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Weight management

Cagrilintide

A long-acting amylin analogue. Dampens appetite through a different path than the GLP-1 compounds.

3 min read 17 sources

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Summary

At a glance

Sources checked on 25 Oct 2026

Targets
2 receptor families

Amylin and calcitonin receptors, an agonist at both (structural data)13

Half-life
~7 days

159 to 195 hours in a phase 1b study, fits one dose per week8

Body weight in phase 2
-10.8 %

after 26 weeks, highest study dose (placebo -3.0%)1

With semaglutide in phase 3
-20.4 %

REDEFINE 1 at 68 weeks, combination (placebo -3.0%)4

Phase 3 in the registry
21 trials

mostly as a combination with semaglutide, 10 of them completed, as of 25 Oct 202616

  • Cagrilintide is a long-acting amylin analogue: a peptide that binds to amylin and calcitonin receptors and so acts on satiety through a different path than GLP-1.1113
  • In phase 2 (26 weeks) body weight fell more with each higher dose, by 10.8 percent on average at the highest study dose, by 3.0 percent on placebo.12
  • The most studied use is the combination with semaglutide: in phase 3 (REDEFINE 1, 68 weeks) it was 20.4 versus 3.0 percent. Separate phase 3 trials of cagrilintide alone (RENEW) run until 2027.416
  • The most common effects in the trials were gastrointestinal, above all nausea. Injection site reactions came on top.12
  • According to ChEMBL, cagrilintide is not approved (highest phase 3, as of October 2026). Everything here is the state of research, not a recommendation.17
Profile

Updated May 2026

Class
Long-acting amylin analogue
Route
Subcutaneous
Frequency
Once weekly
Form
Lyophilised powder

reconstituted with BAC water

Sizes
5 to 20 mg

3 sizes in the shop

Contents 16 sections
  1. At a glance
  2. What is Cagrilintide?
  3. How it works
  4. What you need
  5. Reconstitution
  6. Injection
  7. Dosing
  8. What the research shows
  9. Research status
  10. Side effects
  11. Lifestyle
  12. Storage
  13. Related compounds
  14. FAQ
  15. Glossary
  16. Sources

What is Cagrilintide?

Cagrilintide is a long-acting analogue of amylin, a hormone the body makes that comes from the pancreas together with insulin and signals satiety. It is therefore a sibling concept to the GLP-1 compounds, but acts on a different path.

It is injected once a week. Cagrilintide is still in clinical research and is often thought of together with semaglutide (the combination is called CagriSema). It ships as a freeze-dried powder you dissolve in bacteriostatic water.

Comparison

One, two or three receptors

Which receptors each compound targets, as stated in the TPD lexicon. Tap a card to open its entry.

GLP-1 agonist Semaglutide Amylin Calcitonin GLP-1 1 of 3 receptors Amylin agonist, selective Eloralintide Amylin Calcitonin GLP-1 1 of 3 receptors
Amylin analogue Cagrilintide Amylin Calcitonin GLP-1 2 of 3 receptors
Combination CagriSema (Cagri + Sema) Amylin Calcitonin GLP-1 3 of 3 receptors

Simplified: more receptors does not automatically mean better, each path also brings its own effects. 13

How it works

Amylin and its analogues act on satiety centres in the brain and slow gastric emptying. The result is an earlier and longer-lasting feeling of fullness. Because cagrilintide uses a different path than GLP-1, the two complement each other well, hence the great interest in the combination.

In a research context, cagrilintide alone led to clear weight reduction and to even more in combination with semaglutide.

Where it acts

Two receptor families, several organs

Tap a point or a card. Colour = receptor, grey = effect seen in trials.

