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Weight loss

Cagrilintide, explained simply

A long-acting amylin analogue given once weekly. Alone it produced up to 10.8% weight loss over 26 weeks against 3.0% on placebo; the 20.4% figure people quote is the CagriSema combination with semaglutide, not cagrilintide on its own. Not approved anywhere — the combination is under FDA review.

Well studied in peopleInjection under the skin (like insulin shots)8 cited sourcesResearch compound — not FDA approved

Start here

What is Cagrilintide?

Cagrilintide is a long-acting, lab-made version of amylin, a hormone your pancreas releases after meals to signal fullness. Given as a once-weekly injection, it produced up to 10.8% weight loss over 26 weeks on its own, against 3.0% on placebo 1; the 20.4% figure often quoted belongs to CagriSema, its combination with semaglutide, not to cagrilintide alone 3. It is not approved anywhere — the combination is under FDA review.

How it works in your body

Cagrilintide is a lab-made version of amylin, a hormone your pancreas releases right after you eat. Think of amylin as your body's natural 'I'm full' signal - it tells your brain to stop eating and slows down how fast food leaves your stomach so you feel satisfied longer. The problem with natural amylin is it only lasts about 15-20 minutes. Cagrilintide is specially designed to last about a week, so you only need one injection and the fullness signals keep working day after day.

The deeper mechanism, for the curious

Cagrilintide is an amylin analog (a copy of amylin, a hormone that helps you feel full) made of 37 amino acids with a fatty-acid attachment (lipidated). It switches on two kinds of receptors: amylin receptors (AMY1-3) and calcitonin receptors (CTR). A C18 diacid fatty acid chain, attached through a gamma-glutamate linker, lets it loosely attach to albumin (a protein in the blood). This extends its half-life (how long it stays active in your body) to 159-195 hours and allows once-weekly dosing. The peptide activates receptors in the area postrema and nucleus of the solitary tract (two areas of the brainstem that sense fullness). This helps you feel full and end a meal, through nerve pathways down to the hypothalamic (the brain region that runs your hormone system) feeding centers (the brain's appetite control area). Secondary effects include slower stomach emptying, less glucagon (a hormone that raises blood sugar) released after meals, and possible effects on energy use by preventing compensatory metabolic adaptation (the body slowing its calorie burn in response to weight loss). Combined with GLP-1 receptor agonists (drugs that mimic the gut's fullness hormone) such as semaglutide (drugs that also curb appetite), the two work on separate but converging fullness pathways, producing synergistic effects (a combined effect greater than either alone) on weight loss.

Evidence check

Well studied in people

This has been through large human trials — the strongest kind of evidence. Scientists have tested it on many people and measured what actually happened.

Every numbered marker on this page links to one of the 8 sources at the bottom.

95/100

Appetite Control

Amylin is a pancreatic hormone released with insulin that signals satiety; cagrilintide is a long-acting version of it, engineered with a half-life of 159-195 hours so a single weekly injection holds the signal. The mechanism is independent of GLP-1, which is why the two add together rather than overlap.

92/100

Weight Loss

On its own: up to 10.8% of body weight (11.5 kg) at 26 weeks at the 4.5 mg dose, against 3.0% (3.3 kg) on placebo. Combined with semaglutide 2.4 mg: 20.4% at 68 weeks against 3.0% on placebo in 3,417 adults. The second number is the pair, not the peptide — quoting 20% for cagrilintide alone is wrong by roughly a factor of two.

98/100

Works with GLP-1 drugs

The clearest evidence is the phase 1b trial, where everyone received semaglutide 2.4 mg and only cagrilintide differed: 17.1% weight loss at 20 weeks with cagrilintide 2.4 mg against 9.8% with placebo added to the same semaglutide. That is about 7 percentage points attributable to cagrilintide. In type 2 diabetes the combination also beat semaglutide alone on weight (-15.6% vs -5.1% at 32 weeks), though the difference in HbA1c (a measure of average blood sugar over about 3 months) was small.

