Back to Encyclopedia

Retatrutide

Weight Management

Also known as: LY3437943, GGG tri-agonist, GLP-1/GIP/Glucagon Agonist

Half-life: ~6 days (~144 hours)

Last reviewed:  ·  Published:

Weight LossFat Loss

Overview

Retatrutide (LY3437943) is an investigational once-weekly injectable peptide developed by Eli Lilly as a triple agonist at three incretin / glucoregulatory receptors: GLP-1 (like Semaglutide), GIP (added in Tirzepatide), and glucagon. The addition of glucagon-receptor agonism is the key conceptual innovation: glucagon activation increases energy expenditure and hepatic fat oxidation, complementing the appetite-suppression and insulin-sensitizing effects of GLP-1 and GIP and producing weight loss that exceeds anything previously reported for an injectable agent.

In the Phase 2 obesity trial published in the New England Journal of Medicine in 2023, Retatrutide produced mean weight loss of 24.2% at the highest dose (12 mg weekly) over 48 weeks — substantially exceeding the ~21% peak seen with high-dose Tirzepatide (SURMOUNT-1) and the ~15% with high-dose Semaglutide (STEP-1) at comparable time points. Approximately 100% of subjects on the 12 mg dose achieved ≥5% weight loss, and the weight loss trajectory had not plateaued at 48 weeks — suggesting longer dosing periods would produce further losses. The compound is currently in the Phase 3 TRIUMPH trial program for obesity and the SYNERGY-NASH and FRONTIER trials for metabolic dysfunction-associated steatohepatitis (MASH) and type 2 diabetes.

Retatrutide is not yet FDA approved as of this writing — the TRIUMPH-1 Phase 3 obesity trial is expected to read out in 2026, with FDA submission likely in 2026-2027. It is widely sold by research-peptide vendors at substantial markups, and is used in self-experimentation by users seeking the strongest available weight loss. The side-effect profile is broadly similar to Tirzepatide and Semaglutide (gastrointestinal effects dominate), with the addition of glucagon-mediated effects on heart rate and possibly hepatic glucose output that are still being characterized.

History

Retatrutide was developed at Eli Lilly as the natural extension of their work on Tirzepatide (dual GLP-1/GIP agonist), with the addition of glucagon-receptor agonism aimed at incorporating the energy-expenditure-increasing arm of the metabolic axis. The compound entered clinical trials in 2019. Initial Phase 1 and Phase 2 data in type 2 diabetes (2022) and obesity (2023) generated significant scientific and investor interest as the magnitude of weight loss exceeded all prior incretin-based therapies. Lilly's Phase 3 TRIUMPH program is underway, with TRIUMPH-1 in obesity and TRIUMPH-4 in obesity with cardiovascular disease being the lead obesity studies; SYNERGY-NASH addresses the MASH indication.

Effects

  • Triple receptor agonism: GLP-1, GIP, and glucagon
  • Mean ~24% weight loss at 12 mg weekly (Phase 2, 48 weeks)
  • Appetite suppression and delayed gastric emptying (GLP-1 / GIP)
  • Increased energy expenditure and hepatic fat oxidation (glucagon arm)
  • Improved glycemic control in type 2 diabetes
  • Reduction in hepatic fat content (MASH-relevant)

Side Effects

  • Gastrointestinal: nausea, vomiting, diarrhea (most common, dose-dependent)
  • Decreased appetite (intended)
  • Constipation
  • Increased heart rate (glucagon-mediated, dose-dependent)
  • Injection-site reactions
  • Risk of pancreatitis (incretin-class concern)
  • Theoretical: thyroid C-cell tumors (incretin-class warning — animal data)
  • Hyperglycemia risk if dose-titration is too rapid (glucagon arm)

Tolerability

Phase 2 Retatrutide trial tolerability has been broadly comparable to Tirzepatide and Semaglutide — gastrointestinal effects (nausea, vomiting, diarrhea) dominate and are dose-dependent, occurring most frequently during dose escalation and waning over time. The glucagon-receptor activation adds modest tachycardia (1-3 bpm increase at higher doses) and slightly more pronounced effects on hepatic glucose output that require careful dose titration in subjects with diabetes. Dropout rates due to adverse events in Phase 2 were broadly in line with other incretins. As with all GLP-1-class compounds, pancreatitis monitoring is appropriate and the FDA black-box warning for thyroid C-cell tumors (based on rat data) carries over to this class.