  1. Brain

    Satiety via nerve cells in the brainstem (shown in animal models)14

    AmylinCalcitonin
  2. Stomach

    Gastric emptying slowed (effect of amylin)15

    Amylin
  3. Pancreas

    HbA1c fell by 0.9 percentage points in 32 weeks in type 2 diabetes3

    Observed in trials
  4. Waist

    Waist circumference after 26 weeks at the highest level -9.5 cm (placebo -3.4 cm)2

    Observed in trials
  5. Heart

    No relevant prolongation of the QT interval on the ECG10

    Observed in trials

Known targets13

Compound CHEMBL4802169: three described targets, all Agonist, binding shown in structural data.

Amylin receptor 1 (AMY1)
Gene
CALCR + RAMP1
UniProt
P30988, O60894
ChEMBL
CHEMBL2111189
Action
Agonist, binding shown in structural data
Amylin receptor 3 (AMY3)
Gene
CALCR + RAMP3
UniProt
P30988, O60896
ChEMBL
CHEMBL2111190
Action
Agonist, binding shown in structural data
Calcitonin receptor (CTR)
Gene
CALCR
UniProt
P30988
ChEMBL
CHEMBL1832
Action
Agonist, binding shown in structural data
Blue 3D peptide chains docking onto a glass dome of cells, next to a glass organ model with blue beads trickling out
Symbolic image.

What you need

For subcutaneous use you need:

Supplies

5 things, numbered as in the picture

Tick off what you already have. Vial and BAC water are our real shop photos at the same size.

Cagrilintide vial and bacteriostatic water at the same size with the black TPD label, next to two U-100 insulin syringes, two alcohol swabs and a sharps container with a blue lid

  1. Cagrilintide vial

    The Cagrilintide vial with the freeze-dried powder

    In the shop

  2. Bacteriostatic water

    Bacteriostatic water to dissolve it

    In the shop

  3. U-100 insulin syringes

    U-100 insulin syringes

    Amazon (opens a new tab)

  4. Alcohol swabs

    Alcohol swabs for the vial cap and the skin

    Amazon (opens a new tab)

  5. Sharps container

    A sealable sharps container for used needles

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Reconstitution

The powder is dissolved in bacteriostatic water. How much water you add sets the concentration and therefore how many units you draw for your dose on the insulin syringe.

Use the peptide calculator for this: pick your vial size and the water volume to see the concentration and units per dose.

When dissolving, just add the bac water, it does not matter if it hits the powder directly. Then swirl or shake until everything has dissolved, both are fine.

Step by step

Dissolving the powder

Four steps, the same for every vial size.

  1. 1Wipe the cap

    Clean the rubber stopper with an alcohol swab.

  2. 2Add BAC water

    Just add it, it does not matter if it hits the powder directly.

  3. 3Swirl or shake

    Until everything has dissolved, both are fine.

  4. 4Draw up

    With the U-100 insulin syringe.

Less water higher concentration fewer units on the syringe Example: 10 mg + 2 ml = 5 mg/ml

Injection

The injection is subcutaneous, into the fat layer under the skin, classically the abdomen, the front and the inner side of the thigh or the back of the upper arm.

Injection

Where and at what angle

Pick a spot or switch the angle. Subcutaneous means: into the fat layer, not the muscle.

Rotate the spot each time, never the same one twice in a row.

90°More fat under the skin

Rule of thumb: where there is more fat under the skin, insert straight at 90 degrees. In lean people with little fat, 45 degrees, so the needle stays in the fat layer. Simplified diagram.

  1. Clean the spot with an alcohol swab and let it dry

  2. Pinch up a small fold of skin

  3. Insert the needle: at 90 degrees where there is more fat under the skin, at 45 degrees in lean people with little fat

  4. Inject slowly, wait a moment, then withdraw

  5. Put the needle straight into the sharps container

Rotate the site.

Dosing

Dosing

Dosing, titration and syringe

Loading the dosing information …

  • Getting started and stepping up, drawn as a staircase
  • Units on the U-100 syringe for every step
  • How long one vial lasts

What the research shows

In a phase 2 study (Lau, 2021), weekly cagrilintide led to clear, dose-dependent weight reduction in overweight and obesity and was well tolerated. A further study examined the combination with semaglutide in type 2 diabetes. Cagrilintide is still in clinical research, but the phase 2 data are solid.