What the research points to

The most-asked question

How much Cagrilintide do I take?

The research-reported range is 0.3–4.5 mg, once weekly. Studies used different doses for different situations — find yours:

  1. Starting dose in the dose-finding trial

    0.3 mg

    • How often
      Once weekly
    • For how long
      26 weeks in the dose-finding trial
    • How
      Injection under the skin

    The lowest dose studied as monotherapy. Roughly 100 participants took it for 26 weeks; the cagrilintide groups as a whole lost 6.0% to 10.8% of body weight against 3.0% on placebo, with 0.3 mg at the bottom of that range 1. Participants reached their assigned dose through an escalation period of up to 6 weeks; in the combination trials cagrilintide and semaglutide were co-escalated in 4-week steps over 16 weeks 2. So there is a titration (stepping the dose up gradually) to your own target dose — there is not a ladder from one dose level to the next, because the dose groups ran in parallel and nobody crossed between them 1.

  2. Dose-response

    0.6 mg

    • How often
      Once weekly
    • For how long
      26 weeks in the dose-finding trial
    • How
      Injection under the skin

    A studied dose level, about 100 participants, 26 weeks 1. Also one of the six cagrilintide doses tested alongside semaglutide 2.4 mg in the phase 1b trial 2.

  3. Dose-response, Combination therapy

    1.2 mg

    • How often
      Once weekly
    • For how long
      26 weeks alone; 20 weeks in combination
    • How
      Injection under the skin

    In combination with semaglutide 2.4 mg this dose produced 15.7% weight loss at 20 weeks against 9.8% for semaglutide plus placebo — about 6 points of additional loss attributable to cagrilintide 2.

  4. Weight management, The dose used in every phase 3 trial

    2.4 mg

    • How often
      Once weekly
    • For how long
      26 to 68 weeks depending on the trial
    • How
      Injection under the skin

    The dose that went forward. Every phase 3 trial uses 2.4 mg, both alone and as half of the fixed-dose CagriSema combination: REDEFINE 1 in 3,417 adults with obesity 3, REDEFINE 2 in 1,206 adults with type 2 diabetes 6, and REIMAGINE 2 in 2,713 people with type 2 diabetes, which carried a cagrilintide 2.4 mg monotherapy arm of 152 7. In the phase 1b trial 2.4 mg with semaglutide gave 17.1% weight loss at 20 weeks against 9.8% on semaglutide plus placebo 2. Participants reached their assigned dose through an escalation period of up to 6 weeks; in the combination trials cagrilintide and semaglutide were co-escalated in 4-week steps over 16 weeks 2. So there is a titration (stepping the dose up gradually) to your own target dose — there is not a ladder from one dose level to the next, because the dose groups ran in parallel and nobody crossed between them 1.

  5. Highest studied dose

    4.5 mg

    • How often
      Once weekly
    • For how long
      26 weeks in the dose-finding trial
    • How
      Injection under the skin

    The highest dose ever given to humans, and the top of the monotherapy dose-response: 10.8% weight loss (11.5 kg) at 26 weeks against 3.0% (3.3 kg) on placebo, and against 9.0% (9.6 kg) for liraglutide 3.0 mg — a 1.8 percentage point edge over liraglutide, p=0.03 1. It was not the dose taken into phase 3. A dedicated cardiac study escalated 53 healthy participants to 4.5 mg and found no clinically relevant QTc prolongation against placebo 8.

