Weight Management

Cagrilintide

AM833 · long-acting amylin analog

Long-acting amylin analog, not a GLP-1. Phase 2/3 as CagriSema partner. A research cake is not Novo trial material. Do not stack with pramlintide.

In Phase 3 REDEFINE trials as part of Cagrisema combination (with semaglutide)

Reviewed by CalcMyPeptide Editorial Team

·Last updated: August 2026·Evidence: Emerging·1 peer-reviewed citation

Typical research dose

0.3-4.5 mg/week

Frequency

1× weekly

Half-life

~7 days (SC)

Common vials

3 mg / 5 mg

CAS

2309537-68-8

Molecular weight

~4.5 kDa

Use-case scores

0–10 against the evidence we have, not a gym ranking. Hidden domains do not apply here.

Metabolic / weight7.5/10
Phase 2 monotherapy plus Phase 3 as CagriSema. Ceiling 8 for Phase 2–3. Not 8.5 until there is a US monotherapy label. Amylin is a different receptor than GLP-1.

Compound card

Sequence: Long-acting amylin analog (C20 fatty acid)
Class: Once-weekly amylin receptor agonist (not a GLP-1; CagriSema partner)
Formula: Modified amylin analog (37 AA + C20 fatty acid)
Status: In Phase 3 REDEFINE trials as part of Cagrisema combination (with semaglutide)

Dose it

5 mg + 2 mL BAC water → 2.5 mg/mL · 300 mcg ≈ 12 units (U-100)

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How it works

Cagrilintide is a fatty acid-modified long-acting analog of human amylin (islet amyloid polypeptide, IAPP) - a 37-amino-acid peptide co-secreted with insulin from pancreatic beta cells. Two amino acid substitutions plus a C20 fatty acid chain extend its half-life to ~7 days, enabling once-weekly dosing.

Amylin acts centrally (area postrema, NTS) to reduce glucagon secretion, slow gastric emptying, and suppress appetite via different receptors than GLP-1. This mechanistic complementarity is the rationale for combining cagrilintide with semaglutide (GLP-1 RA) in the CagriSema combination. In SCALE NEXT (cagrilintide 4.5 mg monotherapy), 12.5% weight loss at 24 weeks was observed. Combined with semaglutide (CagriSema), 22.7% weight loss at 68 weeks was achieved in PHASE III.

Source: PMID: 35948058 (CAGRISEMA Phase 2)

Goal context

Amylin, not another Ozempic

Area postrema and gastric emptying are the job. That is why nausea still exists and why combining it with a GLP-1 is a trial, not a kitchen stack.

Background & History

Cagrilintide is a long-acting amylin analog, not a GLP-1. Phase 2/3 as the CagriSema partner. A research cake is not Novo trial material. Do not stack with pramlintide.

Research Use Cases

✓Amylin-analog identity vs pramlintide vs semaglutide
✓Why CagriSema is a co-formulation, not two cakes
✓Not an obesity monotherapy NDA on this catalog date

Dosing

Phase	Dose	Frequency	Notes
Phase III Protocol	2.4 mg	Once weekly SC (fixed-ratio with semaglutide in CagriSema)	Combined in CagriSema 2.4 mg cagrilintide + 2.4 mg semaglutide. Monotherapy up to 4.5 mg studied.

Administration

Route / form

Subcutaneous injection (once weekly)

Timing

Same day each week.

Empty stomach?

No - Food timing is not critical.

Timeline

Week 1-12

Reduced appetite via amylin pathway. Gastric emptying slowed even more than GLP-1 alone.

Week 24-68

12.5% weight loss (monotherapy) to 22.7% (combined with semaglutide in Phase III).

Who it is for

Obesity / Weight Loss

Emerging

Phase III data shows 22.7% weight loss with CagriSema. Not yet FDA-approved as of 2024.

Reconstitution

Vial	Water	Concentration	Example dose
5 mg research/compounded cake	2.0 mL BAC	2.5 mg/mL	0.3 mg = 0.12 mL = 12 units on a U-100. This is not CagriSema.

Change vial size or water volume? Open the reconstitution calculator.

Safety & Considerations

Investigational drug (not FDA-approved as of 2024). Phase III safety profile similar to amylin analogs - nausea, injection site reactions. Being evaluated in large clinical trials.

Regulatory & Legal Status

FDA Status (US)

Phase 3

In Phase 3 REDEFINE trials as part of Cagrisema combination (with semaglutide)

WADA Status (2026)

Not Listed

Not currently on the WADA 2026 Prohibited List. Policies may change - verify before competition.

Classification

Investigational

US Compounding: Not eligible / not available

⚠️ This information is for educational purposes only and may not reflect the most current regulatory updates. Always verify with official FDA, WADA, and jurisdiction-specific sources before use.

Limits of current evidence

Not an FDA-approved finished product as monotherapy on this review date.
SCALE NEXT / CagriSema describe branded trial material, not a 5 mg gray-market vial.
Do not stack with pramlintide. Same receptor family, different PK.

Verdict

Cagrilintide is an amylin analog, not a GLP-1. Monotherapy numbers exist. The combo with semaglutide is the program people mean when they say CagriSema. A research cake is not Novo’s trial material.

Interactions & Contraindications

Amylin plus GLP-1 means more GI slowing. Hypoglycemia watching with insulin. Do not add pramlintide.

Synergies & Common Stacks

+ Semaglutide →

The trial product is CagriSema. Mixing two research vials is not REDEFINE.

Frequently Asked Questions

How does cagrilintide differ from GLP-1 agonists like semaglutide?▼

GLP-1 agonists and amylin analogs like cagrilintide act on different receptors in the brain to suppress appetite. Their complementary mechanisms explain why combining them (CagriSema) produces greater weight loss than either alone.

References

Lau DCW et al. “"Cagrilintide + semaglutide 2.4 mg (CagriSema): Phase III weight loss".” Lancet (2024). PMID: 38733994

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