What is Cagrilintide?
Cagrilintide is a synthetic, long-acting version of a naturally occurring hormone called amylin. Amylin is released by the pancreas after a meal and tells the brain, "You've eaten enough — slow down." The natural hormone wears off quickly. Cagrilintide is engineered to last a full week with a single injection, making it practical to study in clinical trials.[6]
Researchers at Novo Nordisk have been testing cagrilintide primarily in combination with semaglutide — a well-known GLP-1 receptor agonist used for weight management. That combination is nicknamed CagriSema.[1] As a research compound, cagrilintide is not approved for prescription use and is studied for research purposes only.
How Cagrilintide Works
Think of your appetite-control system as a lock with several keyholes. GLP-1 drugs like semaglutide fit one keyhole. Amylin fits a completely different one. Cagrilintide plugs into amylin receptors in the brain — particularly in a region called the area postrema, which acts like a hunger thermostat — and turns the dial down.[6]
Because amylin and GLP-1 work through separate pathways, combining them may produce a stronger effect than either alone, a concept researchers call complementary mechanisms.[3] Cagrilintide also slows the rate at which the stomach empties, which stretches out the feeling of fullness after meals.[6]
What the Research Shows
Early Dose-Finding Work (Phase 2)
A landmark 2021 phase 2 trial published in The Lancet tested cagrilintide on its own across several doses (0.3 mg up to 4.5 mg once weekly) in adults with overweight or obesity but without diabetes, over 26 weeks. The trial confirmed a clear dose-response relationship — higher doses produced greater weight loss — and established that the compound was generally well tolerated.[3]
CagriSema in Type 2 Diabetes (Phase 2)
A 2023 Lancet phase 2 trial studied CagriSema specifically in people who have both obesity and type 2 diabetes. Researchers found meaningful reductions in both body weight and blood-sugar levels (measured as HbA1c), supporting further investigation in larger trials.[4]
REDEFINE 1 — Without Diabetes (Phase 3)
The biggest test so far was the REDEFINE 1 trial, a 68-week, phase 3 study published in the New England Journal of Medicine in 2025. More than 3,400 adults with overweight or obesity (no diabetes) were enrolled. Those receiving CagriSema (cagrilintide 2.4 mg + semaglutide 2.4 mg once weekly) lost an estimated 20.4% of their body weight on average, versus 3.0% with placebo — a difference of about 17 percentage points. The vast majority of CagriSema participants hit the 5%-or-more weight-loss benchmark, and many reached 20%, 25%, or even 30% reduction targets.[1]
REDEFINE 2 — With Type 2 Diabetes (Phase 3)
REDEFINE 2, also published in the New England Journal of Medicine in 2025, looked at 1,206 adults who had both obesity and type 2 diabetes. CagriSema produced an estimated 13.7% body-weight reduction versus 3.4% with placebo. Strikingly, 73.5% of CagriSema participants achieved an HbA1c of 6.5% or lower — a normal-range blood-sugar target — compared with just 15.9% in the placebo group.[2]
Meta-Analysis Summary
A 2024 systematic review and meta-analysis pooling data across cagrilintide trials confirmed the weight-loss efficacy of cagrilintide alone and in combination with semaglutide, while noting that gastrointestinal side effects — particularly nausea — were more common with active treatment than placebo.[5]
What Cagrilintide Is Being Studied For
- Weight management in overweight and obesity — the primary focus across all major trials[1]
- Weight management alongside type 2 diabetes control — simultaneous reduction of body weight and blood sugar[2]
- Combination metabolic therapy — pairing amylin-pathway and GLP-1-pathway agents to hit multiple appetite-control targets at once[3]
How Cagrilintide Is Dosed in Research
Research protocols have used a range of once-weekly subcutaneous (under-the-skin) doses, and the studies have followed careful dose-escalation schedules to improve tolerability. The specific doses tested — from early phase 1b exploration up through the phase 3 REDEFINE trials — are laid out in the dosage chart on this page. If you want to explore dose-scaling calculations, the calculator on this page can help you work through the numbers. Remember: these figures come from controlled clinical research settings and are provided here for educational reference only.
Mixing and Storing Cagrilintide
In clinical trials, cagrilintide was supplied as a solution for subcutaneous injection — meaning it came pre-dissolved, not as a dry powder requiring reconstitution.[3] For research settings that do handle lyophilized (freeze-dried) peptide preparations, general best practices apply: use bacteriostatic water or the solvent specified by the supplier, inject the solvent gently down the side of the vial rather than directly onto the powder, swirl gently (never shake), and allow the solution to dissolve fully before drawing. Store unmixed peptide in a freezer away from light; once mixed, keep it refrigerated (around 2–8 °C) and use within the window recommended by the supplier — typically 28 days. Always label vials with the date of reconstitution. These are general laboratory handling guidelines; researchers should follow their institution's specific protocols.
Sources
- Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity. — The New England journal of medicine, 2025. PMID 40544433.
- Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes. — The New England journal of medicine, 2025. PMID 40544432.
- Once-weekly cagrilintide for weight management in people with overweight and obesity: a multicentre, randomised, double-blind, placebo-controlled and active-controlled, dose-finding phase 2 trial. — Lancet (London, England), 2021. PMID 34798060.
- Efficacy and safety of co-administered once-weekly cagrilintide 2·4 mg with once-weekly semaglutide 2·4 mg in type 2 diabetes: a multicentre, randomised, double-blind, active-controlled, phase 2 trial. — Lancet (London, England), 2023. PMID 37364590.
- Efficacy and Safety of Cagrilintide Alone and in Combination with Semaglutide (Cagrisema) as Anti-Obesity Medications: A Systematic Review and Meta-Analysis. — Indian journal of endocrinology and metabolism, 2024. PMID 39676787.
- Cagrilintide: A Long-Acting Amylin Analog for the Treatment of Obesity. — Cardiology in review, 2024. PMID 36883831.