Every studied protocol, drawn on one scale — 0 to 4.5 mg.
  1. Starting dose in the dose-finding trial0.3 mg
  2. Dose-response0.6 mg
  3. Dose-response, Combination therapy1.2 mg
  4. Weight management, The dose used in every phase 3 trial2.4 mg
  5. Highest studied dose4.5 mg

Adjusting your dose

You're at the right dose if…

  • Gradual, steady weight loss of 1-2 lbs per week
  • Noticeably reduced appetite without severe nausea
  • Feeling satisfied with smaller portions
  • Manageable or no side effects

Consider going up if…

  • You have tolerated the current dose well for at least 4 weeks
  • Weight loss has slowed or plateaued
  • Appetite suppression effects have diminished
  • You want enhanced results and can handle potential increased side effects

Go down if…

  • Experiencing persistent nausea that affects quality of life
  • GI side effects are severe or not improving after 2 weeks
  • Rapid weight loss exceeding 2-3 lbs per week
  • Feeling excessively full or unable to eat adequate nutrition

The ceiling: 4.5 mg once weekly (studied dose); when combined with semaglutide, 2.4 mg cagrilintide with 2.4 mg semaglutide

Reconstitution, in plain words

How do I mix Cagrilintide?

Peptides usually arrive as a freeze-dried powder in a small vial. “Reconstitution” just means adding sterile water back in so you can measure a dose. Here's how it works for Cagrilintide:

What you need

  • Bacteriostatic water (BAC water)
  • Insulin syringe (29-31 gauge, 0.5-1mL)
  • Alcohol swabs
  • Sterile vial of cagrilintide powder
  • Sharps container for safe needle disposal

A worked example

5mg vial + 1mL BAC water = 5mg/mL concentration. Each 0.1mL (10 units) contains 0.5mg cagrilintide.

Working out your dose

For 2.4mg dose at 5mg/mL concentration: draw 0.48mL (48 units on insulin syringe). For easier math, many use 2mL water with 5mg vial for 2.5mg/mL.

Or let the calculator do it

Three quick questions — your vial, your water, your dose — and it tells you the exact syringe mark. “Find dose amount” is preloaded with Cagrilintide's recorded schedule.

CagrilintideOnce weekly

How much peptide is in your bottle?

Look at the label on the vial. It’s the number next to the unit — like "5 mg". Labeled in IU? Switch the unit to IU.

Type a number to continue.
0

Injection sites & technique

Where do I inject Cagrilintide?

The best spots

  • Abdomen (2 inches away from navel)
  • Front of thigh (middle third)
  • Upper arm (outer area)
  • Lower back area (above buttocks)

How to do it, step by step

  • Wash hands thoroughly and clean injection site with alcohol swab
  • Let the alcohol dry completely - this reduces stinging
  • Pinch the skin to create a fold for easier injection
  • Insert needle at a 45-90 degree angle depending on body composition
  • Inject the medication slowly over 5-10 seconds
  • Hold for 10 seconds before removing needle, then release skin

Injection under the skin once weekly

Timing

When do I take Cagrilintide?

Best time of day

Same day each week, any time of day that works for your schedule

With or without food?

Can be taken with or without food - choose whatever is most convenient

Taking it with other peptides

When combining with semaglutide (CagriSema), both can be injected on the same day. The combination is designed to be taken together for synergistic effects.

The honest list

What side effects could Cagrilintide cause?

Common — usually mild

These show up most often. They usually fade as your body adjusts.

  • Nausea

    The most frequently reported side effect, affecting 20-47% of users depending on dose. Usually mild and improves over the first few weeks.

    What to do Start with lower doses and titrate (stepping the dose up gradually) slowly. Eat smaller, more frequent meals. Avoid greasy or heavy foods.

  • Constipation

    Occurs due to slowed gastric emptying and reduced food intake. Reported in 15-25% of users.

    What to do Increase fiber and water intake. Stay physically active. Consider a stool softener if needed.

  • Diarrhea

    May occur especially during dose adjustments. Usually temporary and mild to moderate.

    What to do Stay well hydrated. Avoid foods that trigger symptoms. Usually resolves within 1-2 weeks.

  • Injection site reactions

    Mild redness, swelling, or itching at injection sites. Generally resolves quickly.

    What to do Rotate injection sites regularly. Ensure proper injection technique. Apply ice if needed.

Less common

Worth knowing about, but most people never see these.

  • Vomiting

    Less common than nausea, more likely during dose escalation phases.

