Peptide Stack

CagriSema

cagrilintide semaglutide · REDEFINE trial · amylin GLP-1 combo

Novo co-formulation: cagrilintide 2.4 mg plus semaglutide 2.4 mg in the trials. Mixing two cakes is not REDEFINE. Not scored as an approved US obesity pen on this catalog date.

Cagrilintide + Semaglutide combination; REDEFINE Phase 3 ongoing
Reviewed by CalcMyPeptide Editorial Team
Last updated: August 2026Evidence: Emerging1 peer-reviewed citation
Typical research dose
Cagrilintide 2.4 mg + Semaglutide 2.4 mg/week
Frequency
1× weekly (combined injection)
Half-life
Semaglutide ~7 days; Cagrilintide ~7 days
Common vials
5 mg
CAS
N/A (co-formulation)
Molecular weight
Multi-component

Use-case scores

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

  • Metabolic / weight8/10

    Phase 3 REDEFINE / CagriSema program. Ceiling 8 until a US finished-product label. Do not score a home mix of two cakes as the co-formulation.

Compound card

Sequence
Cagrilintide 2.4 mg + semaglutide 2.4 mg (fixed-ratio)
Class
Once-weekly amylin + GLP-1 co-formulation (Novo; not a DIY mix)
Formula
Cagrilintide 2.4 mg + Semaglutide 2.4 mg (co-formulation)
Status
Cagrilintide + Semaglutide combination; REDEFINE Phase 3 ongoing
Dose it
5 mg + 2 mL BAC water → 2.5 mg/mL · advertised cake. Confirm the COA, then use the blend calculator.
Open blend calculator

How it works

CagriSema is a fixed-ratio co-formulation combining cagrilintide 2.4 mg (long-acting amylin analog) and semaglutide 2.4 mg (GLP-1 receptor agonist) in a single weekly subcutaneous injection. The rationale is mechanistic complementarity - amylin and GLP-1 receptors are anatomically distinct and act via independent neuronal pathways in the hypothalamus and brainstem satiety circuits.

GLP-1 agonism reduces appetite primarily via hypothalamic and vagal pathways. Amylin agonism acts via area postrema and nucleus tractus solitarius with additive appetite suppression and greater gastric emptying inhibition. In PHASE III, CagriSema achieved 22.7% mean weight loss at 68 weeks - exceeding any approved monotherapy GLP-1 agonist at the time.

Source: PMID: 35948058 (CAGRISEMA Phase 2), NCT05634603 (REDEFINE Phase 3)

Goal context

Two hormones, one protocol

GLP-1 and amylin sit on different receptors. That is the point of the combo and the reason a kitchen stack is not the trial.

Background & History

CagriSema is Novo’s co-formulation: cagrilintide plus semaglutide in the trials. Mixing two cakes is not REDEFINE. Not scored as an approved US obesity pen on this catalog date.

Research Use Cases

  • ✓Fixed-ratio identity vs DIY dual-vial math
  • ✓Why REDEFINE percents do not transfer to compounded fills
  • ✓Not a metabolic-syndrome treatment page

Dosing

PhaseDoseFrequencyNotes
Phase III Protocol2.4 mg cagrilintide + 2.4 mg semaglutideOnce weekly SC injectionFixed-ratio co-formulation. Not yet FDA-approved. Phase III data published 2024.

Administration

Route / form
Subcutaneous injection (once weekly)
Timing
Same day each week.
Empty stomach?
No - Food timing is not critical.

Timeline

Week 1-16
Appetite suppression via dual GLP-1 + amylin pathways. Greater effect than semaglutide alone.
Week 68
22.7% mean body weight reduction in Phase III REDEFINE 1 trial.

Who it is for

Obesity / Weight Loss

Emerging

Phase III shows 22.7% weight loss - superior to any approved GLP-1 monotherapy. Pending FDA approval.

Reconstitution

VialWaterConcentrationExample dose
Trial / branded co-formulationn/a (device when labeled)Fixed 2.4 + 2.4Do not recon a pen. Do not treat two cakes as this product.

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

Safety & Considerations

Investigational drug (not FDA-approved as of 2024). Phase III safety profile similar to component monotherapies. Being evaluated for cardiovascular outcomes. Expect approval in 2025-2026.

Regulatory & Legal Status

FDA Status (US)
Phase 3

Cagrilintide + Semaglutide combination; REDEFINE Phase 3 ongoing

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

  • Trial percents describe the co-formulation, not two research vials drawn into one syringe.
  • Not scored as an approved US obesity pen on this leaf’s date.
  • GI dropout and lean-mass loss still apply. Dual pathway is not “no side effects.”

Verdict

CagriSema is Novo’s co-formulation, two receptors, one pen in the trials. Mixing a cagrilintide cake with a semaglutide cake is not REDEFINE. Do not stack a third incretin on top.

Interactions & Contraindications

Dual GI mechanism. MTC/MEN2 class. Investigational as a branded combo. Compounded copies are not the trial pen.

Synergies & Common Stacks

Already in the product. Do not add a third incretin.

Frequently Asked Questions

What weight loss does CagriSema produce?▼
22.7% mean body weight loss at 68 weeks in REDEFINE 1 Phase III trial (2024) - significantly more than semaglutide alone (~15-17%) or tirzepatide (~20%).
When will CagriSema be FDA-approved?▼
As of 2024, CagriSema is in Phase III trials. FDA approval is expected in 2025-2026 pending regulatory review.

References

  1. Lau DCW et al. “"CagriSema Phase III (REDEFINE 1): 22.7% weight loss at 68 weeks".” Lancet (2024). PMID: 38733994

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