Cagrilintide is an analogue of amylin, a hormone released by the pancreas alongside insulin whenever you eat. Amylin's job is to tell your brain the meal has happened. It slows stomach emptying, suppresses glucagon, and produces satiety through receptors in the hindbrain.
That is a different pathway from GLP-1, and the difference is the entire commercial logic behind the compound. Cagrilintide is furthest along not as a standalone drug but as half of CagriSema — a fixed combination with semaglutide — on the reasoning that two separate satiety mechanisms should do more than one.
The evidence so far supports that. As a single agent over 26 weeks it produced around 10% weight loss; combined with semaglutide in a 68-week phase 3 trial it produced roughly 22%, which is the largest figure yet reported for an injectable weight-loss drug. Neither cagrilintide alone nor the combination is approved anywhere, and material sold as cagrilintide today is a research chemical, not a medicine.
How it works
Cagrilintide activates the amylin and calcitonin receptor family in the area postrema and other hindbrain regions. These are the same receptors the natural hormone uses to signal that a meal has been eaten, and activating them produces satiety and slows gastric emptying.
Natural amylin is unusable as a drug because it aggregates into fibrils in solution, the same amyloid behaviour that damages pancreatic islets in type 2 diabetes. Cagrilintide is engineered around that: substitutions that prevent fibril formation, plus an attached fatty acid chain that binds albumin and stretches the half-life to about a week.
The pathway is genuinely separate from GLP-1. Both end in reduced food intake, but through different receptors in different brain regions, which is the mechanistic argument for combining them rather than choosing between them.
Regulatory status — United States
Not approved anywhere, alone or in combination. In late-stage clinical development as CagriSema, a fixed combination with semaglutide. Anything sold as cagrilintide today is a research chemical produced outside the manufacturing controls that a future approval would rest on.
Last reviewed 16 Aug 2026. Regulatory positions in this category change frequently; we date this line so you can see how current it is.
What it is studied for
Each entry states the evidence behind it. We do not rank indications by effectiveness — for most compounds here, that would be a claim nobody can support.
Weight loss as a single agent
Clinical trialStudied, and not the development path being pursued.
EvidenceA 26-week phase 2 trial in 706 adults found up to 10.8% weight loss at the highest dose against 3.0% on placebo.
Weight loss combined with semaglutide
Clinical trialThe actual development programme, as CagriSema.
EvidenceA 68-week phase 3 trial reported roughly 22% mean weight loss, the largest figure published for an injectable weight-loss drug to date. Not yet approved.
Identity and clearance
Molecule
- Class
- Acylated amylin analogue
- Molecular weight
- 3751.9 Da
- Length
- 32 amino acids
Based on the amylin sequence with substitutions that prevent the fibril formation which makes natural amylin undruggable, plus a C20 fatty acid for albumin binding.
Pharmacokinetics
Clinical trialAbout a week, matching semaglutide, which is what makes a single weekly combination injection possible.
Dose protocols reported in sources
Displayed for reference only. Every row says where it came from, and a trial protocol and a community convention are not the same kind of information. None of this is fed into the calculator, and none of it is a recommendation.
| Goal | Dose | Frequency | Route | Units, 5 mg vial | Source | Start this protocol |
|---|---|---|---|---|---|---|
| Phase 2 escalation, single agent | 300 mcg – 4.5 mg | Once weekly, escalating over several weeks | SubcutaneousThe trial escalated from 0.3 mg to a maximum of 4.5 mg weekly. The escalation is not optional in the protocol. Nausea at a starting dose of 4.5 mg would be intolerable for most people. | from 12 u | Clinical trial | Start this |
| Combination with semaglutide, as studied | 2.4 mg | Once weekly | Subcutaneous2.4 mg of cagrilintide alongside 2.4 mg of semaglutide, reached by escalation over 16 weeks. Studied as a single fixed-dose injection, not as two products combined by the user. | 96 u | Clinical trial | Start this |
Start this copies a row into a protocol of your own, which you can then edit. Where a source gave a dose range or an ambiguous frequency, those fields arrive empty — we will not pick a number on your behalf.
