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Cagrilintide

Studied for weight loss combined with semaglutide, weight loss beyond semaglutide alone and weight loss on its own. A long-acting analogue of amylin, the pancreatic satiety hormone, developed by Novo Nordisk and first reported in human trials in 2021.

categoryweight loss
clinical evidencephase 3
community adoptionmoderate
uses graded4
sources10
last reviewed24 Aug 2026
compound file

The answer, first. A long-acting analogue of amylin, the pancreatic satiety hormone, developed by Novo Nordisk and first reported in human trials in 2021. The strongest evidence is for weight loss combined with semaglutide, graded A — approval or replicated trials.

Minus 20.4% against minus 3.0% on placebo at week 68, n=3417 1. Replicated at minus 13.7% against minus 3.4% in type 2 diabetes, n=1206 2. The combination is not approved.

What it is used for

Every use graded on its own evidence, not the compound as a whole. 4 outcomes, ranked by what the human record supports.

#outcome · human · animal · gradewhat the best evidence actually shows
01Weight loss combined with semaglutide3 phase 3 trials · rodent food-intake workgrade AMinus 20.4% against minus 3.0% on placebo at week 68, n=3417 1. Replicated at minus 13.7% against minus 3.4% in type 2 diabetes, n=1206 2. The combination is not approved.
02Weight loss beyond semaglutide alone1 active-controlled phase 3 · additive in rodentsgrade BMinus 18.4% against minus 11.9% on semaglutide 2.4 mg alone at week 68, n=331, in Japan and Taiwan 3. Phase 2 agreed at 32 weeks, n=92 4. One head-to-head phase 3.
03Weight loss on its own1 phase 2, 2 monotherapy arms · rodent satietygrade BMinus 10.8% at 4.5 mg against minus 3.0% on placebo at week 26, n=706, ahead of liraglutide 3.0 mg at minus 9.0% 5. A 302-person monotherapy arm ran inside the phase 3 1.
04Glycaemic control in type 2 diabetes1 phase 3, 1 phase 2 · not the primary modelgrade B73.5% on the combination reached HbA1c of 6.5% or less against 15.9% on placebo at week 68, n=1206 2. Phase 2 agreed at minus 2.2 percentage points, n=92 4. Cagrilintide alone moved HbA1c 0.9 points 4.
gradewhat it means
ARegulatory approval, or multiple adequately-powered trials agreeing with each other
BAt least one well-powered human randomised trial, with the direction replicated
CSmall or open-label human trials only
DAnimal or mechanism data only, with no controlled human outcome
EA claim the human trials have already killed

How it works

The proposed mechanism, in three steps. A mechanism is a reason to run a trial, never a substitute for one.

1targetA nonselective agonist across the calcitonin receptor family, including the amylin receptors formed by calcitonin receptor and RAMP subunits.
2signalAmylin signalling runs through hindbrain and area postrema circuits that report meal size and terminate eating.
3effectSatiety through a pathway separate from GLP-1, which is why the two add rather than overlap in the phase 3 trials.

What it does not do

Claims the current record does not support. Worth knowing before you set expectations.

not supported by the evidence

How it is used

What published protocols administered, and what the community reports doing. Descriptive on both counts, and never a recommendation.

routeSubcutaneous injection, once weekly, in every trial. Escalated in 4-week steps over 16 to 20 weeks before the target dose 9.
formatTrial supply was manufactured solution. Grey-market cagrilintide is sold as lyophilised powder.
published dosesPhase 2 tested 0.3, 0.6, 1.2, 2.4 and 4.5 mg weekly for 26 weeks, n=706 5. Phase 1b co-escalated 0.16 to 4.5 mg alongside semaglutide 2.4 mg 9. The phase 3 programme fixed both at 2.4 mg weekly for 68 weeks 12. Descriptive of protocols.
human pharmacokineticsHalf-life 159 to 195 hours at 0.16 to 4.5 mg, median time to peak 24 to 72 hours, n=95 9.
reported conventionsAs reported on Reddit r/Peptides and vendor threads, 2023 to 2026: once-weekly subcutaneous injection at low milligram amounts, escalated monthly. Most often alongside a GLP-1 drug rather than alone, mirroring the trial pairing. Reports are inconsistent on the starting rung. Convention, not guidance.
commonly paired withSemaglutideTirzepatide

This site does not publish protocols to follow. The doses above are what studies administered or what users report, stated as facts about the literature and the market. How protocols are structured, mixing and storage and the reconstitution calculator cover the arithmetic.

