Cagrilintide
Also called AM833
An investigational long-acting amylin analogue for weight management. It is not a GLP-1 drug and is not the same as CagriSema, which combines it with semaglutide.
Overview
What it is
A modified, more stable version of amylin, a pancreatic hormone that promotes fullness. It acts on amylin and calcitonin receptors.
How it works
It extends amylin's fullness signal to reduce appetite and food intake, a different pathway from GLP-1.
What the research shows
A 26-week phase 2 trial in 706 adults without diabetes found 6.0% to 10.8% average weight loss across doses versus 3.0% with placebo (liraglutide: 9.0%). In REDEFINE 1, cagrilintide alone was compared with semaglutide alone and the combination. The open-label REDEFINE 4 trial found CagriSema did not meet non-inferiority against tirzepatide 15 mg (23.0% vs 25.5% at 84 weeks).
Studied for
- Weight management alonephase 2
- Weight management with semaglutidephase 3, as CagriSema
Safety and regulatory status
Safety and side effects
In phase 2, digestive side effects affected 41% to 63% on cagrilintide versus 32% on placebo; nausea was most common, plus constipation, diarrhea and injection-site reactions. Persistent vomiting or inability to keep fluids down needs medical attention.
Regulatory status
Not FDA approved; FDA states it cannot be used in compounding. A CagriSema application was submitted in December 2025 with a decision expected late 2026.
Mixing and dosing reference
Reference information only. Read before using this section.
Cagrilintide (10 mg Vial) Dosage Protocol
- Vial
- 10 mg Cagrilintide
- Add diluent
- 3 mL
- Concentration
- 3.33 mg/mL
- 1 unit (U-100)
- 33.33 mcg in 0.01 mL
- Route
- Subcutaneous
Phase 2 4.5 mg Target Arm
| Week/Phase | Peptide Amount | U-100 Units | Volume | Frequency |
|---|---|---|---|---|
| Weeks 1–2 | 0.6 mg | 18 units | 0.18 mL | Once weekly |
| Weeks 3–4 | 1.2 mg | 36 units | 0.36 mL | Once weekly |
| Weeks 5–6 | 2.4 mg | 72 units | 0.72 mL | Once weekly |
| Week 7 onward in the 26-week trial | 4.5 mg | 135 units | 1.35 mL | Once weekly |
How to mix
- Clean the vial stopper with an alcohol swab and gather sterile supplies.
- Add 3 mL bacteriostatic water slowly down the inside wall of the vial.
- Gently swirl or roll until fully dissolved. Do not shake.
- Label the vial 3.33 mg/mL with the preparation date and keep it refrigerated.
Dosing details
- Cagrilintide is an amylin analogue and an investigational research peptide developed by Novo Nordisk. Unlike GLP-1 receptor agonists like semaglutide, cagrilintide mimics amylin signaling. In research models, cagrilintide slows gastric emptying, supports satiation pathways, and alters post-meal glucagon signaling.
- The cagrilintide dosing protocol above retains the published once-weekly dosing and two-week titration schedule. This dosing schedule distinguishes vial concentration from target dose and is not an approved or recommended dosage. The phase 2 program also studied a 2.4 mg dose; references to 2.4 mg weekly and 4.5 mg per week describe research target groups rather than strength-specific instructions.
- The effects of cagrilintide were also evaluated in combination with semaglutide. REDEFINE research compared the fixed combination with semaglutide alone and cagrilintide alone, while a separate trial enrolled adults with type 2 diabetes and assessed weight loss and glycemic outcomes. Combination dosing, including cagrilintide 2.4 mg with semaglutide 2.4 mg, belongs to that separate evidence context and does not change the single-agent calculation on this page.
- This strength-specific dosing guide keeps cagrilintide reconstitution math, syringe markings, and vial yield explicit. A cagrilintide dosage calculator can only return correct volume markings when the vial mass and final liquid volume are entered together.
Administration technique
- Clean the vial stopper and skin with alcohol; allow to air dry completely.
- Pinch a skinfold; insert the needle at 45–90° into subcutaneous tissue.
- Do not aspirate for subcutaneous injections; inject slowly and steadily.
- Hold for 5–10 seconds before withdrawing the needle to ensure complete delivery.
- Rotate sites systematically (abdomen, thighs, upper arms) each week to avoid lipohypertrophy.
Important notes
- Use new sterile syringes for each injection; dispose in a sharps container.
- Rotate injection sites (abdomen, thighs, upper arms) weekly to reduce local irritation.
- Gradual dose escalation minimizes gastrointestinal side effects such as nausea.
- Document weekly dose, injection site, and any adverse effects to maintain consistency.
- For maintenance doses requiring >1.0 mL, ensure you have appropriately sized syringes (3 mL).
Protocol source: PeptideDosages.com
Common questions
Is cagrilintide the same as CagriSema?
No. CagriSema adds semaglutide.
Is it better than tirzepatide?
CagriSema did not match tirzepatide 15 mg in REDEFINE 4; it beat tirzepatide 5 mg in a different trial.
Is it a GLP-1?
No. It acts on amylin receptors.
Found in these blends
Related in Metabolic Health
Sources and further reading (6)
- Kruse T, et al. Development of cagrilintide, a long-acting amylin analogue. J Med Chem, 2021.
- Lau DCW, et al. Once-weekly cagrilintide for weight management: phase 2. Lancet, 2021.
- Garvey WT, et al. Coadministered cagrilintide and semaglutide (REDEFINE 1). NEJM, 2025.
- Novo Nordisk. REDEFINE 4 topline results, Feb 2026.
- FDA. Concerns with unapproved drugs used for weight loss.
- Source summary: PeptideDosages.com research overview (rewritten for NVO).