Calculator
Work out what to draw
Pre-filled with a 5 mg vial as a worked example. These are not recommended values — change them to match the vial in front of you.
Draw to 96 units on a 1 mL U-100 syringe. That is 0.96 mL, containing 2.4 mg of Cagrilintide.
CheckThis fills the syringe almost to the top, which leaves no room for error when drawing.
Bioalmanac performs arithmetic on values you enter. It does not recommend doses, schedules or compounds, and nothing here is medical advice. Confirm every calculation against your vial and syringe before drawing, and speak with a licensed healthcare provider.
Open this calculation in the full calculator
Units, concentration, bacteriostatic water — the glossary defines the vocabulary, and a unit is not a fixed volume.
Safety
Reported effects
- NauseaClinical trial
Very common in trials
The dominant side effect, dose-related, and worst during escalation. It is the same pattern as the GLP-1 drugs, for a related reason: both slow gastric emptying.
- Vomiting and constipationClinical trial
Common in trials
- Reduced appetite to the point of inadequate intakeClinical trial
Reported in trials
In the combination trial the appetite suppression was substantial enough that eating enough protein became a practical problem for some participants.
- Injection site reactionsClinical trial
Common
- Long-term effectsClinical trial
Unknown
The longest published trial is 68 weeks. Nothing establishes what years of amylin receptor agonism does, because nobody has yet run that study.
When to stop
- Vomiting severe enough that you cannot keep fluids down. Dehydration is the acute risk.
- Severe, persistent abdominal pain, particularly radiating to the back.
- Losing weight faster than roughly 1% of body weight per week, or being unable to eat adequately. Rapid loss costs muscle and raises gallstone risk.
- Any allergic response: rash, hives, facial swelling or difficulty breathing. Seek urgent care.
- Signs of low blood sugar if you also use insulin or a sulfonylurea.
Interactions and situations that need care
- Pregnancy and breastfeedingAvoid
No safety data, and deliberate weight loss in pregnancy is contraindicated regardless of the drug used.
- History of pancreatitisUse caution
Pancreatitis risk has not been characterised for amylin analogues over long periods, and cagrilintide is most likely to be used alongside semaglutide, for which the concern is established.
- Gastroparesis or severe gastrointestinal diseaseUse caution
Slowed gastric emptying is part of how the compound works, which makes an existing motility disorder worse.
- Insulin or sulfonylurea therapyUse caution
Amylin suppresses glucagon, which is a glucose-lowering action. Stacking it with insulin or a drug that raises insulin causes hypoglycaemia, and those doses need adjusting by a prescriber.
- Mixing it yourself with semaglutideAvoid
The trials used a single manufactured product formulated to hold both peptides stably. Combining two vials bought separately is a different thing chemically, and no data establishes that either peptide survives it intact.
What to expect
- About 10.8% weight loss over 26 weeks as a single agent. Real, and less than semaglutide achieves alone.
- The reason to care about it is the combination. Roughly 22% over 68 weeks with semaglutide is the largest published figure for an injectable weight-loss drug.
- It is not approved. That is not a formality. The trial results come from a manufactured product with controlled purity, and a research chemical shares the sequence and nothing else.
- Nausea during escalation is the dominant experience, as with the GLP-1 drugs.
- The longest published trial is 68 weeks, so nothing at all is known about multi-year use.
Storage and handling
- Freeze-dried powder
- Refrigerated at 2–8 °C, protected from light.
- After mixing
- Refrigerated at 2–8 °C. Do not freeze once mixed.
- Long-term, frozen
- Unopened powder is stable at −20 °C or colder.
With other peptides
- Semaglutidesynergistic
This is the pairing under active development as CagriSema, and the mechanism is genuinely complementary, because amylin and GLP-1 signal satiety through different receptors. The trial evidence is for a single manufactured combination product, not for mixing two separately sourced vials.