What to expect

Where a trial measured it, the trial. Where only the community reports it, that is said out loud.

onsetNo trial measured a first-week effect. Phase 2 read body weight at week 26 after a 6-week escalation, n=706 5. The phase 3 programme read at week 68 after 16 to 20 weeks of escalation, n=3417 15.
most common reportNausea. It was the most frequent event in the phase 2, in 20% to 47% of cagrilintide participants against 18% on placebo 5.
adverse effectsGastrointestinal events in 79.6% on the combination against 39.9% on placebo, week 68, n=3417, mostly transient and mild to moderate 1. Phase 2 alone: gastrointestinal events 41% to 63% against 32% 5.
the stop signalTrial record: 10% of the phase 2 stopped treatment permanently, 4% of the whole trial for adverse events 5. In the phase 3 head-to-head, 10% discontinued the combination 3.

Approval and status

What regulators and sport bodies have actually said, separately from what the evidence shows.

approvalInvestigational. Approved by no regulator as of August 2026.
FDANot approved. Novo filed the fixed-dose cagrilintide-semaglutide combination with FDA on 18 December 2025, review expected during 2026 8.
sport [WADA]Not named. S0 covers unapproved drugs in development 10.
sold asresearch chemical

Check the vial

The grade above describes a molecule studied under controlled conditions. It says nothing about the powder in a particular vial.

That gap is the one part of this market a reader can actually close. How to read a certificate of analysis covers the five measures in five minutes, and the 2026 audit grades vendors on the documents they publish against a rubric printed in full.

Questions we get

What is Cagrilintide used for?

In trials, weight management, nearly always paired with semaglutide. The pairing cut body weight 20.4% against 3.0% on placebo over 68 weeks in 3417 adults.

In 1206 adults with type 2 diabetes it was 13.7% against 3.4%. Alone it cut 10.8% over 26 weeks in a 706-person dose-finding trial. It is approved nowhere. The combination is under FDA review.

How is Cagrilintide used?

Descriptively, from the published protocols: one subcutaneous injection a week, escalated in 4-week steps. The phase 2 tested 0.3 through 4.5 mg over 26 weeks.

The whole phase 3 programme fixed cagrilintide at 2.4 mg weekly alongside semaglutide 2.4 mg for 68 weeks. Research-vial material is not the manufactured drug those protocols used, and no published analysis has compared the two.

How long does Cagrilintide take to work?

No trial measured a first-week effect, so the honest answer is that nobody has published one. Phase 2 read body weight at week 26, after a 6-week escalation.

The phase 3 programme read at week 68, after 16 to 20 weeks of escalation. Its half-life is 159 to 195 hours, so blood levels take roughly a month of weekly dosing to plateau.

Is Cagrilintide an approved drug?

No. Cagrilintide is sold as a research chemical, not as an approved medicine. Novo Nordisk filed the fixed-dose combination with semaglutide for FDA review on 18 December 2025 and no decision has issued.

Cagrilintide alone has not been filed anywhere. On our index it is graded phase 3 on clinical evidence and moderate on community adoption, and those two are rated separately on purpose.

References

  1. Garvey WT, et al. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2025. PMID 40544433
  2. Davies MJ, et al. Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes. N Engl J Med. 2025. PMID 40544432
  3. Yamauchi T, et al. Efficacy and safety of co-administered cagrilintide and semaglutide versus semaglutide alone in adults with overweight or obesity in Japan and Taiwan [REDEFINE 5]: a phase 3a trial. Lancet Diabetes Endocrinol. 2026. PMID 42009015
  4. 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 phase 2 trial. Lancet. 2023. PMID 37364590
  5. Lau DCW, et al. Once-weekly cagrilintide for weight management in people with overweight and obesity: a dose-finding phase 2 trial. Lancet. 2021. PMID 34798060
  6. Fletcher MM, et al. AM833 Is a Novel Agonist of Calcitonin Family G Protein-Coupled Receptors. J Pharmacol Exp Ther. 2021. PMID 33727283
  7. Hankir MK, et al. Central nervous system pathways targeted by amylin in the regulation of food intake. Biochimie. 2025. PMID 39426704
  8. Novo Nordisk. Novo Nordisk files for FDA approval of CagriSema, the first once-weekly combination of GLP-1 and amylin analogues for weight management. Company release, 18 December 2025. prnewswire.com
  9. 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 phase 1b trial. Lancet. 2021. PMID 33894838
  10. World Anti-Doping Agency. Prohibited List 2026, International Standard, in force 1 January 2026. wada-ama.org

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