Trevogrumab_Dosage, benefits & legal status
Also known as Trevogrumab, anti-GDF8, REGN1033
A myostatin antibody trialled with semaglutide, where the three-drug version got dangerous.
Common vial size is what vendors typically sell, not a recommendation. Enter your own vial in the calculator.
What is Trevogrumab?
Plain language first. The technical label stays, but it never stands alone.Overview
It is an attempt to make weight loss come more from fat. It is not approved anywhere, and it is an antibody rather than a peptide.
Trevogrumab is an antibody that blocks myostatin, the signal that limits muscle growth. It is being tested alongside semaglutide for the same reason as apitegromab: about a third of the weight lost on semaglutide is muscle.
What it's used for
An experimental antibody given alongside semaglutide, to lose more fat and less muscle.
How does Trevogrumab work?
What it does in the body, and where.Trevogrumab blocks myostatin, the brake on muscle growth. The interesting part of this trial is what happened when a second brake was blocked at the same time.
- 01Semaglutide takes muscle along with fatThe trial measured it directly: about a third of the weight lost on semaglutide alone was muscle, not fat.
- 02Blocking myostatin prevents about half of thatAt 200 mg it preserved 50.8% of the muscle that would have been lost, and at 400 mg, 51.3%. Doubling the dose changed almost nothing.
- 03Blocking a second signal preserved more, and cost moreAdding garetosmab, which blocks a related signal called activin A, preserved 80.9%. But dropouts jumped from under 10% to 28.3%, and two people died.
- 04More is not automatically betterThis is the clearest example in the category. The best result on paper came from the arm with the worst safety, and the company has not linked the deaths to the drug either way.
Where this compound is thought to act.
What else is it used for?
Each use below carries its own evidence level. Approved means regulators have cleared it for that purpose. Investigational means it is in trials. Early research means it is being studied and is not established.
- Keeping muscle during weight loss on semaglutide, where about half the usual muscle loss was prevented at either doseInvestigational
- Holding onto weight-loss results after the losing phase, which the trial is still testingInvestigational
How much, and do you cycle it?
The range, and whether you take breaks.200 or 400 mg (trial doses), in the trial schedule. Given through a 26-week weight-loss phase, then a 26-week holding phaseTrial dose
The trial design splits into losing weight and then keeping it off. The second half is testing whether the drug alone holds the result, and those results are not out yet.
How long does it stay in the body?
The half-life, and where the figure comes from.Not establishedNo figure
No numeric human half-life has been disclosed. Antibodies of this class typically run around 21 days, but that is a class expectation rather than a measurement of this one.
You can compare this against the whole library to see where it sits.
How do I dose and price it?
Enter your vial and your dose. Pick a mix. We show the draw and the cost.The vial holds a fixed amount of drug. Adding more water does not make more drug, it just spreads it thinner, so you draw a bigger number on the syringe for the same dose.
Trevogrumab is dosed by body weight: 200 to 400 mg.
Given by infusion in a trial, not sold as a vial. No draw can be shown.
Trevogrumab starts at $194.95 across 1 vendor.
2 listings, last read Aug 25, 2026. Shipping and card fees are not included.
How do you store it?
Before mixing, and after.Dry powder in the freezer or fridge. Once mixed, fridge, and use within about a month.
Unmixed lyophilized Trevogrumab keeps for a long time cold. Once you add water the clock starts: most reconstituted vials hold up for roughly 28 to 30 days at fridge temperature. Keep it out of light, and do not freeze it after mixing.
What are the side effects and cautions?
Known cautions and warnings for this compound.This is not something you can buy or mix. It is given in a clinic as part of a trial, and there is no vial size or syringe draw, so the calculator does not apply. Two doses have been tested, 200 mg and 400 mg, and they performed almost the same.
Who should avoid it
- Not available outside a clinical trial
- Pregnancy
- No safety record outside the trial setting
Stop and get help
- Signs of an allergic reaction during or after an infusion
- Anything unusual, since the safety record is short
Common effects
- On its own with semaglutide it was generally well tolerated, with 4% to 10% of people stopping early
- Added to a second antibody called garetosmab, 28.3% stopped early
- Two deaths happened in that three-drug group, one from an undetermined cause and one from cardiac arrest, both in people with existing heart risk. The company has not found a link to the treatment
Where this page says nothing is established, that means nobody has studied it, not that a compound is safe.
Is Trevogrumab approved?
And where the numbers on this page come from.No. Trevogrumab is not approved anywhere and is currently in company-run clinical trials. There is no legal route to obtain it outside a trial.
- Approval statusInvestigational
- RouteInto a vein
- CheckedAugust 2026
What has happened recently
Not approved anywhere. Regeneron has stated that the safety and effectiveness of trevogrumab have not been assessed by any regulator. The trial is still running: after 26 weeks of weight loss, people move into a 26-week phase to see whether the drug holds the result.
You can compare this against the whole library, or read how to check a seller.
