Cagrilintide
Weekly amylin analog, under investigation
Experimental material. Read before using anything from here.
Nothing on this page is a medical recommendation, prescription or treatment plan. It is an organized translation of protocols circulating in research communities and, where it exists, of what published trials tested. The two are marked differently — and they are not equivalent.
Most of the compounds here have no FDA approval for human use. Several are sold labeled "research use only", which means they have not gone through purity, sterility or dosage controls for human consumption. A community-reported dose is not a validated dose: it is what someone reported having done.
Talk to a licensed health professional before considering any of these compounds. If you already use one and feel anything unexpected, seek care — do not wait for the next routine test.
No package insert, no approved dose
This compound has no FDA registration — checked in the label database on September 4, 2026. That does not make it safer than semaglutide or tirzepatide, which carry a black box warning: it makes it less known. There is no approved titration ladder, no defined maximum dose and no official contraindication list to compare with the tables on this page.
The related analogs that already have a package insert carry a thyroid C-cell tumor warning — and tirzepatide is contraindicated in medullary thyroid carcinoma and MEN 2 in the package inserts of both countries, while semaglutide is only in the United States. The full audit is in The GLP-1s against the package insert.
Summary
Weekly peptide under investigation, developed by Novo Nordisk. It is a long-acting analog of amylin, the hormone the pancreas releases together with insulin to signal satiety after eating. In plain terms: it prolongs the signal of being full. It appears on its own and in combination with semaglutide (CagriSema), tirzepatide and retatrutide.
Quick reference
- Route
- Subcutaneous injection, 1×/week, on the same day of the week.
- Half-life
- About 159 to 195 h (~7 to 8 days) — hence the weekly dose.
- Vials
- Most suppliers list 5 mg or 10 mg lyophilized.
- Status
- Phase 3 completed as monotherapy and in CagriSema; on its own it is not approved.
Protocol and dosing schedule
| Phase | Weeks | Cagrilintide Dose | Purpose |
|---|---|---|---|
| Initiation | Weeks 1–4 | 0.25 mg/week | GI adaptation; lowest tolerated dose |
| Step 2 | Weeks 5-8 | 0.5 mg/week | Dose escalation |
| Step 3 | Weeks 9-12 | 1.0 mg/week | GI side effects often peak here |
| Step 4 | Weeks 13-16 | 1.7 mg/week | Approaching maintenance |
| Maintenance | Weeks 17+ | 2.4 mg/week | Target dose used in late-stage study protocols |
Cycle Guidelines
| Approach | Duration | Review point | Notes |
|---|---|---|---|
| Short cycle | 16 weeks | Week 16 | Reaches maintenance just as titration completes |
| Standard cycle | 26-32 weeks | Week 26 / 32 | Matches Phase 2 trial durations |
| Long cycle | 68 weeks | Week 68 | Matches REDEFINE 1 and REDEFINE 2 endpoints |
Cagrilintide Reconstitution Guide
| Vial size | BAC water added | Concentration | 0.6 mg Draw | 1.2 mg Draw | 2.4 mg Draw | 4.5 mg Draw |
|---|---|---|---|---|---|---|
| 5 mg | 2.0 mL | 2.5 mg/mL | 0.24 mL / 24 units | 0.48 mL / 48 units | 0.96 mL / 96 units | 1.80 mL / 180 units* |
| 5 mg | 3.0 mL | 1.67 mg/mL | 0.36 mL / 36 units | 0.72 mL / 72 units | 1.44 mL / 144 units* | Exceeds vial |
| 10 mg | 2.0 mL | 5.0 mg/mL | 0.12 mL / 12 units | 0.24 mL / 24 units | 0.48 mL / 48 units | 0.90 mL / 90 units |
