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โ„– 023

Cagrilintide

An appetite-control shot for weight loss. A long-acting amylin agonist that works on a different pathway than the GLP-1 drugs, often paired with Semaglutide as 'CagriSema' to break GLP-1 plateaus.

Fat Loss
Evidence: Moderate

Cagrilintide: An appetite-control shot for weight loss. A long-acting amylin agonist that works on a different pathway than the GLP-1 drugs, often paired with Semaglutide as 'CagriSema' to break GLP-1 plateaus. Cagrilintide is an amylin agonist, a different appetite-control pathway than the GLP-1 drugs.

FDA โ“˜
Not approved
WADA
Not banned
Typical dose
Start 0.3 mg sub-q weekly
Half-life โ“˜
~7 days
Route โ“˜
Subcutaneous
Schedule
Once weekly
In plain English

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.

Status & legalityWhat do these mean? โ†’
Natty? โ“˜
Not natty
FDA โ“˜
Not approved

Investigational. Phase 3 trials by Novo Nordisk, often paired with semaglutide as 'CagriSema'.

Compounding โ“˜
Investigational

In clinical trials, not yet approved for prescription.

WADA โ“˜
Not listed
Prescribed โ“˜

Not yet approved. Trial access only.

Who it's for

  • โ†’Users plateaued on Semaglutide or Tirzepatide
  • โ†’People wanting cleaner satiety without bigger GLP-1 nausea
  • โ†’Combination-therapy stacks under provider guidance

What to expect

  1. Week 1

    Mild appetite drop. Less nausea than the GLP-1 drugs.

  2. Week 4

    First titration step. Modest weight loss alone, stronger when stacked with semaglutide.

  3. Week 8

    Steady-state. Best results in 'CagriSema' combination with semaglutide.

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  2. 2See what to stack & monitor

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How it works (mechanism)

Long-acting amylin agonist. Binds amylin receptors (also calcitonin receptor crosstalk) to slow gastric emptying and increase satiety through a different pathway than GLP-1. Pairs naturally with Semaglutide as 'CagriSema.'

Dosing protocol

Members only

Stacks well with

Members only

Side effects

01Mild nausea
02Reduced appetite
03Constipation
04Fatigue

When NOT to use

  • โš History of medullary thyroid carcinoma or MEN-2
  • โš Pancreatitis history
  • โš Pregnancy / nursing

Bloodwork to monitor

  • โ€ข A1C if metabolic context
  • โ€ข Lipid panel

Common mistakes

  • โ€ข Expecting standalone results to match Tirzepatide (it won't)
  • โ€ข Titrating too fast
  • โ€ข Skipping protein during the cut

What it actually is

Cagrilintide is a long-acting analog of amylin, a hormone your pancreas releases alongside insulin whenever you eat. Strictly it is a dual amylin and calcitonin receptor agonist โ€” amylin and calcitonin receptors overlap, and the calcitonin arm is part of why the class behaves as it does. It is investigational โ€” not approved on its own โ€” and its main significance is as half of CagriSema, the combination with semaglutide that has been through phase 3. It works on a genuinely different appetite pathway from the GLP-1 drugs, which is why combining them adds effect rather than duplicating it.

Amylin slows gastric emptying, suppresses glucagon after meals, and signals satiety through the brainstem โ€” a different route from GLP-1's. Native amylin has a half-life of minutes and clumps together, which is why it took engineering to make a usable version. Cagrilintide is modified to resist that and to bind albumin, giving it a weekly half-life. Because the amylin and GLP-1 satiety pathways converge on different receptors, hitting both produces more appetite suppression than maximising either alone.

Forms, and which is which

CagriSema (with semaglutide)The form with phase 3 evidence

The fixed combination that the large 2025 NEJM trials tested. This is what the evidence is actually about.

Verdict: The version the data supports, and not yet approved.

Cagrilintide aloneUnderstanding the mechanism

Tested alone in a 2021 Lancet phase 2 trial with meaningful but clearly smaller weight loss than the combination or than tirzepatide.

Verdict: Real data, modest effect on its own.

Research-chemical powderHow non-trial use happens

Buyer reconstitutes. No approved product exists, so nothing can be verified.

Verdict: The only route outside a trial, entirely unverified.

Self-mixed 'CagriSema'Nothing defensible

Combining two research-chemical vials in one syringe is not the trialled fixed-dose combination, and compatibility in solution is not something a buyer can assess.

Verdict: Imitates a trial product without any of what made it one.

