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Comparison

Semaglutide vs Cagrilintide

Semaglutide vs Cagrilintide: different appetite pathways and why CagriSema (the combo) is being studied.

№ 009
Semaglutide
Fat LossEvidence: Strong

Semaglutide is the first wave of modern weight-loss drugs — sold as Ozempic and Wegovy. Single-receptor version of Tirzepatide. Slightly less effective and slightly rougher side effects, but well-studied and widely available.

Onset
80
Documentation
95
Side intensity
82
Popularity
92
№ 022
Cagrilintide
Fat LossEvidence: Moderate

Cagrilintide is an amylin agonist — a different appetite-control pathway than the GLP-1 drugs. Often paired with Semaglutide as 'CagriSema' for weight loss that breaks past GLP-1 plateaus. Once-weekly injection.

Onset
80
Documentation
95
Side intensity
82
Popularity
65
Side-by-side
Field
Left
Right
Category
Fat Loss
Fat Loss
Half-life
~7 days
~7 days
Route
Subcutaneous
Subcutaneous
Schedule
Once weekly
Once weekly
Cycle length
Open-ended, titrate over months
Open-ended
Dose
Start 0.25mg weekly. Titrate every 4 weeks. Common max 2.4mg.
Start 0.3 mg sub-q weekly. Titrate to 2.4 mg over 4-week steps. Common max 2.4 mg.
FDA
Approved as Ozempic (2017, type 2 diabetes), Rybelsus (2019, oral), and Wegovy (2021, obesity).
Investigational. Phase 3 trials by Novo Nordisk, often paired with semaglutide as 'CagriSema'.
WADA
Not listed
Not listed
Natty?
Not natty
Not natty
Prescribed
Yes — extremely widely prescribed. Insurance coverage variable for weight-loss indication.
Not yet approved. Trial access only.
Top side effects
Nausea (often more than tirzepatide); Constipation; Fatigue
Mild nausea; Reduced appetite; Constipation

Which one should you pick?

Pick Semaglutide if beginners to glp-class peptides or users with insurance coverage on wegovy / ozempic.

Pick Cagrilintide if users plateaued on semaglutide or tirzepatide or people wanting cleaner satiety without bigger glp-1 nausea.

Full entry
№ 009 Semaglutide →
Full entry
№ 022 Cagrilintide →