- DoseFrom published clinical trials. Not approved by a regulator for this dose.
- Vial sizeFrom what vendors typically list; not a recommendation.
- Sources
- Reviewed14 August 2026
What else is like Trevogrumab?
Others in Muscle building, side by side.If you're weighing Trevogrumab, it's worth reading GDF-8 (Myostatin), FLGR242, and Bimagrumab in the same class.
A myostatin antibody trialled with semaglutide, where the three-drug version got dangerous.
- Dose
- 200 or 400 mg (trial doses)
- How often
- In the trial schedule
The protein that limits muscle growth, which is the opposite of what most buyers want.
- Dose
- Research only
- How often
- Varies
Sold as an upgraded follistatin. Nobody outside the sellers has said what is in the vial.
- Dose
- No established dose
- How often
- No established schedule
An experimental shot that strips fat while adding muscle.
- Dose
- 10 up to 30 mg/kg per month (trial doses)
- How often
- Monthly
10What these words mean
Show glossary +
What these words mean
- 503A and 503B
- The two kinds of compounding pharmacy in US law. A 503A pharmacy prepares medicine for one named patient. A 503B outsourcing facility makes larger batches under stricter manufacturing rules.
- Agonist
- Something that switches a receptor on. The opposite is an antagonist. It blocks the receptor instead.
- Amino acid
- The building blocks that link together in a chain to make a peptide or a protein. The order they sit in is what makes one peptide different from another.
- Amylin
- A hormone released alongside insulin that slows the stomach emptying and reduces appetite. Several weight loss compounds copy it.
- Analog
- A compound built to copy a natural one with small deliberate changes, usually so it lasts longer or holds onto its target more tightly.
- Animal study
- Research done in rats, mice or other animals. Most findings do not repeat in people, so an animal result is a reason to keep looking. It is not a reason to act.
- Antibody
- A large immune protein, far bigger than a peptide, engineered to lock onto one specific target. These are made by drug companies and are not sold as research powders.
- Bacteriostatic water
- Sterile water with a tiny amount of preservative, used to mix powdered peptides.
- Banned in drug-tested sport
- Prohibited by the World Anti-Doping Agency (WADA); using it can disqualify a competing athlete.
- Bioavailability
- How much of a dose actually reaches your bloodstream. Most peptides survive stomach acid badly, so most of them are injected instead of swallowed.
- Bioregulator
- Very short peptides from a Russian research tradition, usually two to four amino acids long, sold for supporting a specific organ. Human evidence is thin and most of it is published in Russian.
- Blend
- One vial holding more than one compound, mixed together by the seller. Working out a dose means working out each ingredient separately, because they are rarely present in equal amounts.
- Boxed warning
- The most serious warning the FDA puts on a drug label, printed inside a black border. It flags a risk considered severe enough to sit above everything else on the label.
- Bulks list
- The FDA's list of ingredients that compounding pharmacies are allowed to use. A substance can sit under review on it for years without anything being decided either way.
- Certificate of analysis (COA)
- A lab report on a batch of product. It only means something if it names the batch you actually received, comes from an independent lab, and can be checked with that lab.
- Clinical trial
- A study that gives a treatment to people under a written plan and measures what happens. It is the only kind of evidence that can show something works in humans.
- Compounding
- A licensed pharmacy preparing a medicine to order. Being allowed to compound something is not the same as the FDA approving it, and the two get mixed up constantly.
- Concentration
- How strong the mixed peptide is, in milligrams per milliliter (mg/mL). More water makes it weaker; less water makes it stronger.
- Cycle
- A stretch of time using a compound followed by a break. Most cycling patterns come from community practice. Very few have been tested.
- DAC
- Short for Drug Affinity Complex. An attachment added to a peptide so it grabs onto a blood protein and stays in the body for days instead of minutes.
- Dead space
- The small amount of liquid left sitting inside the needle and hub after you inject. On very small doses it can be a real share of what you meant to take.
- Dilute
- Adding more liquid to make a mix weaker. The amount of peptide in the vial does not change. It is just spread through more water, so each draw is bigger.
- Endpoint
- The result a trial said in advance that it would measure. A study can be reported as positive and still have missed the endpoint it set out to hit.
- FDA approved
- Reviewed by the FDA and cleared for a specific use, in a specific form, at a specific dose. Approval for one use is not approval for another, and approval in another country is not approval here.
- Fragment
- A short piece cut out of a larger natural protein. A fragment can behave very differently from the whole protein it came from, so evidence about one does not transfer to the other.
- Ghrelin
- The hunger hormone. Some growth hormone compounds work by copying it, so they can make you noticeably hungrier.
- GHRH
- A natural signal telling the pituitary gland to release growth hormone. Several compounds copy it.
- GHRP
- A second, separate signal that also triggers growth hormone release, through a different door than GHRH. This is why the two types are often used together.
