The amylin analog that pairs with semaglutide for even greater appetite suppression and fat loss — the foundation of the "CagriSema" stack.
Cagrilintide is a long-acting amylin analog developed by Novo Nordisk. Amylin is a peptide hormone co-secreted with insulin by pancreatic beta cells; it slows gastric emptying, suppresses glucagon, and promotes satiety. Cagrilintide is engineered to last a full week per injection.
Its most well-known use is in combination with semaglutide — the CagriSema stack. Novo Nordisk filed the CagriSema NDA on 18 December 2025; REDEFINE 1 and 2 (the obesity Phase 3 pivotals) were published in NEJM in June 2025. Important caveat: in February 2026, the open-label REDEFINE 4 head-to-head trial vs tirzepatide (n=809, 84 weeks) failed non-inferiority — CagriSema produced −23.0% weight loss vs tirzepatide’s −25.5%. CagriSema is a strong drug, but the “most effective obesity drug” framing that circulated based on early Phase 2 numbers no longer holds.
Not yet FDA approved (Phase 3). Not WADA prohibited. Available as a research chemical only.
Binds amylin and calcitonin receptors in the hindbrain, slowing gastric emptying and producing post-meal satiety independent of GLP-1 pathways.
Because amylin works on different receptors than GLP-1, cagrilintide adds effect on top of semaglutide rather than competing for the same pathway. This is why the stack produces larger weight loss than either alone.
Reduces inappropriate post-meal glucagon release, supporting glycemic control without the hypoglycemia risk of insulin itself.
Amylin and GLP-1 both act in the area postrema, a region of the brainstem outside the blood-brain barrier that samples what is circulating. The important finding is that they act on different populations of neurons there: amylin strongly activates calcitonin-receptor-expressing cells that GLP-1 and GLP-1 agonists leave untouched (Züger et al., Physiology & Behavior 2013, PMID 23438370).
That is the mechanistic basis for stacking. A GLP-1 drug does not occupy the amylin route, so adding an amylin analogue recruits a signal the first drug never reached — rather than pushing harder on a receptor already saturated.
It is worth being precise about this, because the popular version of the explanation is tidier than the biology. You will often read that amylin works in the brainstem while GLP-1 works in the hypothalamus, as though they occupied separate territory. They overlap in the area postrema, and amylin's reach extends well beyond it — into the nucleus tractus solitarius, parabrachial nucleus, midbrain, and the hypothalamus itself (Hankir, Biochimie 2025, PMID 39426704). The pathways are distinct at the level of which neurons respond, not by brain region.
Cagrilintide has been studied both on its own and combined with semaglutide. The combination is where the headline numbers come from.
A dose-finding trial across 57 sites in ten countries. 706 participants received cagrilintide (0.3–4.5 mg weekly), 99 received liraglutide 3.0 mg, and 101 placebo, over 26 weeks. Weight reduction ranged from 6.0% to 10.8% across cagrilintide doses versus 3.0% on placebo.
It also beat an established drug head to head: cagrilintide 4.5 mg produced 10.8% versus 9.0% for liraglutide 3.0 mg (difference 1.8 percentage points, p = 0.03). A modest margin, but a real one against an approved comparator.
The first look at the combination, and the origin of the frequently quoted ~17% figure. Small and short by design — a phase 1b safety and pharmacology study, not an efficacy trial.
The pivotal trial. 3,417 adults without diabetes, randomised to cagrilintide-semaglutide, semaglutide alone, cagrilintide alone, or placebo, for 68 weeks. Mean weight change was −20.4% with the combination versus −3.0% with placebo — a difference of 17.3 percentage points.
Because it included both single agents as separate arms, this trial answers the question that matters: the combination outperformed either component alone, which is the evidence that the two pathways genuinely add rather than overlap.
1,206 patients with type 2 diabetes. Weight change was −13.7% versus −3.4% on placebo, and 73.5% reached an HbA1c of 6.5% or less, against 15.9% on placebo.
Two things worth reading here. Weight loss is markedly lower than in REDEFINE 1 — that gap between diabetic and non-diabetic populations shows up consistently across this whole drug class. And tolerability is not trivial: gastrointestinal adverse events were reported by 72.5% of the combination group versus 34.4% on placebo.
A head-to-head against tirzepatide has been reported at roughly −23.0% versus −25.5% over 84 weeks, with cagrilintide-semaglutide missing non-inferiority. This has not been published or indexed in PubMed as of this writing — it comes from company topline announcement rather than a peer-reviewed report. That is normal for trial results at this stage, and it is a weaker form of evidence than everything above: no methods to inspect, no adverse event tables, no independent review.
Build your protocol, log every dose, monitor your body's response, and get reminders so you never miss a dose.
Start Tracking FreeNot medical advice. These figures describe what is reported in the literature and what practitioners and communities do — not a recommendation, and for most compounds here no human dose-finding study exists. Talk to a qualified healthcare provider.
