CagriSema

Two separate appetite brakes in one weekly injection, and the first GLP-1 plus amylin product to reach regulators.

Evidence: BHuman trials what's this?
Grade B. Completed Phase 3 programme; FDA decision expected late 2026.
Also known as: Cagrilintide 2.4 mg + semaglutide 2.4 mg, fixed dose
Class: Investigational fixed-dose pharmaceutical combination (amylin + GLP-1). Novo Nordisk. Not a home stack.

The 30-second version

WhatA ready-made weekly injection of cagrilintide and semaglutide at 2.4 mg each.

Results~20–23% weight loss at 68 weeks, more than either drug alone (REDEFINE 1).

The honest catchIn a head-to-head trial, tirzepatide still came out ahead.

What it is

The other two blends in this guide, GLOW and KLOW, are combinations of research peptides put together by the community. CagriSema is different: a finished pharmaceutical developed by Novo Nordisk and filed with the FDA in December 2025. It pairs the GLP-1 drug semaglutide with the amylin analogue cagrilintide in a single fixed-dose weekly injection. Full pharmacology for each half is in the Semaglutide (03) and Cagrilintide (04) chapters.

Why the two combine

GLP-1 half. Semaglutide reduces hunger, slows the stomach and improves insulin release.

Amylin half. Cagrilintide brings fullness through its own, separate receptors.

No interference. Neither drug changes how the body handles the other.

Additive. Two independent routes to fullness add up.

Outcome. More weight loss than either component alone.

What the research shows

REDEFINE 1 (68 weeks, more than 3,400 adults with obesity and no diabetes): about 20–23% weight loss depending on the analysis, against 16.1% for semaglutide alone, 11.8% for cagrilintide alone and 2.3% for placebo. About 92% of participants lost at least 5%¹. Beating both halves is the key result: it shows the combination genuinely adds something.

REDEFINE 2 (type 2 diabetes): 15.7% vs 3.1% on placebo, a smaller figure as is typical in diabetes². REDEFINE 4 (head to head): 23.0% vs 25.5% for tirzepatide, which missed its non-inferiority goal³.

A powerful combination. In a direct comparison, tirzepatide still came out slightly ahead.

Evidence at a glance

Use	Grade	Best evidence	Main gap	Read
Weight loss	BHuman trials	~20–23% at 68 weeks¹	Not yet approved	Strong
vs components	BHuman trials	Beat semaglutide and cagrilintide alone¹	—	Proves additivity
vs tirzepatide	BHuman trials	23.0% vs 25.5%³	Missed non-inferiority	Second best

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
Trial / forthcoming label	Both components raised together over ~16 weeks to 2.4 mg + 2.4 mg weekly	Subcutaneous	B

It follows the same titration logic as semaglutide: increase only once side effects settle, hold or step back if they don’t, and support the climb with fibre, fluids and protein. It is supplied ready to use and isn’t meant to be mixed at home.

Reported side effects

Nausea, vomiting, diarrhoea, constipation, possibly a little more than semaglutide alone
Gallbladder problems with rapid weight loss
Muscle loss without enough protein and training
Rare: pancreatitis; semaglutide-class thyroid C-cell boxed warning

Who should avoid it

Personal or family history of medullary thyroid cancer or MEN2
History of pancreatitis
Pregnancy
Glucose-lowering medicines need adjusting

Regulatory status checked Oct 2026

Body	Status	Detail
FDA (US)	Under review	Filed December 2025; decision expected late 2026.
EMA (EU)	Not approved	Not yet authorised.
CDSCO (India)	Not approved	Not available as a combination.
WADA	Not prohibited	GLP-1 and amylin analogues are not listed.

The NexGen read

Two brakes beat one

CagriSema is solid evidence that amylin adds to GLP-1. It is a regulated, fixed-dose medicine, not something to recreate by mixing two vials at home. Once it’s approved, it will sit just behind tirzepatide on raw weight loss.

References

Cagrilintide–semaglutide in adults with overweight or obesity (REDEFINE 1). N Engl J Med. 2025. NCT05567796. doi:10.1056/NEJMoa2502081
Novo Nordisk. REDEFINE 2: CagriSema in type 2 diabetes with obesity or overweight. 2025.
Novo Nordisk. REDEFINE 4: CagriSema versus tirzepatide, head-to-head. Topline 2025.