- Tirzepatidecaution
Plausible on paper, since amylin signalling is separate from both GLP-1 and GIP. No trial has tested it, and stacking three appetite-suppressing mechanisms risks intake falling below what is safe.
- Eloralintideincompatible
Both are amylin receptor agonists. Running them together stacks one mechanism and its nausea rather than adding a second.
In use
Stacks with Cagrilintide in them
Documented combinations, with full schedules.
Checking your vial
Research chemicals carry no manufacturing standard, so what the vial looks like is often the only quality signal available before you use it. More on assessing quality and COAs.
White cake, clear solution after gentle mixing
Standard for a lyophilised acylated peptide.
Cloudy or opalescent solution, or visible fibrous material
Amylin analogues are engineered specifically to resist fibril formation. Anything that looks like strands or gel in the solution means that has failed. Do not use it.
Collapsed or melted cake
Heat exposure in transit.
Questions
- What is CagriSema?
- A fixed combination of cagrilintide and semaglutide in a single weekly injection, in late-stage trials. The phase 3 result was roughly 22% weight loss over 68 weeks.
- How is amylin different from GLP-1?
- Both are gut-and-pancreas hormones that signal satiety, but through different receptors in different parts of the brain. That separation is why combining them adds up rather than overlapping.
- Can I mix cagrilintide with my own semaglutide?
- The trials used a single product manufactured to hold both peptides stably in one solution. Two vials mixed by hand is not that, nothing establishes that the mixture is stable, and the failure mode is that one or both degrade without looking any different.
- Is it approved?
- No. Not alone, and not in combination, anywhere. It is in late-stage development.
References
Cagrilintide for weight management in people with overweight and obesity: a multicentre, randomised, double-blind, placebo-controlled, dose-finding phase 2 trial
The Lancet, 2021 · Randomised, double-blind, placebo-controlled phase 2 trial
Adults with overweight or obesity · n = 706 · 0.3 mg to 4.5 mg subcutaneous, once weekly · 26 weeks
Up to 10.8% mean weight loss at the highest dose against 3.0% on placebo. Nausea was the most common adverse event and was dose-related.
10.1016/S0140-6736(21)01751-7
Cagrilintide with semaglutide (CagriSema) in adults with overweight or obesity: REDEFINE 1
New England Journal of Medicine, 2025 · Randomised, double-blind, placebo-controlled phase 3 trial
Adults with obesity, or overweight with a comorbidity · 2.4 mg cagrilintide with 2.4 mg semaglutide, once weekly · 68 weeks
Mean weight loss of approximately 22% against placebo, exceeding what either component achieves alone. Gastrointestinal effects were the most common adverse events. The trial studied a single manufactured combination product.
Cagrilintide compared with
Related compounds
Semaglutide
A long-acting GLP-1 receptor agonist approved for type 2 diabetes and for weight management, dosed once weekly.
Tirzepatide
A once-weekly dual agonist that activates both the GIP and GLP-1 receptors, approved for type 2 diabetes and for weight management.
Eloralintide
An amylin receptor agonist that produced up to 20% weight loss in phase 2, as a single agent. That last part is what makes it notable.
Retatrutide
An investigational once-weekly triple agonist acting on the GLP-1, GIP and glucagon receptors. Not approved anywhere.
Next
What to do with Cagrilintide
- Keep a record of itTurn a dose and a schedule into a protocol, then log what you actually take. Cagrilintide is filled in for you.
- See what it costsPer-milligram prices read from vendor sites and confirmed by a person, so vial sizes compare.
- Check a combinationWhat our profiles record about Cagrilintide alongside each other compound — including the pairs where nothing is recorded.
Keep this page honest
If something here is wrong, out of date, or missing a source, tell us and we will fix it and say that we did.
This page is educational. It describes what published research reports, not what you should do. Peptides discussed here are largely not approved for human use, and nothing on Bioalmanac is medical advice. No clinician reviews these pages.
Page last updated 16 Aug 2026