It helps you feel full sooner and adds to semaglutide's weight loss.
How people take it
In trials, people injected 2.4 mg once a week alongside 2.4 mg of semaglutide.
Know this
Nausea and other stomach side effects are very common, so the dose is raised slowly.
What it is
Cagrilintide is an experimental weekly shot made by Novo Nordisk. It's a long-lasting copy of amylin, a hormone your pancreas releases with insulin after meals. It's mainly being developed in a combo with semaglutide called CagriSema, which was filed with the FDA in December 2025 and was still under review as of October 2026.
How it works
Amylin works on a different part of the brain than GLP-1 drugs like semaglutide. It helps you feel full, slows how fast your stomach empties, and softens the sugar spike after a meal. Because it works a different way, adding it to semaglutide cuts appetite more than either drug alone.
What people use it for
Weight loss
Adding to semaglutide when weight loss stalls
Type 2 diabetes (with semaglutide, in trials)
The evidence
Some human studies
The trial data is good, mostly for the combo with semaglutide. Over 68 weeks, cagrilintide 2.4 mg plus semaglutide 2.4 mg gave about 20% weight loss versus 3% on placebo (about 14% versus 3% in people with type 2 diabetes), and cagrilintide alone gave about 12%. Stomach side effects hit about 80% of people on the combo, it isn't approved on its own, and long-term safety is still being studied.
68 weeks in the trials, after a 16-week step-up (see titration)
Route
Subcutaneous injection
Why: This is the dose from the big phase 3 REDEFINE trials. Both drugs last about a week, so one weekly shot of each keeps levels steady.
Phase 2 range (alone)
Trial dose
Dose
0.3–4.5 mg
How often
Once a week
When
Same day each week
Cycle
26 weeks, with up to 6 weeks of step-up
Route
Subcutaneous injection
Why: In the dose-finding trial, weight loss went up as the dose went up, and 4.5 mg did slightly better than daily liraglutide (another weight-loss shot).
Add-on to an existing GLP-1
Reported
Dose
0.25–2.4 mg
How often
Once a week
When
Often the same day as the GLP-1 shot, in a separate syringe
Cycle
Ongoing; start at 0.25 mg and step up no faster than every 4 weeks
Route
Subcutaneous injection
Why: People often add it when weight loss slows on semaglutide. Start low, because the two drugs stack up on nausea as well as on appetite control.
Step-up schedule
Weeks
Dose
1–4
0.25 mg once a week (each drug, in REDEFINE)
5–8
0.5 mg once a week
9–12
1 mg once a week
13–16
1.7 mg once a week
17 on
2.4 mg once a week (trial maintenance dose)
Start at the low end, and change one thing at a time. If you take medication or have a health condition, check with a doctor first.
We may earn a commission from these links. Counts include one syringe and two swabs per dose.
Stay safe
Side effects
Nausea, vomiting, constipation or diarrhea (common, worse while stepping up the dose and with semaglutide)
Low appetite, burping, stomach pain
Reactions where you inject
Tiredness
Dehydration from vomiting or diarrhea
Gallbladder problems (seen with semaglutide and possible with the combo)
Low blood sugar when combined with insulin or sulfonylureas (a type of diabetes pill)
Skip it if
Pregnant, trying to get pregnant, or breastfeeding
History of pancreatitis (pancreas inflammation)
Severe slow stomach emptying (gastroparesis)
If combined with semaglutide: personal or family history of medullary thyroid cancer or MEN 2 (a rare inherited condition that causes gland tumors)
Under 18
Interactions
Semaglutide: the tested pairing; side effects stack up, so raise both doses slowly
Insulin or sulfonylureas: higher risk of low blood sugar
Pramlintide (another amylin drug): don't combine
Pills that need exact blood levels: slower stomach emptying can change how they're absorbed
Get help right away for swelling of the face or throat, trouble breathing, chest pain, or a spreading, hot, red injection site.
Storage & legal
Storage
Powder: fridge or freezer. Once mixed: fridge, use within about 4 weeks. Don't mix it in the same syringe as other peptides unless that combo has been tested.
Legal status
FDA: Not approved. CagriSema (cagrilintide plus semaglutide) is under FDA review; a decision was expected in late 2026.
Sport (WADA): Prohibited at all times under S0 (non-approved substances).
Yes, but less than semaglutide or tirzepatide. Alone it gave roughly 10–12% weight loss in trials. Its main use is on top of semaglutide.
Can I pair it with tirzepatide?
People do, but that pairing hasn't been tested in published trials. The only combo with real trial data is with semaglutide.
Why step up so slowly?
The trials raised the dose every 4 weeks over 16 weeks to keep nausea and vomiting down. Going faster mostly just makes people sick.
Sources
Garvey WT, et al. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2025;393(7):635-647. PubMed 40544433
Davies MJ, et al. Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes. N Engl J Med. 2025;393(7):648-659. PubMed 40544432
Lau DCW, et al. 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. 2021;398(10317):2160-2172. PubMed 34798060
Enebo LB, et al. Safety, tolerability, pharmacokinetics, and pharmacodynamics of concomitant administration of multiple doses of cagrilintide with semaglutide 2.4 mg for weight management: a randomised, controlled, phase 1b trial. Lancet. 2021;397(10286):1736-1748. PubMed 33894838
Frias JP, et al. 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. 2023;402(10403):720-730. PubMed 37364590