The studies with links are in the source block below.

Study results

What the trials measured

Interactive: switch tabs, tap points, show or hide arms. Arms are named relative to each other, no dosing advice.

Body weight after 26 weeks2

Mean change in percent per level, phase 2 trial with 706 participants

Dose finding in overweight and obesity2 Without diabetes, dosed once a week
Placebo -3.0%
Level 1 (lowest) -6.1%
Level 2 -6.9%
Level 3 -8.5%
Level 4 -9.5%
Level 5 (highest, 4.5 mg) -10.8%

Values from the results posted on the trial registry. The abstract reports 6.0 to 10.8 percent versus 3.0 percent on placebo, assuming everyone took the treatment as planned. A comparison group on a daily GLP-1 compound is not shown here.

Share with clear weight loss2

Share of participants after 26 weeks, same phase 2 trial

Lost at least 5%2
Placebo 31%
Level 1 (lowest) 57%
Level 2 62%
Level 3 76%
Level 4 74%
Level 5 (highest, 4.5 mg) 89%
Lost at least 10%2
Placebo 10%
Level 1 (lowest) 15%
Level 2 24%
Level 3 36%
Level 4 44%
Level 5 (highest, 4.5 mg) 53%

Rounded values from the results posted on the trial registry (analysis for everyone who took the treatment as planned).

Body weight after 68 weeks456

Mean change in percent per trial, combination with semaglutide

REDEFINE 14 Overweight or obesity without diabetes
Placebo -3.0%
Combination (CagriSema) -20.4%
REDEFINE 25 With type 2 diabetes
Placebo -3.4%
Combination (CagriSema) -13.7%
REDEFINE 56 East Asia, compared with semaglutide alone
Semaglutide alone -11.9%
Combination (CagriSema) -18.4%

Values as stated in the trial abstracts. REDEFINE 1 also had a cagrilintide-only group (302 participants), whose value the abstract does not report. The trials differ in population and are not directly comparable.

Body weight after 32 weeks3

Mean change in percent, phase 2 trial with 92 participants

Alone and combined3 Type 2 diabetes, all three groups without placebo
Semaglutide alone -5.1%
Cagrilintide alone -8.1%
Combination (CagriSema) -15.6%

Values as stated in the trial abstract. Long-term blood sugar is shown in the HbA1c tab.

Long-term blood sugar HbA1c after 32 weeks3

Change in percentage points, the same phase 2 trial with 92 participants

Alone and combined3 Type 2 diabetes, all three groups without placebo
Cagrilintide alone -0.9 pp
Semaglutide alone -1.8 pp
Combination (CagriSema) -2.2 pp

Long-term blood sugar (HbA1c) fell by 0.9 (cagrilintide alone), 1.8 (semaglutide alone) and 2.2 percentage points (combination).

Glass brain model on a transparent pedestal in a bright room
Symbolic image.

Research status

Where the research stands

From its design based on amylin to the phase 3 programme, mostly combined with semaglutide: registered trials with status, participants and results. As of 25 Oct 2026. 16

  1. Preclinical Designed from amylin, cell assays and animals
  2. Phase 1 24 trials, 17 completed
  3. Phase 2 6 trials, 6 completed
  4. Phase 3 21 trials, 10 completed
  5. Approval not yet
23,859 participants in phase 3 Planned figures for running trials Not approved yet. ChEMBL lists cagrilintide with phase 3 as the highest phase and no approval year.17
Show all 27 phase 2 and 3 trials on a timelineHide timeline 16 completed 11 running 6 with results
Phase 2
Phase 3

Bar: start to primary endpoint (planned for running trials). Green = completed, blue = progress until 25 Oct 2026. Phase 1: 24 trials on safety and pharmacokinetics, not shown as bars.