| 10 mg | 3.0 mL | 3.33 mg/mL | 0.18 mL / 18 units | 0.36 mL / 36 units | 0.72 mL / 72 units | 1.35 mL / 135 units* |
Cagrilintide Timeline & What to Monitor
| Trial | Duration | Population | Mean Weight Loss |
|---|---|---|---|
| Lancet 2021 Phase 2 | 26 weeks | Overweight/obese, no T2D (n=706) | 10.8% at 4.5 mg vs 3.0% placebo |
| Lancet 2023 Phase 2 | 32 weeks | T2D + obesity (n=92) | 8.1% cagrilintide alone; 15.6% with semaglutide |
| REDEFINE 1 (NEJM 2025) | 68 weeks | Obesity, no T2D (n=3,417) | 11.8% cagrilintide alone; 20.4% CagriSema |
| REDEFINE 2 (NEJM 2025) | 68 weeks | T2D + BMI ≥27 (n=1,206) | 13.7% CagriSema vs 3.4% placebo; HbA1c down 1.91 pp |
Cagrilintide vs Semaglutide vs Tirzepatide vs Retatrutide
| Parameter | Cagrilintide | Semaglutide | Tirzepatide | Retatrutide |
|---|---|---|---|---|
| Receptors | AMY1R/2R/3R + CTR | GLP-1R | GLP-1R + GIPR | GLP-1R + GIPR + Glucagon-R |
| Half-life | ~7-8 days | ~7 days | ~5 days | ~6 days |
| Dosing frequency | 1×/week | 1×/week | 1×/week | 1×/week |
| Max studied dose | 4.5 mg/week (mono) | 2.4 mg/week | 15 mg/week | 12 mg/week |
| Peak monotherapy weight loss | 11.8% at 68 wk | 14.9-17% at 68 wk | 22.5% at 72 wk | ~24% at 48 wk |
| FDA status (June 2026) | Investigational | Approved (2021) | Approved (2023) | Investigational |
| HbA1c reduction (T2D) | ~0.9 pp mono; 1.91 pp CagriSema | 1.5-1.8 pp | 2.0-2.4 pp | 1.6-2.0 pp |
| Notable differentiator | Amylin pathway; additive with GLP-1 | Established CV outcomes | Highest single-agent obesity efficacy | Triple-agonist mechanism |
Storage and handling
The rules below apply to practically every lyophilized peptide in this reference. Where a compound has its own requirement, it appears in the table in the previous section.
- Lyophilized powder, sealed: refrigerator, between 2 and 8 °C, protected from light. Many tolerate room temperature for short transport periods, but that is tolerance, not a recommendation.
- After reconstitution: always refrigerated, between 2 and 8 °C. The stability window drops to days or a few weeks, depending on the compound.
- Never freeze after reconstituting. The freeze–thaw cycle degrades the peptide.
- Do not shake. Swirl the vial slowly. Shaking breaks the peptide chain.
- Bacteriostatic water down the wall of the vial, in a slow stream, not squirted directly onto the powder.
- Cloudy solution, with particles or a color change: discard. There is no recovery.
Lab tests and monitoring
This list is the one that appears recurrently in the source, with small variations by compound. It serves as a starting point for a conversation with a professional — not as a substitute for that conversation.
- Before starting: complete blood count, comprehensive metabolic panel, lipid panel, fasting glucose and HbA1c, TSH and free T4, blood pressure and resting heart rate.
- Depending on the compound: IGF-1 (GH axis), lipase and amylase (VIP and the incretin agonists), serum copper and ceruloplasmin (GHK-Cu and blends containing it), CRP.
- Reassessment: most protocols review between week 4 and week 8, and then every 8–12 weeks.
- Do not wait for the routine lab test in the face of abdominal pain, visual changes, a change in a mole, shortness of breath, asymmetric swelling or any new and persistent symptom. That is a reason to seek care, not a spreadsheet item.
Evidence limits
Data source: peptidedosingprotocols.com, accessed on September 3, 2026. Translation and organization in Portuguese are original work. No primary source (PubMed, trial registry, package insert) was checked in building this page — the check was against the secondary source, and that alone.