Cagrilintide
Cagrilintide is the amylin side of weight management in this catalog, a different lever from the GLP-1 drugs rather than a competing one. It slows how fast the stomach empties and increases fullness after eating, working through the amylin and calcitonin receptor system instead of GLP-1. People run it alongside semaglutide, as CagriSema, when they want more than either compound produces alone, or on its own for the same appetite and fullness effect. It's dosed once weekly by subcutaneous injection, the same schedule as semaglutide.
What it does
Weight loss, alone or combined
Cagrilintide is for people who want more from their weight-loss protocol than a GLP-1 alone provides, or who want an amylin-based option instead of one. On its own, the highest dose in trials produced average weight loss of 10.8% over 26 weeks. Combined with semaglutide as CagriSema, that number climbs to 20.4% average weight loss over 68 weeks, the largest combination result in this category. Neither cagrilintide nor CagriSema is approved yet.
Sources: Lau DCW et al., 2021, Garvey WT et al., 2025
Appetite and fullness
Reduced appetite and early fullness are what people notice first on cagrilintide, and some stomach upset should be expected right alongside it, not read as something going wrong. In trials, gastrointestinal symptoms, mostly nausea, showed up in 41 to 63% of people on cagrilintide alone and rose with dose; combined with semaglutide, the rate was 79.6%. Both trials described the symptoms as mostly transient and mild to moderate, easing as the body adjusts.
Sources: Lau DCW et al., 2021, Garvey WT et al., 2025
Weekly injection, syringe size
Cagrilintide is a once-weekly subcutaneous shot, the same rhythm as semaglutide, which is why the two pair so easily as CagriSema. The community protocol starts at 0.6 mg and steps up every two weeks to a 4.5 mg weekly maintenance dose. At that maintenance dose, the injection volume runs to about 1.35 mL, which won't fit a standard insulin syringe. Past 1.0 mL, you need a 3 mL syringe instead.
Sources: peptidedosages.com, Cagrilintide 10, peptidedosages.com, Cagrilintide overview
Dosing
Community reportedCommunity subcutaneous protocol, 10 mg vial0.6 mg to 4.5 mg, weekly
| Timeframe | Dosage | Frequency | Note |
|---|---|---|---|
| Weeks 1-2 | 0.6 mg | weekly | Starting dose1 |
| Weeks 3-4 | 1.2 mg | weekly | |
| Weeks 5-6 | 2.4 mg | weekly | |
| Weeks 7-16 | 4.5 mg | weekly | Maintenance2 |
- The cited source states that gradual dose escalation minimizes gastrointestinal side effects such as nausea. This is consistent with the dose-dependent gastrointestinal adverse-event rates seen in the phase 2 trial.
- At the source's own reconstitution of 10 mg in 3.0 mL, a 4.5 mg dose is 1.35 mL, which EXCEEDS a standard 100-unit U-100 insulin syringe. The source notes that doses above 1.0 mL require a 3 mL syringe with a 25-27G, one-half to five-eighths inch subcutaneous needle.
Primary structure
Structure is recorded as written chemistry rather than a plain residue chain, and is reproduced here as recorded rather than simplified:
37-amino-acid amylin analog carrying N14E and V17R salt-bridge substitutions and proline substitutions that reduce fibril formation. Full sequence not reproduced here.
Full research
Evidence tier
Human trials, not approved for this use
Multiple large peer-reviewed randomized controlled trials in humans exist, including a phase 2 dose-finding trial in The Lancet and phase 3 trials in the New England Journal of Medicine. That is well beyond early human data. It is not the approved-drug tier because neither cagrilintide monotherapy nor the CagriSema combination has been approved by the FDA or EMA as of this entry; the NDA was filed in December 2025 with a decision expected in Q4 2026. Because no approved label exists, no label-derived dosing is available and every trial dose recorded here is trial-derived only.