    What to do Eat bland, easy-to-digest foods. Slow down dose increases. Contact provider if persistent.

  • Headache

    Occasional headaches reported, usually mild and transient.

    What to do Stay hydrated. Use over-the-counter pain relief if needed. Usually improves with time.

Serious — stop and get medical help

Rare, but if any of these happen, stop and contact a medical professional.

  • Severe allergic reactions

    Rare but possible. Signs include rash, swelling, difficulty breathing.

    What to do Stop medication immediately and seek emergency medical care if you experience these symptoms.

Week by week

What should I expect from Cagrilintide, and when?

  1. Weeks 1-6

    You might notice
    What's normal
    What's next

  2. Week 26

    You might notice
    What's normal
    What's next

  3. Week 68 (combination only)

    You might notice
    What's normal
    What's next

How to tell it's actually working

Weight loss indicators

  • Clothes fitting more loosely
  • Scale showing consistent weekly weight reduction
  • Reduced waist circumference
  • Visible changes in body composition
  • Need to tighten belt or buy smaller sizes

Appetite and eating changes

  • Feeling satisfied with smaller portions
  • Reduced interest in snacking between meals
  • Less food noise and obsessive food thoughts
  • Natural preference for lighter, smaller meals
  • Ability to stop eating when full

Metabolic improvements

  • Better blood sugar readings (if monitored)
  • Improved fasting glucose on lab work
  • More stable energy throughout the day
  • Less sluggishness after meals
  • Better cholesterol and triglyceride (blood fat) levels

Not seeing anything? The usual reasons

  • Dose too low - may need to increase to therapeutic levels (2.4mg or higher)
  • Not enough time - meaningful results typically take 8-12 weeks at adequate doses
  • Calorie-dense liquid calories bypassing satiety signals - watch smoothies, alcohol, sugary drinks
  • Eating through fullness signals - pay attention to your body's cues
  • Inconsistent dosing schedule - must be same day each week for optimal levels
  • Unrealistic expectations - 1-2 lbs per week is healthy, sustainable weight loss

Is it right for you?

Who should avoid Cagrilintide?

Do not use it if…

  • Pregnancy or breastfeeding
  • Active eating disorders
  • Severe gastroparesis

Be extra careful if…

  • You have a history of pancreatitis (inflammation of the pancreas)
  • You have gallbladder disease or a history of gallstones
  • You have diabetic retinopathy (diabetes-related eye damage)
  • You are taking insulin or sulfonylureas (diabetes drugs; this raises the risk of low blood sugar)
  • You have significant kidney impairment
  • You have difficulty maintaining adequate nutrition

When to stop

  • Severe allergic reaction (rash, swelling, difficulty breathing)
  • Persistent severe nausea or vomiting not improving with dose reduction
  • Signs of pancreatitis (severe abdominal pain radiating to back)
  • Planned pregnancy or positive pregnancy test
  • Inability to maintain adequate nutrition despite dose adjustments
  • Any concerning symptoms your healthcare provider advises stopping for

Always consult your healthcare provider before stopping or modifying your dose. Do not stop abruptly without medical guidance, especially if you are also on diabetes medications.

What it mixes badly (and well) with

Medications

  • Avoid
    Insulin

    Raises the risk of hypoglycemia (dangerously low blood sugar); your insulin dose may need to be lowered, especially doses taken after meals

  • Avoid
    Sulfonylureas

    Higher risk of hypoglycemia (dangerously low blood sugar); your dose may need adjusting with your provider's guidance

  • OK together
    Metformin

    Generally safe to combine; may give extra benefits for metabolism

  • Check first
    Oral medications

    Slower stomach emptying may change how fast pills are absorbed; take critical medicines at separate times

Other peptides

  • OK together
    Semaglutide

    Designed to be combined; the CagriSema combination shows greater weight loss because the two drugs work in different ways that complement each other

  • Check first
    Tirzepatide

    May be combined, but both affect appetite strongly; watch for too much appetite suppression