What it is claimed to do, graded

Weight loss when combined with semaglutideStrong

Two large randomised trials published in NEJM in 2025, in people with obesity and in people with obesity and type 2 diabetes. This is phase 3 evidence.

Weight loss on its ownModerate

The 2021 Lancet phase 2 trial showed real weight reduction as monotherapy โ€” around 6% to 10.8% across doses, against 3% on placebo โ€” clearly smaller than the combination.

Blood sugar control in type 2 diabetesModerate

Supported within the combination trials rather than established for cagrilintide alone.

Better tolerated than GLP-1 drugsNone shown

Gastrointestinal side effects in the trials were common and broadly similar in character to the class.

Breaks a GLP-1 plateauLimited

Mechanistically reasonable given the separate pathway, and the trials tested the combination from the start rather than as a rescue for people who had plateaued.

Grades describe how much human evidence exists for that specific claim, not whether it will work for you or whether it is safe.

Pros and cons

Pros
  • โ€ข A genuinely different mechanism from the GLP-1 drugs, so the combination is additive rather than redundant
  • โ€ข Phase 3 evidence exists for the combination, which is rare for anything not yet approved
  • โ€ข Weekly dosing
  • โ€ข Amylin biology is well understood โ€” this is not a compound in search of a mechanism
Cons
  • โ€ข Not approved anywhere, on its own or in combination
  • โ€ข Clearly weaker than tirzepatide or semaglutide as a standalone
  • โ€ข The evidence is about a fixed combination that cannot be reproduced by mixing two grey-market vials
  • โ€ข Gastrointestinal side effects are common
  • โ€ข All non-trial supply is unverified

When to stop

  • โ€ข Severe persistent abdominal pain radiating to the back
  • โ€ข Vomiting that prevents keeping fluids down โ€” dehydration on this class has caused acute kidney injury
  • โ€ข Right upper abdominal pain with fever or jaundice โ€” gallbladder disease rises with rapid weight loss
  • โ€ข A new neck lump, hoarseness or difficulty swallowing
  • โ€ข Any serious allergic reaction
  • โ€ข New or worsening vision changes
  • โ€ข Hypoglycaemic episodes if you take glucose-lowering medication
  • โ€ข Pregnancy, or planning one

Interactions

Semaglutide, as the CagriSema fixed combinationCompatible

The specific combination the phase 3 evidence covers. It does not generalise to pairing cagrilintide with any other GLP-1 agonist, which has not been tested.

Insulin or sulfonylureasCaution

Additive glucose lowering with hypoglycaemia risk. A prescriber should be adjusting the other drug.

Oral medications generallyMonitor

Delayed gastric emptying can change absorption rate. There is no established universal spacing interval for cagrilintide, so this is monitoring rather than a timing rule.

PramlintideAvoid

The approved amylin analog. Same mechanism, so combining them is duplication with added risk.

Resistance training and adequate proteinCompatible

The countermeasure to lean mass loss during rapid weight reduction.

Is this for you?

Probably worth reading further if
  • โ€ข People who have read the CagriSema data and understand it is not an approved product
  • โ€ข Anyone weighing the amylin pathway against the approved options with a clinician
Skip it if
  • โ€ข You want an approved medicine
  • โ€ข Personal or family history of medullary thyroid carcinoma or MEN-2, or prior pancreatitis โ€” these come from the semaglutide half of the combination the evidence is about, not from cagrilintide alone
  • โ€ข You are pregnant or trying to conceive
  • โ€ข You are planning to mix your own version of a fixed-dose combination

The one number

Two phase 3 NEJM trials of the semaglutide combination in 2025
N Engl J Med, 2025 (PMIDs 40544433 and 40544432)

Sources for the claims above

  • Coadministered cagrilintide and semaglutide in adults with overweight or obesity
    N Engl J Med, 2025
  • Cagrilintide-semaglutide in adults with overweight or obesity and type 2 diabetes
    N Engl J Med, 2025
  • Once-weekly cagrilintide monotherapy for weight management
    Lancet, 2021

Drug & supplement interactions

  • โš Slows gastric emptying, affects oral medication absorption
  • โš Pairs intentionally with Semaglutide; combined nausea profile

Community patterns

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AI Coach, live sample
Member answer
is 250mcg of bpc enough for a knee injury?
For a knee, is the standard working dose and a solid place to start. The trick with BPC is consistency, give it weeks, not days. , run it , and don't drop below , results tend to fall off under that line. If nothing's moved by week 3, that's when earns its place.
how much bac water for a 10mg reta vial?
is the standard play for a 10 mg reta vial. That gives you , clean unit math across the whole titration: on a 100-unit insulin syringe. Run instead if you want fewer, more concentrated shots. Most people titrate up over , and that mix keeps the numbers cleanest.
what should i track on bloodwork for tirzepatide?
Lipid panel, ALT/AST (liver enzymes), and an A1C, baseline before you start then every 3 months. If you've got metabolic-syndrome history, add fasting glucose and insulin so you can actually watch insulin sensitivity improve. You don't need a big hormone panel for a GLP-1.

