CagriSema
Investigational fixed-dose combination of cagrilintide (a long-acting amylin analog) and semaglutide (a GLP-1 receptor agonist), studied once weekly for weight management.
This is a combination sold as one vial. It has not been studied as a single substance, so what is known is what is known about each part, linked above. Sources that report a dose for the blend report it for that mixture, not for any component on its own.
We have not published an audit on CagriSema. Everything below is reference material, not our own reading of the literature, treat it as a starting point for questions, not as a grade.
How it is thought to work
Combines amylin-receptor agonism (cagrilintide) with GLP-1 receptor agonism (semaglutide); studied for appetite regulation and weight management.
CagriSema combines cagrilintide (which mimics the amylin hormone to reduce appetite and slow gastric emptying) and semaglutide (a GLP-1 receptor agonist that also reduces appetite and slows gastric emptying), targeting two different receptor pathways to produce greater weight loss than either compound alone.
Reported side effects
The most common side effects are gastrointestinal, especially nausea, constipation, and vomiting, which were mild-to-moderate in most cases and peaked during the dose escalation phase.
What gets monitored
HbA1c (noted as an outcome in REDEFINE 2: 73.5% reached HbA1c ≤6.5%); at-home blood test referenced via SiPhox Health. [Source: peptidedosingprotocols.com]
What sources report
These are figures published elsewhere, reproduced with their source. Peppersite does not recommend an amount for CagriSema or for anything else, and nothing below has been checked against the study it came from.
| Amount | Frequency | Route | Reported by |
|---|---|---|---|
| cagrilintide 2.4 mg + semaglutide 2.4 mg | Once weeklyREDEFINE trials ran 68 weeks; research cycles are commonly 12-24 weeks; short investigative cycles 8-12 weeks. | Subcutaneous | peptidedosingprotocols.comWhat it saysHide(secondary reference; provider confirmation required). [Source: peptidedosingprotocols.com] |
- Once weeklyREDEFINE trials ran 68 weeks; research cycles are commonly 12-24 weeks; short investigative cycles 8-12 weeks.
- Subcutaneous
- peptidedosingprotocols.com
What it saysHide
(secondary reference; provider confirmation required). [Source: peptidedosingprotocols.com]
- 1. Wash your hands and lay out a clean work surface. 2. Wipe the rubber stopper of each vial with an alcohol swab and let it dry. 3. Draw the planned BAC water volume into a fresh syringe. 4. Inject the BAC water down the inside wall of the peptide vial, do not spray directly onto the lyophilized powder. 5. Swirl gently until the powder is fully dissolved. Do not shake. 6. Label the vial with the date of reconstitution and the concentration. 7. Refrigerate at 36-46°F (2-8°C) and use within the supplier-specified stability window. For pre-blended vials: BAC water volume is dictated by the vial concentration printed on the COA, there is no universal default for a fixed-dose combination, so verify the supplier's spec before reconstituting. Illustrative examples: 20 mg vial + 2.0 mL BAC water = 10 mg/mL (0.48 mL = 48 units U-100 per weekly maintenance draw); 20 mg vial + 2.5 mL BAC water = 8 mg/mL (0.60 mL = 60 units U-100); 20 mg vial + 3.0 mL BAC water = 6.67 mg/mL (0.72 mL = 72 units U-100). For separate vials: reconstitute each compound independently; e.g. 5 mg vial + 2.0 mL BAC water = 2.5 mg/mL (0.96 mL = 96 units U-100 per 2.4 mg draw); 10 mg vial + 3.0 mL BAC water = 3.33 mg/mL (0.72 mL = 72 units U-100 per 2.4 mg draw).
Common questions
Is CagriSema FDA-approved?
No. As of June 2026, CagriSema is not FDA-approved. Novo Nordisk submitted a New Drug Application to the FDA on December 18, 2025, with FDA review expected during 2026. Until any approval is granted, CagriSema remains investigational and is not available as a prescription medication.
What is the CagriSema dose used in clinical trials?
The REDEFINE 1 and REDEFINE 2 Phase 3 trials used a once-weekly subcutaneous dose of cagrilintide 2.4 mg combined with semaglutide 2.4 mg, reached after roughly 16 weeks of dose titration. The titration started at 0.25 mg of each compound and stepped up every 4 weeks.
How much weight loss did CagriSema produce in REDEFINE 1?
In REDEFINE 1, adults with obesity or overweight (without diabetes) treated with CagriSema had a mean body weight reduction of 20.4% at 68 weeks under the treatment-policy estimand, compared with 3.0% on placebo. Under the trial-product estimand, the reduction was 22.7%.
What is the difference between the treatment-policy and trial-product estimands?
The treatment-policy estimand estimates the effect regardless of whether participants stayed on treatment or used rescue therapies. The trial-product estimand estimates the effect if participants stayed on treatment as intended. CagriSema's REDEFINE 1 result reads as 20.4% under treatment-policy or 22.7% under trial-product — they answer different questions.
How does CagriSema compare to tirzepatide?
Both produce large average weight loss in obesity. In a head-to-head open-label trial reported in February 2026, average weight loss at 84 weeks favored tirzepatide, and the sponsor noted CagriSema did not meet its prespecified non-inferiority target against tirzepatide. As of June 2026, tirzepatide is FDA-approved and CagriSema is not.
What are the most common CagriSema side effects?
Gastrointestinal events were the most common in both REDEFINE 1 and REDEFINE 2. In REDEFINE 1, GI events were reported in 79.6% of CagriSema participants versus 39.9% on placebo, including nausea (55%), constipation (30.7%), and vomiting (26.1%). Symptoms typically peaked during dose escalation and tapered during maintenance. Discontinuation due to adverse events was 5.9% in REDEFINE 1 and 8.4% in REDEFINE 2.
How long is a typical CagriSema research cycle?
REDEFINE 1 and REDEFINE 2 ran 68 weeks, with the first ~16 weeks dedicated to dose titration. Many research planning windows are shorter — 12 to 24 weeks is common for tolerability and titration assessment, with longer cycles for efficacy endpoints. Shorter cycles will see proportionally smaller weight-change endpoints than the full trial-length numbers.
Does CagriSema improve blood sugar in addition to weight?
Yes, in adults with type 2 diabetes. In REDEFINE 2, 73.5% of CagriSema participants reached HbA1c ≤6.5% versus 15.9% on placebo (treatment-policy estimand). Sponsor-reported REIMAGINE 2 data described an HbA1c reduction of 1.91 percentage points alongside 14.2% weight loss.
Sources
The reference sections above are imported from our compound knowledge base, which classes the evidence for CagriSema as human data available. That classification is the knowledge base’s, not ours, our own grade appears only where an audit is linked above. Research use only; nothing here is medical advice or a protocol.
Blend of cagrilintide (amylin analog) and retatrutide (triple GLP-1/GIP/glucagon agonist), studied for weight management.
Blend of cagrilintide (amylin analog) and tirzepatide (GIP/GLP-1 dual agonist), studied for weight management.
Investigational GLP-1 and glucagon receptor dual agonist studied for weight management and metabolic health.
Investigational triple GLP-1 / GIP / glucagon receptor agonist studied for weight management.
Semaglutide is one of the most widely studied weight-loss and diabetes drugs in the world.
Dual GIP and GLP-1 receptor agonist studied for weight management and glycemic control.