  • OK together
    BPC-157

    Generally safe to combine for gut support during weight loss

  • Avoid
    Pramlintide

    Do NOT combine; both are amylin analogs (copies of the fullness hormone amylin) that work in overlapping ways

Supplements

  • OK together
    Protein supplements

    Highly recommended to maintain muscle mass during weight loss

  • OK together
    Fiber supplements

    Can help with constipation - take with plenty of water

  • OK together
    Multivitamins

    Recommended as reduced food intake may limit nutrient intake

  • OK together
    Electrolytes

    Helpful if experiencing GI side effects to prevent dehydration

Who it tends to suit

Weight loss and appetite control

Cagrilintide excels at reducing hunger by mimicking amylin, a hormone your pancreas naturally releases after meals. Phase 2 trials showed people losing up to 10.8% of body weight with cagrilintide alone - and that's without combining it with other medications.

Boosting results from GLP-1 medications (drugs like semaglutide)

When you hit a plateau with semaglutide or want even better results, cagrilintide adds a second satiety pathway. The CagriSema combination achieved over 20% weight loss in clinical trials - significantly more than either drug alone.

People who want once-weekly convenience

Unlike older amylin medications that required three daily injections, cagrilintide's extended half-life (how long it stays active in your body) of about a week means you only inject once weekly. Set a reminder on your phone and you're done.

Those seeking natural-feeling appetite reduction

Cagrilintide works by enhancing your body's own fullness signals rather than forcing you to eat less. Many users report feeling genuinely satisfied with smaller meals rather than fighting willpower battles.

Metabolic health improvement

Beyond weight loss, cagrilintide helps with blood sugar control and metabolic markers. It slows stomach emptying and reduces post-meal glucose spikes, making it valuable for people with or at risk for type 2 diabetes.

The safety picture overall

Gastrointestinal effects are the dominant finding and they are common, not rare. In the 26-week dose-finding trial, gastrointestinal adverse events occurred in 41% to 63% of cagrilintide participants across the dose groups against 32% on placebo, with nausea in 20% to 47% against 18%; 73 of 906 participants (10%) stopped treatment permanently and 30 (4%) did so because of adverse events 1. In the 68-week phase 3 obesity trial the combination with semaglutide produced gastrointestinal adverse events in 79.6% against 39.9% on placebo, mainly transient and mild to moderate 3; in the type 2 diabetes phase 3 the figures were 72.5% against 34.4% 6. In the 2,713-person REIMAGINE 2 trial, adverse events were reported by 82.2% (125 of 152) of those on cagrilintide 2.4 mg alone against 70.5% (105 of 149) on placebo 7. A dedicated cardiac study in 105 healthy participants found no clinically relevant QTc prolongation at the highest studied dose of 4.5 mg against placebo 8.

Cagrilintide is not approved anywhere, so none of this comes from a regulator-reviewed label — it comes from the trials, all of them funded and run by Novo Nordisk. Monotherapy evidence is thinner than the phase 3 headline numbers suggest: about 100 participants per dose group for 26 weeks in the dose-finding trial 1, 302 in the REDEFINE 1 cagrilintide arm 3, and 152 in REIMAGINE 2 7. Most of the large-scale safety data describes the COMBINATION with semaglutide, where the two drugs cannot be separated. There is no data beyond 68 weeks, none in pregnancy, and none in people using cagrilintide without medical supervision.

Keeping it good

How do I store Cagrilintide?

Before mixing (powder)

Store in refrigerator at 36-46 degrees F (2-8 degrees C). Keep in original packaging to protect from light. Never freeze. Can tolerate brief room temperature exposure during shipping but return to refrigeration promptly.

After mixing (liquid)

Refrigerate immediately after mixing with bacteriostatic water. Do not freeze reconstituted solution. Use within 28 days of first puncture. Keep vial upright to minimize contamination risk.

