Research/Compounds/GLP1/Cagrilintide
Investigational (Phase 3)SubQ Weekly · Amylin

Cagrilintide

Long-Acting Amylin Analog — Appetite & Satiety Hormone

Half-life
~7 days
Route
SubQ weekly
Typical dose
0.3–4.5 mg/week
Reconstitutable
No — pre-filled pen

What is Cagrilintide?

Cagrilintide is a long-acting amylin analog developed by Novo Nordisk. Amylin is a peptide co-secreted with insulin from pancreatic beta cells that promotes satiety, slows gastric emptying, and reduces glucagon secretion. Cagrilintide's key clinical application is its combination with semaglutide as CagriSema — which Phase 3 data shows produces approximately 22.7% weight loss, approaching Tirzepatide efficacy.

Cagrilintide binds amylin receptors (AMY1-3) in the area postrema and hypothalamus, producing satiety signals that are distinct from and complementary to GLP-1 receptor activation. By combining GLP-1 (appetite suppression, insulin secretion) with amylin (satiety, glucagon suppression, gastric emptying delay) pathways, the CagriSema combination addresses obesity through two complementary mechanisms rather than one.

Research Evidence

SilverCagriSema Combination — Weight Loss

Phase 2 COMBINE 3 trial of CagriSema (cagrilintide 2.4mg + semaglutide 2.4mg) showed approximately 22.7% body weight reduction at 32 weeks — among the highest ever reported for a weekly injectable combination.

SilverMonotherapy Weight Loss

Cagrilintide alone showed approximately 10.8% weight reduction in Phase 2, comparable to liraglutide and establishing amylin agonism as a meaningful weight loss mechanism.

BronzePhase 3 (REDEFINE)

Phase 3 REDEFINE trials of CagriSema are ongoing as of 2026. Results expected to support potential FDA submission.

Evidence grades: Gold = RCT human data · Silver = consistent animal/human data · Bronze = limited or preliminary

Dosing Protocols

CagriSema dose
Cagrilintide 2.4mg + Sema 2.4mg weekly
The combination under investigation in Phase 3. Not yet commercially available.
Monotherapy dose
0.3–4.5 mg/week
Phase 2 dose escalation from 0.3mg to 4.5mg weekly. Clinical development focused on combination use.
Status
Phase 3 / Investigational
Not FDA approved or available through compounding pharmacies as of 2026.

Reconstitution / Preparation

This compound does not require reconstitution — oral or pre-mixed formulation.

Frequently Asked Questions

What is the difference between Cagrilintide and Pramlintide?

Both are amylin analogs. Pramlintide (Symlin) is FDA-approved, short-acting, and requires injection with each meal. Cagrilintide is a long-acting analog with a 7-day half-life allowing once-weekly dosing. This makes cagrilintide practical as a weekly combination partner with semaglutide (CagriSema), whereas pramlintide's dosing burden limits its use.

How does CagriSema compare to Tirzepatide?

Phase 2 CagriSema data shows approximately 22.7% weight loss, very close to Tirzepatide's SURMOUNT-1 results (~20.9% at 72 weeks). The head-to-head comparison is eagerly awaited. CagriSema combines two distinct mechanisms (GLP-1 + amylin) while Tirzepatide combines two receptor agonisms (GLP-1 + GIP). The Phase 3 REDEFINE data will clarify the comparative efficacy.

References

  1. [1]Frias JP, et al. COMBINE 3: cagrilintide 2.4 mg combined with semaglutide 2.4 mg in adults with overweight or obesity. Obesity (Silver Spring). 2023.
  2. [2]Enebo LB, Berthelsen KK, Kankam M, et al. Safety, tolerability, pharmacokinetics, and pharmacodynamics of cagrilintide with semaglutide. Lancet. 2021;397(10286):1736-1748.
Disclaimer: This profile is for informational and research purposes only. Not medical advice. Always consult a licensed healthcare provider before using any compound.

This profile was prepared using AI-assisted research synthesis. Citations are provided where applicable — verify with primary sources before clinical application.

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