The amylin analog that pairs with semaglutide for even greater appetite suppression and fat loss — the foundation of the "CagriSema" stack.
Cagrilintide is a long-acting amylin analog developed by Novo Nordisk. Amylin is a peptide hormone co-secreted with insulin by pancreatic beta cells; it slows gastric emptying, suppresses glucagon, and promotes satiety. Cagrilintide is engineered to last a full week per injection.
Its most well-known use is in combination with semaglutide — the CagriSema stack. Novo Nordisk filed the CagriSema NDA on 18 December 2025; REDEFINE 1 and 2 (the obesity Phase 3 pivotals) were published in NEJM in June 2025. Important caveat: in February 2026, the open-label REDEFINE 4 head-to-head trial vs tirzepatide (n=809, 84 weeks) failed non-inferiority — CagriSema produced −23.0% weight loss vs tirzepatide’s −25.5%. CagriSema is a strong drug, but the “most effective obesity drug” framing that circulated based on early Phase 2 numbers no longer holds.
Not yet FDA approved (Phase 3). Not WADA prohibited. Available as a research chemical only.
Binds amylin and calcitonin receptors in the hindbrain, slowing gastric emptying and producing post-meal satiety independent of GLP-1 pathways.
Because amylin works on different receptors than GLP-1, cagrilintide adds effect on top of semaglutide rather than competing for the same pathway. This is why the stack produces larger weight loss than either alone.
Reduces inappropriate post-meal glucagon release, supporting glycemic control without the hypoglycemia risk of insulin itself.
Most meaningful data comes from the CagriSema program. Cagrilintide monotherapy studies are smaller but support the mechanism.
| Benefit | Evidence |
|---|---|
| Weight loss (mono) | Phase 2: ~10% body-weight loss at 2.4 mg weekly over 26 weeks |
| Weight loss (stacked) | CagriSema Phase 2 (Lau 2021, PMID 34798060): ~17% over 32 weeks. REDEFINE 1+2 Phase 3 (NEJM June 2025) supported the Dec 2025 NDA filing; REDEFINE 4 head-to-head vs tirzepatide (Feb 2026) showed −23.0% vs tirzepatide’s −25.5% over 84 weeks (n=809), missing non-inferiority. |
| Appetite control | Significant reductions in food cravings and post-meal hunger |
| Glycemic control | Modest HbA1c reductions; complementary to GLP-1 agonists |
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Start Tracking Free| Weeks | Weekly Dose |
|---|---|
| 1–2 | 0.25 mg |
| 3–4 | 0.5 mg |
| 5–6 | 1.0 mg |
| 7–8 | 1.7 mg |
| 9+ | 2.4 mg (target) |
Hold at any step for an extra 2 weeks if GI side effects are pronounced. Some users stay at 1.7 mg if tolerability limits further escalation, though the Phase 2/3 trials (PMIDs 34798060, 40544433, 40544432) targeted 2.4 mg as the maintenance dose.
Most users pair cagrilintide with semaglutide at matched doses (e.g. both at 2.4 mg weekly). Inject on the same day but in different sites or (if pharma compounded) as a co-formulation.
0.25 mg weekly titrating to 2.4 mg over 8 weeks. Less total weight loss than CagriSema but fewer total side effects and lower cost.
10 mg vial + 2 mL BAC water = 5 mg/mL = 5000 mcg/mL
| Dose | Volume | Syringe Units |
|---|---|---|
| 0.25 mg | 0.05 mL | 5 units |
| 0.5 mg | 0.10 mL | 10 units |
| 1.0 mg | 0.20 mL | 20 units |
| 1.7 mg | 0.34 mL | 34 units |
| 2.4 mg | 0.48 mL | 48 units |
10 mg vial at 2.4 mg/week = ~4 weeks per vial
Pre-filled with a typical Cagrilintide setup. Edit any field — the draw updates live.
Insulin syringe — 100 units = 1 mL
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Start Tracking FreeNo. Cagrilintide as a monotherapy is not FDA approved. CagriSema — the fixed-dose combination of cagrilintide + semaglutide developed by Novo Nordisk — was filed with the FDA in December 2025 and is currently under review. A regulatory decision is expected 2026–2027. As of May 2026, neither cagrilintide alone nor CagriSema is approved by any regulatory authority. Sold by peptide vendors only as a research chemical.
Cagrilintide is a long-acting amylin receptor agonist — a synthetic analog of the gut hormone amylin (the same hormone that pramlintide / Symlin mimics, but pramlintide has a ~48-minute half-life requiring mealtime dosing). Cagrilintide adds a C20 fatty-diacid acylation that drives reversible albumin binding, extending the half-life to approximately 7 days — once-weekly subcutaneous dosing, the same way semaglutide works.
Trial-validated maintenance dose: 2.4 mg once weekly subcutaneously (the dose used in CagriSema and the Phase 2 cagrilintide-alone trial). Titration schedule: typically 0.3 → 0.6 → 1.2 → 2.4 mg with stepwise increases every 4 weeks. CagriSema combines this 2.4 mg cagrilintide dose with 2.4 mg semaglutide in a single weekly injection.
For a 10 mg lyophilized vial, a typical reconstitution is 10 mg + 2 mL of bacteriostatic water, yielding 5 mg/mL. A 2.4 mg dose draws to 0.48 mL (48 units on a 100-unit insulin syringe). For titration: 0.3 mg = 0.06 mL (6 units), 0.6 mg = 0.12 mL (12 units), 1.2 mg = 0.24 mL (24 units).
That stack IS CagriSema — Novo Nordisk’s combination product. In the REDEFINE-1 Phase 3 trial, CagriSema produced approximately 22.7% mean weight loss at 68 weeks, comparable to tirzepatide and substantially more than semaglutide alone (~15% in STEP-1). Mechanism-wise, amylin agonism complements GLP-1 agonism — different receptors, additive satiety / gastric-emptying effects. Combining the two research-grade compounds yourself is the off-label community equivalent.
Appetite suppression often noticeable within the first 1–2 weeks. Weight loss accumulates over months as the dose titrates upward. In Phase 2 monotherapy (Lau 2021 Lancet), cagrilintide produced ~10.8% weight loss at 26 weeks on 4.5 mg (a higher monotherapy dose than the 2.4 mg used in CagriSema). The full CagriSema effect compounds over the 68-week trial duration.
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