. (2024) Positive Topline Results from the MOMENTUM 48-Week Phase 2 Obesity Trial of Pemvidutide — corporate press release (weight loss, lipid, blood pressure, and adverse-event data). View Scientific Paper →
Safety and efficacy of weekly pemvidutide versus placebo for metabolic dysfunction-associated steatohepatitis (IMPACT): 24-week results from a multicentre, randomised, double-blind, phase 2b study. Lancet (2025). PMID 41237796. View Scientific Paper →
Browne SK, Suschak JJ, Tomah S, et al. (2025) Safety and efficacy of 24 weeks of pemvidutide in metabolic dysfunction-associated steatotic liver disease: a randomized, controlled clinical trial. JHEP Rep. PMID 41113119, DOI 10.1016/j.jhepr.2025.101483. View Scientific Paper →
Nestor JJ, Parkes D, Feigh M, Suschak JJ, Harris MS (2022) Effects of ALT-801, a GLP-1 and glucagon receptor dual agonist, in a translational mouse model of non-alcoholic steatohepatitis. Sci Rep 12:6666. PMID 35461369, DOI 10.1038/s41598-022-10577-2. View Scientific Paper →
ClinicalTrials.gov NCT04561245 — ALT-801 (Pemvidutide) in Healthy Overweight and Obese Volunteers to Study Safety and Tolerability (Phase 1 SAD/MAD). View Scientific Paper →
Altimmune, Inc. — Pemvidutide program overview (mechanism, balanced 1:1 GLP-1/glucagon agonism, EuPort albumin-binding domain, once-weekly dosing). View Scientific Paper →
Pemvidutide (ALT-801), a Balanced (1:1) GLP-1/Glucagon Dual Receptor Agonist, Induces Rapid and Marked Weight Loss without the Need for Dose Titration in People with Overweight/Obesity. Diabetes (2022) 71(Suppl 1):334-OR. View Scientific Paper →