Signs it has gone bad

  • Cloudy or discolored solution (should be clear)
  • Visible particles, floaters, or clumps
  • Solution that has been accidentally frozen
  • Unusual smell when opening vial

Not our opinion — the published record

What the studies actually found about Cagrilintide

2021

Once-weekly cagrilintide for weight management in people with overweight and obesity

The dose-finding trial, and the source of every cagrilintide-alone dose. 906 adults without diabetes at 57 sites in ten countries were randomly assigned, in a 6:1 ratio, to one of these: once-weekly cagrilintide injected under the skin at 0.3, 0.6, 1.2, 2.4 or 4.5 mg (100-102 people per dose group), once-daily liraglutide 3.0 mg (99), or placebo (101). It ran 26 weeks, after a dose build-up period of up to 6 weeks. These were PARALLEL dose groups (each person stayed on one dose), not a ladder anyone climbed. Weight fell 6.0% to 10.8% (6.4-11.5 kg) across the cagrilintide groups against 3.0% (3.3 kg) on placebo. That is a difference of 3.0 to 7.8 percentage points, p<0.001 (p is the chance the result happened by luck). The top dose beat liraglutide 3.0 mg: 10.8% (11.5 kg) against 9.0% (9.6 kg), a difference of 1.8 percentage points, p=0.03. Stomach and gut side effects happened in 41-63% of cagrilintide participants against 32% on placebo. Nausea happened in 20-47% against 18%. 73 participants (10%) stopped treatment for good, 30 (4%) because of side effects.

Lau DCW et al.

2021

Safety, tolerability, pharmacokinetics, and pharmacodynamics of cagrilintide with semaglutide

The phase 1b combination trial (an early safety-focused trial), with 95 adults exposed. Six groups of people with a BMI of 27.0-39.9 were assigned in sequence, 3:1, to once-weekly cagrilintide at 0.16, 0.30, 0.60, 1.2, 2.4 or 4.5 mg (11-12 people each) or matching placebo (24). Everyone also took semaglutide 2.4 mg. Both drugs were raised together in 4-week steps over 16 weeks, with no lifestyle program. At week 20, weight fell 15.7% on cagrilintide 1.2 mg and 17.1% on 2.4 mg, against 9.8% on the combined placebo-plus-semaglutide group. The differences were -6.0 (95% CI -9.9 to -2.0) and -7.4 (-11.2 to -3.5) percentage points (the CI, or confidence interval, is the range the true value likely falls in). The 4.5 mg group fell 15.4% against 8.0% on its matching placebo. Note what the placebo group is here: everyone got semaglutide 2.4 mg, so the 9.8% is semaglutide's own effect, and cagrilintide added roughly 6-7 points on top. Of 566 side effects in 92 participants, 207 (37%) were stomach and gut problems. Cagrilintide's half-life (the time for half the drug to leave the body) was 159-195 hours, which is what makes weekly dosing possible.

Enebo LB et al.

2025

Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity

REDEFINE 1, the phase 3a obesity trial (a large late-stage trial). 3,417 adults without diabetes were included. They had a BMI of 30 or more, or 27 or more with an obesity-related health problem. They were randomly assigned, 21:3:3:7, to once-weekly cagrilintide-semaglutide 2.4 mg each (2,108), semaglutide 2.4 mg alone (302), cagrilintide 2.4 mg alone (302), or placebo (705), with a lifestyle program, for 68 weeks. Body weight fell 20.4% on the combination against 3.0% on placebo (difference -17.3 percentage points, 95% CI -18.1 to -16.6, p<0.001), with more people reaching 5%, 20%, 25% and 30% loss. Stomach and gut side effects affected 79.6% on the combination against 39.9% on placebo, mostly short-lived and mild to moderate. The 20.4% belongs to the combination. The summary does not report a figure for the cagrilintide-alone group.

Garvey WT et al.

2021

Development of Cagrilintide, a Long-Acting Amylin Analogue

Describes how chemists developed cagrilintide. Attaching a fatty acid (lipidation) stretched the half-life (the time for half the drug to leave the body) from minutes (pramlintide) to about one week, while the drug kept working at its receptors (docking sites on cells).