Dosing Ranges

Obesity / weight loss (Phase 2 / 3 protocol)

Dose Range

1-12 mg

Frequency

Once weekly (SubQ), dose-titrated

Duration

Long-term per clinical protocol

Self-experimentation (no clinical guidance)

Dose Range

0.5 mg start, titrate to tolerance

Frequency

Once weekly

Duration

Long-term with careful titration

Dosing information is for educational purposes only. Consult a healthcare professional before using any peptide.

Reconstitution

Preparation Details

Typical Vial Size

10 mg

Water Type

Bacteriostatic water (BAC water)

Mixing Volume

2 mL

Half-Life

~6 days (~144 hours)

Molecular Weight

~4,731 Da

Store reconstituted vial refrigerated at 2-8°C. Use within 30 days. Once-weekly subcutaneous injection in abdomen, thigh, or upper arm. Start at the lowest practical dose (typically 0.5-1 mg weekly) and titrate up over 4-8 week intervals to minimize gastrointestinal adverse events.

Calculate Retatrutide dose

Regulatory Status

FDA Status

Not FDA approved. In Phase 3 clinical trials (TRIUMPH program for obesity, SYNERGY-NASH for MASH). FDA submission anticipated 2026-2027 pending Phase 3 readouts.

Legal Status

Unregulated research chemical. Prohibited by WADA (incretin-class).

USA

Not approved

Phase 3 trials in progress (TRIUMPH program); FDA filing expected 2026-2027

EU

Not approved

Phase 3 trials in progress; EMA filing expected after Phase 3 readout

UK

Not approved

Research-only; classified as research chemical

Australia

Not approved

TGA has not authorized

Canada

Not approved

Not authorized for human use

Cited Studies

Triple-hormone-receptor agonist retatrutide for obesity — a Phase 2 trial

Jastreboff AM, Kaplan LM, Frías JP, Wu Q, Du Y, Gurbuz S, Coskun T, Haupt A, Milicevic Z, Hartman ML

New England Journal of Medicine (2023)

Pivotal Phase 2 obesity trial showing 24.2% mean weight loss at 12 mg weekly over 48 weeks in adults with obesity — the strongest weight-loss effect reported for any pharmacological agent and the data set that drove Retatrutide into Phase 3.

View Study →

Efficacy and safety of retatrutide in adults with type 2 diabetes: a Phase 2 randomised trial

Rosenstock J, Frías JP, Jastreboff AM, Du Y, Lou J, Gurbuz S, Thomas MK, Hartman ML, Haupt A, Milicevic Z, Coskun T

The Lancet (2023)

Phase 2 type 2 diabetes trial demonstrating substantial HbA1c reductions and weight loss with Retatrutide in T2D patients, supporting parallel development for the diabetes indication alongside obesity.

View Study →

A new era in obesity management: triple-agonist pharmacotherapy and the metabolic axis

Müller TD, Blüher M, Tschöp MH, DiMarchi RD

Nature Reviews Drug Discovery (2022)

Authoritative review of the rationale for incretin-based combination therapies including triple agonists like Retatrutide, with a focus on how glucagon-receptor activation complements GLP-1 and GIP signaling to amplify weight loss.

View Study →

Compare Retatrutide with

Track Retatrutide and more with PinnyPeptide.

Sign Up to Track Retatrutide

Free forever · defaults pre-filled from this article