Original dosing schedule
The Dosing table above this section now shows a community- or vendor-sourced schedule (peptidedosages.com). The regulatory-label or clinical-trial dosing this entry was originally built on is kept here, unchanged, rather than removed.
Clinical trial
| Timeframe | Dosage | Frequency | Note |
|---|---|---|---|
| 26 weeks | 0.3, 0.6, 1.2, 2.4, or 4.5 mg | weekly | Randomized dose arms1 |
- Doses studied in a randomized controlled trial, not an approved regimen and not a recommendation. The 4.5 mg arm produced the largest weight change at -10.8 percent versus -3.0 percent for placebo.
Clinical trial
| Timeframe | Dosage | Frequency | Note |
|---|---|---|---|
| 68 weeks | 2.4 mg cagrilintide plus 2.4 mg semaglutide | weekly | REDEFINE 1 and 2 combination arm |
- Combination regimen studied in phase 3. Not approved. Recorded for completeness, not as guidance.
Identity
| Full name | Cagrilintide |
|---|---|
| Class | Acylated long-acting analog of human amylin (islet amyloid polypeptide), built on a pramlintide-like 37-amino-acid backbone with stabilizing substitutions and a C20 fatty-diacid linker giving reversible albumin binding |
| Brand names | AM833, NN9838, NNC0174-0833 |
| Molecular weight | 4409 g/mol |
| Sequence | 37-amino-acid amylin analog carrying N14E and V17R salt-bridge substitutions and proline substitutions that reduce fibril formation. Full sequence not reproduced here. |
Mechanism of action
Plain language
Cagrilintide mimics amylin, a hormone released alongside insulin that signals a meal has been eaten. It slows how fast the stomach empties and increases fullness. Because this is a different pathway from GLP-1 drugs such as semaglutide, the two can be combined.
Technical
Nonselective agonist at calcitonin-family receptors, acting at both the amylin receptor (a calcitonin receptor and RAMP heterodimer) and the calcitonin receptor. Downstream effects are delayed gastric emptying and increased satiety signaling. Acylation with a C20 eicosanedioic diacid via a gamma-glutamate linker drives reversible albumin binding, extending half-life from native amylin's roughly 4 minutes to approximately 159 to 195 hours and enabling once-weekly dosing.
Sources: Development of Cagrilintide, 2021
What it’s used for
Human trials, not approved for this use
- Weight management as monotherapy. A phase 2 dose-finding trial in 706 adults with overweight or obesity randomized participants to once-weekly subcutaneous cagrilintide at 0.3, 0.6, 1.2, 2.4, or 4.5 mg, placebo, or liraglutide 3.0 mg daily for 26 weeks. At the 4.5 mg dose, mean body-weight change was -10.8 percent versus -3.0 percent for placebo and -9.0 percent for liraglutide.
Sources: Lau DCW et al., 2021
- Weight management combined with semaglutide (CagriSema). REDEFINE 1 randomized 3,417 adults with overweight or obesity and without diabetes to CagriSema (cagrilintide 2.4 mg plus semaglutide 2.4 mg), semaglutide alone, cagrilintide alone, or placebo, once weekly for 68 weeks. Mean weight change was -20.4 percent for CagriSema, -16.1 percent for semaglutide alone, -11.8 percent for cagrilintide alone, and -3.0 percent for placebo.
Sources: Garvey WT et al., 2025
- Weight management and glycemic control in type 2 diabetes, combined with semaglutide. REDEFINE 2 studied the same combination in adults with obesity and type 2 diabetes.
Sources: Nauck M et al., 2025
Off-label / community use
- Sold as a research compound and dosed in the community by once-weekly subcutaneous injection, using a titration that mirrors the phase 2 trial dose range. Novo Nordisk submitted CagriSema to the FDA on 18 December 2025 with a decision expected in Q4 2026. As of this entry neither cagrilintide monotherapy nor CagriSema is approved in the United States or European Union, so there is no approved label and no approved indication.