Side effects

As with the appetite-dampening substances, gastrointestinal effects come first: nausea, fullness, occasionally diarrhoea or constipation, mainly at the start and after dose increases. The slow titration is exactly for that.

Tolerability

Frequency in the phase 2 trial

Out of 100 participants per group, how many had the event from week 0 to 32.

18 of 100 Placebo
20 of 100 Level 1 (lowest)
27 of 100 Level 2
36 of 100 Level 3
31 of 100 Level 4
47 of 100 Level 5 (highest, 4.5 mg)
Event PlaceboLevel 1 (lowest)Level 2Level 3Level 4Level 5 (highest, 4.5 mg)
Nausea2 18%20%27%36%31%47%
Constipation2 7%11%9%8%17%21%
Fatigue2 3%8%5%8%10%20%
Injection site reaction2 0%4%4%7%12%10%

Rounded shares from the results posted on the trial registry (about 100 participants per group). The abstract reports gastrointestinal effects overall in 41 to 63 percent versus 32 percent on placebo.21

Lifestyle

Cagrilintide takes the appetite away, the rest is on you:

  1. Enough protein so you do not lose too much muscle along with fat.

  2. Drink enough, with low appetite you often drink less automatically.

  3. Resistance training keeps muscle mass.

  4. Eat slowly, with delayed gastric emptying you fill up faster.

Bowl of cottage cheese with berries and banana, a carafe of water and two light blue dumbbells on a bright table

Storage

The undissolved powder is robust, normal room temperature (around 20 to 25 degrees) is fine, ideally kept in the dark. The reconstituted solution goes into the fridge (2 to 8 degrees) and stays stable there for at least 4 to 6 months with barely any loss of potency, in practice considerably longer. The bacteriostatic water brings a preservative that keeps the dissolved form stable for longer.

Shelf life

How long it keeps

Undissolved (powder) Room temperature, around 20 to 25 degrees, dark

Robust, no fridge needed. Keeps for several months without trouble.

Dissolved (mixed) Fridge, 2 to 8 degrees

At least 4 to 6 months with barely any loss of potency. The bacteriostatic water brings a preservative.

  • Keep it dark
  • Dissolved: 2 to 8 degrees
  • Note the mixing date on the vial
Nine vials with white powder and blue caps in the door shelf of a bright fridge
Powder dark at room temperature, once dissolved into the fridge (2 to 8 degrees), stable there for at least 4 to 6 months. Symbolic image.

Related

Related compounds

Same receptors, blends with Cagrilintide or a different path: all in the TPD lexicon.

Cagrilintide
CagriSema (Cagri + Sema) Contains cagrilintide plus semaglutide Reta + Cagri Blend Contains cagrilintide plus Retatrutide Eloralintide Also amylin, prefers AMY1 Semaglutide Partner in CagriSema, GLP-1 only Tirzepatide Different path: GLP-1 and GIP Retatrutide Different path: three receptors

FAQ

Common questions about Cagrilintide

Short answers, each backed by the sources below.

Is cagrilintide approved?

No, according to ChEMBL there is no approval (as of 25 October 2026). ClinicalTrials.gov lists 21 phase 3 trials, ten of them completed. Most test the combination with semaglutide. Cagrilintide alone is being tested in phase 3 in the RENEW trials, with the primary endpoint planned for May 2027.1716

How does cagrilintide differ from GLP-1 compounds such as semaglutide?

The receptor. Cagrilintide binds to amylin and calcitonin receptors, not to the GLP-1 receptor. In rats it acted through specific nerve cells in the brainstem: when a signal there was switched off, the effect of cagrilintide disappeared but that of semaglutide did not. That is why the combination of the two is being studied.131214

What did the phase 2 trial show?