- GLP-1
- A natural gut hormone that lowers appetite and blood sugar. Drugs that copy it, like semaglutide, are used for weight loss.
- Growth hormone secretagogue
- A compound that nudges your body to release more of its own growth hormone, rather than injecting the hormone itself.
- Half-life
- How long a compound stays active in your body. A longer half-life means you inject less often.
- HPLC
- A lab method that separates out everything in a sample so the amounts can be measured. It shows how much of the main ingredient is there. It does not confirm that the main ingredient is the right molecule.
- In vitro
- Done in a dish or a test tube, on cells outside a living body. It is the earliest kind of evidence there is.
- Injection site
- The spot on the body where you inject. Moving it around gives the skin and fat underneath time to recover between doses.
- Intramuscular (IM)
- An injection into a muscle, using a longer needle.
- Intravenous (IV)
- An injection into a vein. It needs training and equipment and is not something to do at home.
- Investigational
- Still being tested in clinical trials and not yet approved or legally sold for general use.
- Lyophilized
- Freeze-dried into a powder so it keeps longer. That is the white cake or dust in the bottom of an unmixed vial.
- Mass spectrometry
- A lab method that weighs molecules to confirm what they are. HPLC answers how much is in the sample. This answers what it is.
- mcg and mg
- Units of dose. 1 milligram (mg) equals 1,000 micrograms (mcg).
- Myostatin
- A natural brake on muscle growth. Several compounds are built to block it, though human results have been far smaller than the animal work suggested.
- Off-label
- A doctor prescribing an approved drug for something other than its approved use. This is legal and common, and it is different from a compound having no approval at all.
- Orphan drug designation
- A status given to treatments for rare conditions to make them worth developing. It is an incentive, not an approval, and a compound can hold it while being approved for nothing.
- PCAC
- The FDA advisory committee that reviews compounding ingredients. It recommends. It does not approve, and the FDA does not have to follow what it says.
- Peer review
- Other scientists checking a paper before a journal publishes it. It filters out some bad work. It does not make a finding true.
- Peptide vs small molecule
- A peptide is a short chain of amino acids. A few items here (like MK-677 or methylene blue) are small molecules, not true peptides, but people use them the same way.
- Placebo
- A dummy treatment given for comparison. Without one it is very hard to tell a real effect apart from expectation and time passing.
- Purity
- The share of a sample that is the intended compound, usually given as a percentage. A high purity number on the wrong molecule is still the wrong molecule.
- Randomized
- Deciding by chance who gets which treatment, so the two groups are comparable. Studies that skip this are much easier to read the wrong way.
- Receptor
- A docking point on a cell that a compound attaches to. If a cell has no matching receptor, the compound does nothing to it.
- Reconstitution
- Mixing a powdered peptide with liquid (bacteriostatic water) so it can be drawn into a syringe.
- Research only
- No approved dose or use in people. Sold for research and not reviewed by the FDA for safety or quality.
- Stack
- Using more than one compound at the same time. Almost no combinations have been tested together in people, so a stack is usually built on guesswork.
- Sterile water
- Water with nothing added to stop bacteria growing. It works for a single dose, but a vial mixed with it should not be kept and used again.
- Subcutaneous
- An injection just under the skin, into the fat layer, usually with a short, thin insulin needle.
- Titrate
- Starting at a low dose and increasing it slowly over time so your body adjusts and side effects stay mild.
- Trial phases
- The stages of human testing. Phase 1 checks safety in a small group, phase 2 looks for an effect, and phase 3 tests it against a comparison in a large group.
- Units (on the syringe)
- The marks on an insulin syringe. 100 units equals 1 mL. They measure how much liquid you draw, not the dose in milligrams.
Guides for this compound
- How to Reconstitute a Peptide
Mix peptide powder with bacteriostatic water, step by step.
- How to Read an Insulin Syringe
Read the units, convert to millilitres, and draw the exact dose.
- mcg vs mg: The Peptide Dosing Mistake to Avoid
Your vial says mg and your protocol says mcg. Here is the conversion and how to check it.
- Why Does My Peptide Injection Itch or Welt
Injection-site irritation, a histamine reaction, or a true allergy, and how to tell them apart.
- How to Read a Peptide COA
What the purity number does and does not tell you, and how to spot an edited report.
Sources
- Regeneron, complete 26-week Phase 2 COURAGE results, presented at EASD(2025)33% of semaglutide-induced weight loss was lean mass. Adding trevogrumab prevented about half of it. The triplet arm had substantially higher discontinuation and two deaths, with no causal link established.
- Regeneron, interim Phase 2 COURAGE results(2025)Lean mass preserved: 50.8% at trevogrumab 200 mg, 51.3% at 400 mg, 80.9% with garetosmab added. Semaglutide alone lost 7.9 lb of lean mass.
Last reviewed 14 August 2026
Peptide Decoding is published by Decoded Sciences LLC. We take no payment from vendors for coverage, inclusion or ranking, and our affiliate relationships are disclosed in full.