Sources: peptidedosages.com, Cagrilintide 10, peptidedosages.com, Cagrilintide overview
Pharmacokinetics
| Elimination half-life |
Clinical trial Approximately 159 to 195 hours (roughly 7 to 8 days) Sources: Development of Cagrilintide, 2021 No citable figure. Half-life is extended by reversible albumin binding via the C20 fatty-diacid modification; native amylin's half-life is approximately 4 minutes. This supports the once-weekly dosing used in every trial and in the community protocol. |
|---|
Reconstitution
| Vial strength | 10 mg (also sold in 5 mg vials) |
|---|---|
| Diluent | Bacteriostatic water |
| Diluent volume | 3.0 mL |
| Concentration | Approximately 3.33 mg/mL |
Sources: peptidedosages.com, Cagrilintide 10
Dose calculator
Enter a vial strength, diluent volume, and desired dose to see the resulting concentration, dose volume, and units on a standard U-100 insulin syringe. Nothing entered here is saved, stored, or sent anywhere – the calculation runs only in your browser.
This calculator needs JavaScript. The arithmetic it runs is: concentration = vial strength in mg divided by diluent volume in mL; dose volume in mL = dose in mg divided by concentration; units on a U-100 syringe = dose volume in mL times 100.
Storage and post-reconstitution stability
Unopened storage
Lyophilized peptide stored frozen or refrigerated and protected from light, per standard peptide-handling practice. No cagrilintide-specific stability study for research-compound vials was located.
Post-reconstitution stability – Not established
Refrigerated, general peptide-handling practice
No citable figure. No cagrilintide-specific post-reconstitution stability study was located in this research pass. Any duration figure circulating on vendor sites is an unsourced commercial claim rather than data from a published stability study.
Safety
Notable risks
- Gastrointestinal adverse events are the dominant and dose-dependent risk. In the phase 2 monotherapy trial they occurred in 41 to 63 percent of cagrilintide arms versus 32 percent on placebo, with nausea specifically in 20 to 47 percent versus 18 percent on placebo, rising with dose. Injection-site reactions were also among the most frequent adverse events.
Sources: Lau DCW et al., 2021
- In REDEFINE 1, gastrointestinal adverse events affected 79.6 percent of the cagrilintide-semaglutide group versus 39.9 percent of placebo, including nausea, vomiting, diarrhea, constipation, or abdominal pain, and were described as mainly transient and mild-to-moderate in severity.
Sources: Garvey WT et al., 2025
- There is no approved label, so no regulator-reviewed contraindication list exists. Trial protocols in this program excluded participants with a personal or family history of medullary thyroid carcinoma or MEN2, and those with a history of pancreatitis. That is a precautionary class-level practice carried over from the amylin, calcitonin, and GLP-1 drug classes. No cagrilintide-specific human causal signal for medullary thyroid carcinoma or pancreatitis was located in this research pass, and that absence is not evidence of safety.
Sources: Garvey WT et al., 2025
Sources
- Development of Cagrilintide, a Long-Acting Amylin Analogue, Journal of Medicinal Chemistry (2021)
- Lau DCW et al., Once-weekly cagrilintide for weight management in people with overweight and obesity, a phase 2 dose-finding trial, The Lancet 2021;398:2160-2172 (2021)
- Garvey WT et al., Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity (REDEFINE 1), NEJM 2025;393(7):635-647 (2025)
- Nauck M et al., Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes (REDEFINE 2), NEJM 2025 (2025)
- Enebo LB et al., Safety, tolerability, pharmacokinetics and pharmacodynamics of concomitant administration of multiple doses of cagrilintide and semaglutide, The Lancet 2021;397:1736-1748 (2021)
- peptidedosages.com, Cagrilintide 10 mg vial dosage protocol
- peptidedosages.com, Cagrilintide overview
- PubChem CID 171397054, Cagrilintide
This is a research and educational reference, not medical advice. Nothing on this site is a recommendation to use any compound.