Cagrilintide

A once-weekly version of amylin, the body’s own fullness hormone. It works on a different appetite brake from GLP-1.

Evidence: BHuman trials what's this?
Grade B. Well-run Phase 2 trials alone, plus Phase 3 as part of CagriSema.
Also known as: AM833 · NNC0174-0833
Class: Acylated long-acting amylin analogue. Investigational, Novo Nordisk.

The 30-second version

WhatA fatty-acid-modified amylin that lasts about a week, where the older amylin drug needs three shots a day.

ResultsUp to ~10.8% weight loss at 26 weeks on its own, and ~17% in 20 weeks alongside semaglutide.

The honest catchIt is not approved as a standalone drug. Its future is mostly as half of CagriSema.

What it is

Every time you eat, your pancreas releases amylin alongside insulin. Amylin tells the brain you’ve had enough, slows the stomach and quiets the urge to keep eating. The older amylin drug, pramlintide, works but has to be injected before every meal. Cagrilintide carries a fatty-acid chain that stretches its half-life to roughly 160–180 hours, so one injection covers the whole week.

How it works

Weekly depot. Absorbed slowly from under the skin and active for about seven days.

Brainstem. Reaches the area postrema and nucleus of the solitary tract, the satiety control centre.

Receptors. Activates amylin and calcitonin receptors and switches on the fullness signal.

Effects. Earlier fullness, slower stomach emptying, less glucagon after meals.

Outcome. Lower food intake and gradual weight loss, through a pathway separate from GLP-1.

Because amylin and GLP-1 are different brakes, adding one to the other gives a bigger combined effect rather than doubling up on the same mechanism. That reasoning is behind CagriSema.

What the research shows

Phase 2 dose-finding (Lau, Lancet 2021): 706 adults received weekly doses from 0.3 to 4.5 mg against placebo and liraglutide for 26 weeks. Weight loss rose with dose, reaching about 10.8% at 4.5 mg¹. Phase 1b with semaglutide: about 17% in 20 weeks, and neither drug changed how the body handled the other². Later trials of the combination in diabetes³ and in obesity⁴ pushed results into the 20% range (see CagriSema).

Cagrilintide is not a GLP-1 drug. It acts on a different appetite brake, which is why it adds to semaglutide instead of competing with it.

Evidence at a glance

Use	Grade	Best evidence	Main gap	Read
Weight loss, alone	BHuman trials	~10.8% at 4.5 mg, 26 weeks¹	Not approved	Real effect
With semaglutide	BHuman trials	~17% in 20 weeks; no interaction²	Combination still in review	Additive
Satiety mechanism	BHuman trials	Slower emptying, more fullness	—	Well established

Dosing: what has been reported

Not a recommendation. These figures describe what was studied or what circulates in practice, kept separate so you can see how solid each one is. Speak with a qualified clinician before acting on any of it.

Setting	Figure	Route	Grade
Published trials	0.3, 0.6, 1.2, 2.4 or 4.5 mg weekly, increased gradually¹	Subcutaneous	B
In CagriSema	2.4 mg fixed, with semaglutide 2.4 mg	Subcutaneous	B
Community	Follows the trial steps: 0.3 → 0.6 → 1.2 → 2.4 (→ 4.5) mg, about every 4 weeks	Subcutaneous	D

Nausea is usually milder than with the GLP-1 drugs, and there’s no meaningful heart-rate effect. Hold a step if side effects haven’t settled. When it’s used as part of CagriSema, follow the combined titration instead of running two separate climbs.

Preparing & storing

Reconstitute with bacteriostatic water, swirl gently, refrigerate and protect from light. One mixed vial covers several weekly doses. Inject on the same day each week and rotate sites. Meal timing doesn’t matter.

Reported side effects

Nausea (most common, worst during increases), sometimes vomiting
Reduced appetite that can tip into eating too little
Constipation or diarrhoea
Mild injection-site reactions; occasional early fatigue

Trials found it well tolerated, with mostly mild to moderate effects. Like all stomach-slowing drugs, it can delay absorption of oral medicines.

Who should avoid it

Pregnancy and breastfeeding
Eating disorders: appetite suppressants are not appropriate
History of pancreatitis or serious GI disease (needs medical input)
People taking glucose-lowering drugs need monitoring
Tested athletes: unapproved substances fall under WADA S0

Regulatory status checked Oct 2026

Body	Status	Detail
FDA (US)	Not approved	Investigational; development is mainly as CagriSema.
EMA (EU)	Not approved	Investigational.
CDSCO (India)	Not approved	No approval identified.
WADA	S0 risk	Amylin itself isn’t banned, but non-approved substances fall under S0.

The NexGen read

A real second appetite brake

Unlike most research peptides, cagrilintide has proper human trials behind it. On its own it gives moderate weight loss with a gentler side-effect profile than GLP-1s. It is most valuable as a partner to semaglutide.

References

Lau DCW, Erichsen L, Francisco AM, et al. Once-weekly cagrilintide for weight management: a dose-finding phase 2 trial. Lancet. 2021;398(10317):2160–2172. PMID 34798060
Enebo LB, Berthelsen KK, Kankam M, et al. Cagrilintide with semaglutide 2.4 mg for weight management: a phase 1b trial. Lancet. 2021;397(10286):1736–1748. PMID 33894838
Frías JP, Deenadayalan S, Erichsen L, et al. Co-administered cagrilintide and semaglutide in type 2 diabetes: a phase 2 trial. Lancet. 2023;402(10403):720–730.
Garvey WT, Blüher M, Osorto Contreras CK, et al. Coadministered cagrilintide and semaglutide in adults with overweight or obesity. N Engl J Med. 2025;393(7):635–647.