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Frequently asked

What is Cagrilintide?+
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.
Is Cagrilintide FDA approved?+
Investigational. Phase 3 trials by Novo Nordisk, often paired with semaglutide as 'CagriSema'.
Is Cagrilintide legal?+
Cagrilintide is not FDA-approved, so there is no approved prescription version. Most supply is sold as "research only" by peptide vendors. A compounding pharmacy may only use substances the FDA permits for compounding, and many research peptides are not permitted โ€” do not assume a compounded prescription is available. Possession is generally not criminalized but distribution without authorization may be. Verify local laws.
Is Cagrilintide banned by WADA?+
Cagrilintide is not currently on the WADA prohibited list.
Are you still natty after taking Cagrilintide?+
No. Cagrilintide is a performance-enhancing peptide and would disqualify a strict natty claim.
Do doctors prescribe Cagrilintide?+
Not yet approved. Trial access only.
What's the typical dose of Cagrilintide?+
Dosing depends on your goal, experience, and tolerance. The full Cagrilintide protocol (dose, frequency, and how to titrate) is in the members section on the entry page.
What are the side effects of Cagrilintide?+
Common side effects include: Mild nausea; Reduced appetite; Constipation; Fatigue. Less common effects and full safety details are on the entry page.
How long until Cagrilintide starts working?+
Mild appetite drop. Less nausea than the GLP-1 drugs.
What can you stack with Cagrilintide?+
Cagrilintide is commonly combined with complementary compounds. The full stacking protocol (what to pair, dosing, and timing) is in the members section on the entry page.
Where do people get Cagrilintide?+
Pepdex does not sell, ship, or recommend suppliers. Cagrilintide is not FDA-approved; prescription versions require licensed clinical care, and "research only" markets carry real legal and quality risks. /coa explains how to verify a Certificate of Analysis and /guides/scam-vendor-spotting covers the red flags.
Cagrilintide vs Retatrutide, which is better?+
How Cagrilintide and Retatrutide compare on research category, evidence tier, regulatory status, and reported side effects. Full head-to-head comparison: https://pepdex.co/compare/cagrilintide-vs-retatrutide
Cagrilintide vs Semaglutide, which is better?+
Semaglutide vs Cagrilintide: different appetite pathways and why CagriSema (the combo) is being studied. Full head-to-head comparison: https://pepdex.co/compare/semaglutide-vs-cagrilintide
Cagrilintide vs Tirzepatide, which is better?+
Tirzepatide vs Cagrilintide: GLP-1 + GIP appetite control vs amylin pathway. Two different levers on hunger. Full head-to-head comparison: https://pepdex.co/compare/tirzepatide-vs-cagrilintide

Common questions about Cagrilintide

Head-to-head with Cagrilintide

Compare
Cagrilintide vs Retatrutide โ†’
Compare
Cagrilintide vs Semaglutide โ†’
Compare
Cagrilintide vs Tirzepatide โ†’

Tracked alongside Cagrilintide

Same goal, different aisle โ€” each graded on its own evidence in the Pepdex catalog.

Whey protein โ†’
muscle preservation is the open question on any GLP-1 run
Electrolytes โ†’
appetite suppression cuts fluid and sodium intake with it
Fiber โ†’
the constipation answer that shows up in every GLP-1 thread
Metformin โ†’
the prescription neighbour people compare these protocols against

More in Fat Loss

โ„– 009
Tirzepatide

Strong weight loss with a cleaner side effect profile than semaglutide. A dual agonist (GLP-1 + GIP), FDA-approved as Mounjaro / Zepbound.

โ„– 010
Semaglutide

The original weight-loss wave, sold as Ozempic / Wegovy. A GLP-1 agonist.

โ„– 003
Retatrutide

Triple agonist (GLP-1 + GIP + glucagon) from Eli Lilly. In trials it outperforms Tirzepatide for weight loss.

โ„– 059
Liraglutide (Saxenda / Victoza)

Daily GLP-1 receptor agonist. FDA-approved 2010 (Victoza, T2D) and 2014 (Saxenda, obesity). The first wave of modern GLP-1 weight-loss therapy and direct predecessor to Semaglutide.