Cagrilintide is not yet approved, but the dosing below is trial-derived. Phase 2 (PMID 34798060) tested 0.3–4.5 mg weekly; the phase 3 REDEFINE programme used 2.4 mg, which is the maintenance dose the titration targets.
| Weeks | Weekly Dose |
|---|---|
| 1–2 | 0.25 mg |
| 3–4 | 0.5 mg |
| 5–6 | 1.0 mg |
| 7–8 | 1.7 mg |
| 9+ | 2.4 mg (target) |
Hold at any step for an extra 2 weeks if GI side effects are pronounced. Some users stay at 1.7 mg if tolerability limits further escalation, though the Phase 2/3 trials (PMIDs 34798060, 40544433, 40544432) targeted 2.4 mg as the maintenance dose.
Most users pair cagrilintide with semaglutide at matched doses (e.g. both at 2.4 mg weekly). Inject on the same day but in different sites or (if pharma compounded) as a co-formulation.
0.25 mg weekly titrating to 2.4 mg over 8 weeks. Less total weight loss than CagriSema but fewer total side effects and lower cost.
Not medical advice. These figures describe what is reported in the literature and what practitioners and communities do — not a recommendation, and for most compounds here no human dose-finding study exists. Talk to a qualified healthcare provider.
10 mg vial + 2 mL BAC water = 5 mg/mL = 5000 mcg/mL
| Dose | Volume | Syringe Units |
|---|---|---|
| 0.25 mg | 0.05 mL | 5 units |
| 0.5 mg | 0.10 mL | 10 units |
| 1.0 mg | 0.20 mL | 20 units |
| 1.7 mg | 0.34 mL | 34 units |
| 2.4 mg | 0.48 mL | 48 units |
10 mg vial at 2.4 mg/week = ~4 weeks per vial
Pre-filled with a typical Cagrilintide setup. Edit any field — the draw updates live.
Insulin syringe — 100 units = 1 mL
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Cagrilintide is sold for research use only. StackTrax does not sell it, does not endorse personal use, and does not point to a specific supplier for it.
Quality varies enormously among research-chemical suppliers. At minimum, look for:
Lyvn is the vendor we recommend elsewhere on this site — every batch third-party tested, with the full independent panel published per batch. We are not making a recommendation for Cagrilintidespecifically; their catalogue is simply a worked example of the criteria above.
For research use only. Not for human consumption. 21+.
Build your protocol, log every dose, monitor your body's response, and get reminders so you never miss a dose.
Start Tracking FreeNo. Cagrilintide as a monotherapy is not FDA approved. CagriSema — the fixed-dose combination of cagrilintide + semaglutide developed by Novo Nordisk — was filed with the FDA in December 2025 and is currently under review. A regulatory decision is expected 2026–2027. As of May 2026, neither cagrilintide alone nor CagriSema is approved by any regulatory authority. Sold by peptide vendors only as a research chemical.
Cagrilintide is a long-acting amylin receptor agonist — a synthetic analog of the gut hormone amylin (the same hormone that pramlintide / Symlin mimics, but pramlintide has a ~48-minute half-life requiring mealtime dosing). Cagrilintide adds a C20 fatty-diacid acylation that drives reversible albumin binding, extending the half-life to approximately 7 days — once-weekly subcutaneous dosing, the same way semaglutide works.
Trial-validated maintenance dose: 2.4 mg once weekly subcutaneously (the dose used in CagriSema and the Phase 2 cagrilintide-alone trial). Titration schedule: typically 0.3 → 0.6 → 1.2 → 2.4 mg with stepwise increases every 4 weeks. CagriSema combines this 2.4 mg cagrilintide dose with 2.4 mg semaglutide in a single weekly injection.
For a 10 mg lyophilized vial, a typical reconstitution is 10 mg + 2 mL of bacteriostatic water, yielding 5 mg/mL. A 2.4 mg dose draws to 0.48 mL (48 units on a 100-unit insulin syringe). For titration: 0.3 mg = 0.06 mL (6 units), 0.6 mg = 0.12 mL (12 units), 1.2 mg = 0.24 mL (24 units).
That stack IS CagriSema — Novo Nordisk’s combination product. In the REDEFINE-1 Phase 3 trial, CagriSema produced approximately 22.7% mean weight loss at 68 weeks, comparable to tirzepatide and substantially more than semaglutide alone (~15% in STEP-1). Mechanism-wise, amylin agonism complements GLP-1 agonism — different receptors, additive satiety / gastric-emptying effects. Combining the two research-grade compounds yourself is the off-label community equivalent.
Appetite suppression often noticeable within the first 1–2 weeks. Weight loss accumulates over months as the dose titrates upward. In Phase 2 monotherapy (Lau 2021 Lancet), cagrilintide produced ~10.8% weight loss at 26 weeks on 4.5 mg (a higher monotherapy dose than the 2.4 mg used in CagriSema). The full CagriSema effect compounds over the 68-week trial duration.
Disclaimer: This guide is for educational and informational purposes only and is not intended as medical advice, diagnosis, or treatment. The compounds discussed are not FDA approved for human use. Always consult a qualified healthcare provider before starting any new supplement or peptide protocol. StackTrax does not sell peptides or supplements directly — purchase links go to third-party vendors. StackTrax is not responsible for the products, quality, or business practices of any third-party vendor.
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StackTrax guides cover peptides and compounds that are not FDA-approved for the uses discussed. The dosing, reconstitution, and safety information is compiled from published research and community protocols for educational purposes only.
Before using any compound mentioned here, consult a qualified healthcare provider. StackTrax does not sell, prescribe, or recommend these substances for personal use.