Kruse T et al.

2023

Efficacy and safety of CagriSema in type 2 diabetes

In people with type 2 diabetes, CagriSema (the cagrilintide-semaglutide combination) led to 15.6% weight loss versus 5.1% with semaglutide alone over 32 weeks. HbA1c (a measure of average blood sugar over about 3 months) fell by similar amounts, and the combination was well tolerated.

Frias JP et al.

2025

Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes (REDEFINE 2)

A phase 3a trial (a large late-stage trial) in 12 countries. 1,206 adults with type 2 diabetes and a BMI of 27 or more were randomly assigned, 3:1, to once-weekly cagrilintide-semaglutide, 2.4 mg of each (904), or placebo (302), with a lifestyle program, for 68 weeks. Body weight fell 13.7% against 3.4% on placebo (difference -10.4 percentage points, 95% CI -11.2 to -9.5, p<0.001). HbA1c (a measure of average blood sugar over about 3 months) reached 6.5% or lower in 73.5% against 15.9% on placebo. Stomach and gut side effects were reported by 72.5% against 34.4% on placebo, most short-lived and mild to moderate.

Davies MJ, Bajaj HS, Broholm C, et al.

2026

Cagrilintide-semaglutide (CagriSema) versus semaglutide or cagrilintide in people with type 2 diabetes (REIMAGINE 2)

The largest trial to include a cagrilintide-alone group. 2,713 people with type 2 diabetes in 30 countries were randomly split into six groups for 68 weeks. These included cagrilintide 2.4 mg alone (n=152) alongside cagrilintide-semaglutide 2.4 mg each (n=603), semaglutide 2.4 mg (n=605), the 1.0 mg combination (n=595), semaglutide 1.0 mg (n=609) and placebo (n=149). On the main measure, the 2.4 mg combination beat semaglutide 2.4 mg on HbA1c (a measure of average blood sugar over about 3 months): -1.91 vs -1.75 percentage points, a difference of -0.16 (95% CI -0.27 to -0.05, p=0.0035). That is a real but small gap. Side effects: 86.9% (524/603) on the 2.4 mg combination, 82.2% (125/152) on cagrilintide alone, 81.2% (491/605) on semaglutide 2.4 mg, and 70.5% (105/149) on placebo, most often stomach and gut problems.

Buse JB, Bajaj HS, Dalskov SM, et al.

2024

Cagrilintide is not associated with clinically relevant QTc prolongation: a thorough QT study in healthy participants

A dedicated heart-safety study in 105 healthy people, randomly assigned to once-weekly cagrilintide injected under the skin, raised to 4.5 mg (n=53), or placebo (n=52). Oral moxifloxacin 400 mg served as a positive control (a drug known to affect the heart rhythm) to prove the test could detect a real signal. After the final 4.5 mg dose, the upper limit of the two-sided 90% confidence interval (the range the true value likely falls in) for the placebo-adjusted QTcF change (a measure of the heart's electrical recovery time) was below 10 ms at every timepoint. So the highest dose ever studied does not slow the heart's electrical recovery to a clinically relevant degree.

Gabe MBN, Fuhr R, Sinn A, et al.

If this isn't the right fit

What people use instead of Cagrilintide

Similar weight loss without using the amylin (fullness hormone) route

  • Semaglutide
  • Tirzepatide
  • Liraglutide

Maximum possible weight loss

  • CagriSema (cagrilintide + semaglutide)
  • Retatrutide
  • Tirzepatide

Lower cost weight loss option

  • Compounded semaglutide
  • AOD-9604
  • Tesofensine

Non-injectable appetite control

  • Oral semaglutide (Rybelsus)
  • 5-Amino-1MQ
  • Dietary interventions

Your questions

Cagrilintide FAQ

How is cagrilintide different from semaglutide?