In the dose-finding trial with 706 participants weight fell by 6.0 to 10.8 percent after 26 weeks depending on the level, by 3.0 percent on placebo. At the highest level, 53 percent lost at least 10 percent according to the registry, on placebo 10 percent.12

How long does cagrilintide stay in the body?

The half-life was 159 to 195 hours in a phase 1b study, so about seven days. That fits one dose a week, which is how the trials give it. With impaired kidney or liver function the level after a single dose was not meaningfully different.89

What does the combination with semaglutide add?

In REDEFINE 1 weight fell by 20.4 percent on average after 68 weeks, by 3.0 percent on placebo. With type 2 diabetes (REDEFINE 2) it was 13.7 versus 3.4 percent. In a phase 2 trial in type 2 diabetes participants lost 15.6 percent in 32 weeks with the combination, 8.1 with cagrilintide alone and 5.1 percent with semaglutide alone.453

Which side effects were seen?

Most often gastrointestinal effects, above all nausea: in the phase 2 trial 20 to 47 percent had it depending on the level, 18 percent on placebo. Constipation, injection site reactions and, at the highest level, more frequent fatigue came on top. The QT interval on the ECG did not lengthen relevantly in a dedicated study.1210

Which trials are still running?

Eleven phase 3 trials are not finished yet. The largest is REDEFINE 3 on cardiovascular events with 7,101 participants (primary endpoint planned for September 2027). For cagrilintide alone RENEW 1, 2 and 4 are running, plus a trial in children and adolescents until 2030.16

Glossary

Terms explained briefly

Dotted words in the text open these explanations directly.

Agonist
A substance that binds to a receptor and activates it, like the body's own messenger.
Amylin
Hormone that the pancreas releases together with insulin. It slows gastric emptying and glucagon after meals and signals fullness to the brain.
CagriSema
Working name of the combination of cagrilintide and semaglutide, both injected once a week.
Calcitonin receptor
Receptor that forms the amylin receptors together with a helper protein (RAMP). Cagrilintide activates both forms.
Gastric emptying
The pace at which the stomach passes its contents on to the gut. Slower means food stays in the stomach longer and you feel full for longer.
GLP-1
Glucagon-like peptide 1: gut hormone that releases insulin, slows gastric emptying and signals fullness in the brain. Semaglutide acts through this receptor.
Half-life
Time after which only half of a substance is left in the blood. At about seven days one dose a week keeps the level steady.
HbA1c
Long-term blood sugar: reflects average blood sugar over the past eight to twelve weeks.
Lyophilisate
Freeze-dried powder. Without water a peptide keeps much longer.
Placebo
Dummy preparation without active substance. Comparing against it shows what is due to the substance itself.
Receptor
Protein on the cell surface that a messenger docks onto. Only then does the cell respond.
Subcutaneous
Into the fat layer just under the skin.
Trial phases
Phase 1 tests tolerability in a few people, phase 2 looks for the dose, phase 3 confirms benefit and safety in thousands. After that, approval can be requested.

Evidence

Sources

Show all 17 sourcesHide sources 14 Studies2 Trial registry1 Database checked 25 Oct 2026

Studies

  1. Phase 2 dose-finding trial in overweight and obesity

    Lau et al., The Lancet, 2021

    DOI 10.1016/S0140-6736(21)01751-7 PMID 34798060 NCT03856047
    Checked 25 Oct 2026 via doi.org, Crossref, PubMed
  2. Phase 2 trial in type 2 diabetes, alone and with semaglutide

    Frias et al., The Lancet, 2023

    DOI 10.1016/S0140-6736(23)01163-7 PMID 37364590 NCT04982575
    Checked 25 Oct 2026 via doi.org, Crossref, PubMed
  3. Phase 3 trial REDEFINE 1 on the combination in overweight

    Garvey et al., New England Journal of Medicine, 2025

    DOI 10.1056/NEJMoa2502081 PMID 40544433 NCT05567796
    Checked 25 Oct 2026 via doi.org, Crossref, PubMed
  4. Phase 3 trial REDEFINE 2 on the combination with type 2 diabetes

    Davies et al., New England Journal of Medicine, 2025

    DOI 10.1056/NEJMoa2502082 PMID 40544432 NCT05394519
    Checked 25 Oct 2026 via doi.org, Crossref, PubMed
  5. Phase 3 trial REDEFINE 5 in East Asia

    Yamauchi et al., The Lancet Diabetes & Endocrinology, 2026

    DOI 10.1016/S2213-8587(25)00402-4 PMID 42009015 NCT05813925
    Checked 25 Oct 2026 via doi.org, Crossref, PubMed
  6. Phase 3 trial REIMAGINE 2 in type 2 diabetes

    Buse et al., The Lancet Diabetes & Endocrinology, 2026

    DOI 10.1016/S2213-8587(26)00125-7 PMID 42251859 NCT06065540
    Checked 25 Oct 2026 via doi.org, Crossref, PubMed
  7. Phase 1b trial with half-life, together with semaglutide

    Enebo et al., The Lancet, 2021

    DOI 10.1016/S0140-6736(21)00845-X PMID 33894838 NCT03600480
    Checked 25 Oct 2026 via doi.org, Crossref, PubMed
  8. Trials in impaired kidney and liver function

    Nielsen et al., Clinical Pharmacokinetics, 2026

    DOI 10.1007/s40262-026-01654-0 PMID 42228334
    Checked 25 Oct 2026 via doi.org, Crossref, PubMed
  9. Study on the QT interval on the ECG

    Gabe et al., Diabetes, Obesity and Metabolism, 2024

    DOI 10.1111/dom.15951 PMID 39279639 NCT05804162
    Checked 25 Oct 2026 via doi.org, Crossref, PubMed
  10. Development of the long-acting amylin analogue

    Kruse et al., Journal of Medicinal Chemistry, 2021

    DOI 10.1021/acs.jmedchem.1c00565 PMID 34288673
    Checked 25 Oct 2026 via doi.org, Crossref, PubMed
  11. Pharmacology at amylin and calcitonin receptors

    Fletcher et al., Journal of Pharmacology and Experimental Therapeutics, 2021

    DOI 10.1124/jpet.121.000567 PMID 33727283
    Checked 25 Oct 2026 via doi.org, Crossref, PubMed
  12. Structures of binding to amylin and calcitonin receptors

    Cao et al., Nature Communications, 2025

    DOI 10.1038/s41467-025-58680-y PMID 40204768
    Checked 25 Oct 2026 via doi.org, Crossref, PubMed
  13. Site of action in the brainstem (rat, mouse, macaque)

    Ludwig et al., Nature Metabolism, 2026

    DOI 10.1038/s42255-026-01539-3 PMID 42260119
    Checked 25 Oct 2026 via doi.org, Crossref, PubMed
  14. Review of amylin and amylin analogues

    Alhazmi und le Roux, Diabetes, Obesity and Metabolism, 2026

    DOI 10.1111/dom.71074 PMID 42452898
    Checked 25 Oct 2026 via doi.org, Crossref, PubMed

Trial registry

  1. Results of the phase 2 trial on the trial registry

    ClinicalTrials.gov, NCT03856047, Ergebnisse vom 18.07.2023

    NCT03856047
    Checked 25 Oct 2026 via ClinicalTrials.gov API v2
  2. All trials on ClinicalTrials.gov

    ClinicalTrials.gov, U.S. National Library of Medicine

    Checked 25 Oct 2026 via ClinicalTrials.gov API v2

Database

  1. Development phase and targets in ChEMBL

    ChEMBL, EMBL-EBI (CHEMBL4802169)

    Checked 25 Oct 2026 via ChEMBL

In the shop

Cagrilintide in the catalog

Sizes, prices and shipping times are on the product page.

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