They work through completely different mechanisms. Semaglutide mimics GLP-1 (a gut hormone that tells your brain you're full), while cagrilintide mimics amylin. Both are natural fullness hormones, but they switch on different docking spots (receptors) in your brain. Think of them as two different volume knobs for your hunger signals. That's why combining them (CagriSema) works so well: you're turning down appetite through two separate pathways.

When will cagrilintide be FDA approved?

Novo Nordisk submitted CagriSema (the combination of cagrilintide and semaglutide) to the FDA in 2025 based on successful Phase 3 trials. Approval is anticipated, but exact timing depends on the FDA review process. Cagrilintide alone is currently being studied for its own dedicated approval pathway.

Can I use cagrilintide by itself or does it need to be combined with semaglutide?

Cagrilintide works effectively on its own - the Phase 2 trial showed 10.8% weight loss with cagrilintide alone at the highest dose. However, the combination with semaglutide (CagriSema) produces even better results - around 20% weight loss. Your provider can help determine which approach is right for your goals.

What if I'm already on semaglutide - can I add cagrilintide?

Yes, that's actually the strategy behind CagriSema. If you've plateaued on semaglutide or want enhanced results, adding cagrilintide targets a complementary satiety pathway. Clinical trials show the combination significantly outperforms either drug alone for weight loss.

How long until I notice results with cagrilintide?

Most people notice reduced appetite within the first 1-2 weeks. Meaningful weight loss typically becomes apparent by weeks 4-8 as doses are titrated (stepping the dose up gradually) up. Maximum results are seen over 6-12 months of consistent use. Remember, healthy weight loss of 1-2 pounds per week is both safe and sustainable.

Are the side effects better or worse than GLP-1 medications (drugs like semaglutide)?

The side effect profiles are similar - both primarily cause GI symptoms like nausea and constipation. Some data suggests cagrilintide may be slightly better tolerated, with lower rates of nausea in head-to-head comparisons. Most side effects improve within the first few weeks and can be minimized with gradual dose increases.

Will I regain weight if I stop taking cagrilintide?

Like other weight loss medications, stopping cagrilintide typically leads to weight regain because the underlying biology driving weight gain remains. These medications are designed for long-term use. Maintaining weight loss usually requires ongoing treatment combined with sustained lifestyle changes.

Is cagrilintide safe for people with diabetes?

Yes, cagrilintide has been studied specifically in people with type 2 diabetes. It can improve blood sugar control in addition to promoting weight loss. However, if you're on insulin or sulfonylureas, doses may need adjustment to prevent low blood sugar. Always work with your healthcare provider.

8 sources

References

Every numbered marker on this page points to one of these. Same sources, same numbering as the Cagrilintide research profile on Peptide Initiative.

  1. Once-weekly cagrilintide for weight management in people with overweight and obesityLau DCW et al. · 2021
  2. Safety, tolerability, pharmacokinetics, and pharmacodynamics of cagrilintide with semaglutideEnebo LB et al. · 2021
  3. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or ObesityGarvey WT et al. · 2025
  4. Development of Cagrilintide, a Long-Acting Amylin AnalogueKruse T et al. · 2021
  5. Efficacy and safety of CagriSema in type 2 diabetesFrias JP et al. · 2023
  6. Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes (REDEFINE 2)Davies MJ, Bajaj HS, Broholm C, et al. · 2025
  7. Cagrilintide-semaglutide (CagriSema) versus semaglutide or cagrilintide in people with type 2 diabetes (REIMAGINE 2)Buse JB, Bajaj HS, Dalskov SM, et al. · 2026
  8. Cagrilintide is not associated with clinically relevant QTc prolongation: a thorough QT study in healthy participantsGabe MBN, Fuhr R, Sinn A, et al. · 2024

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Every claim on this page traces back to the research database behind Peptide Initiative — studies, citations, clinical trial data, and the technical detail we deliberately left out here.

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This guide is education, not medical advice. Cagrilintide is a research compound that is not FDA-approved for human use. Talk to a clinician before taking anything.