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RUO · Not ApprovedAmylin Analog+2 more

Cagrilintide

A long-acting amylin analog. We read all 60 studies. The protocol is below.

Updated 03 May 2026Read 8 minEvidence ●●●○○Citations 60
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Free — puts Cagrilintide on your decision board.

The Cagrilintide Report · $19

Everything you need to start: dose, sourcing, safety, our verdict.

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Built from 60 cited studies.

Status
Research-only
Class
Amylin Analog
Evidence
3/ 5●●●○○
FDA status
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Phase 2 mono weight loss
$19 ↓
REDEFINE-1
$19 ↓
Read this if
  • you read Endpoints or Stat News and want to know what CagriSema actually did
  • you're already running semaglutide and curious whether amylin adds something
  • a tele-clinic offered you a "CagriSema" bundle and you want a second read — the one question to ask: **what's the cagri:sema mg ratio?** If they say anything other than 2.4 mg : 2.4 mg, the dose has no phase 3 data behind it
Skip this if
  • you want an FDA-approved drug — this isn't one yet
  • you haven't tried a single-agonist GLP-1 first
  • you have a personal or family history of medullary thyroid carcinoma
The 4 ways you can buy Cagrilintide
Brand
✗
Not available
No FDA-approved cagrilintide exists yet.
Compounded 503A
⚠
Off-label compounding
$200–$500/mo where available
Mid–high. Compounders shipping cagrilintide pre-approval are legally exposed.
RUO (research-only)
✓
Sold 'for research only'
$80–$150/mo
The dominant pre-approval supply path. No purity guarantee.
Gray market
✓
Unregulated overseas import
$22–$25/mo
Crypto/Wise pay; pre-approval molecule so identity verification is hard — no reference standards y…
Click any lane for the full Sourcing breakdown.
First 90 days · Cagrilintide
Weeks 1–2
GI side effects start. Nausea is the rate-limiter. Don't titrate up if you can't tolerate the starting dose — the side-effect curve gets steeper, not flatter.
Weeks 4–8
Appetite suppression becomes the obvious effect. 1–2 lbs/week is typical. Hit a plateau? Hold the dose, don't immediately bump.
Week 12 — decide
Bloodwork: A1c, lipids, liver enzymes, fasting insulin. Visible weight change should be 5–10%. If the trajectory is flat at 12 weeks and you've titrated, this isn't your molecule.
Quit if
  • Pancreatitis-like pain (severe upper-abdominal, won't sit still): stop and call your doctor.
  • Gallbladder pain or persistent vomiting that won't resolve.
  • Severe muscle loss without resistance training (the 'GLP-1 face' is real — protein floor matters).
  • 12 weeks at full dose with zero weight movement (rare, but real).
Identity

What it is.

Cagrilintide is a synthetic long-acting analog of amylin, a hormone the pancreas releases alongside insulin after a meal.

On its own it produces modest weight loss. The interesting product is the combination: CagriSema, which pairs cagrilintide with semaglutide in a single weekly shot. The bet is that hitting and amylin pathways together produces more weight loss than either alone.

CagriSema is in late-stage trials as of mid-2026 and is not yet FDA approved. Standalone cagrilintide is also not approved. There is no legal version. Anything sold under either name on the is a research-chemical bet.

TL;DR

TL;DR. 30-second version.

The compressed verdict — what Cagrilintide actually is, what the human evidence shows, and the watch-for in three bullets. Locked.

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Mechanism

Mechanism.

Mechanism · in the Cagrilintide report

How the molecule actually works — receptor profile, downstream signaling, what to expect mechanistically.

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Evidence

Evidence. What we actually know in humans.

Evidence · in the Cagrilintide report

The trial breakdown — phase, n, primary endpoint, who funded, what hit, what didn't.

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Human-Evidence Factbox
FDA status
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Phase 2 mono weight loss
$19 ↓
REDEFINE-1
$19 ↓
Mechanism
$19 ↓
Dosing
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Expected approval window
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Dose

Dose. The actual protocol.

Dose · in the Cagrilintide report

The specific protocol — dose, titration schedule, cycle pattern, frequency, route.

We read 60 studies to write this report.
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Sourcing

Sourcing. Where the cohort actually buys.

Sourcing · in the Cagrilintide report

Sourcing breakdown — vendor methodology, red flags, our published test results, COA checklist.

We read 60 studies to write this report.
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Safety

Safety. Side effects.

Safety · in the Cagrilintide report

The watch-for list — contraindications, drug interactions, monitoring labs, when to stop.

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Editorial Position

Editorial position.

Editorial Position · in the Cagrilintide report

Our editorial position — explicit yes / no / depends, with the reasoning behind it.

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Citations

Citations.

  1. 01Garvey WT, et al. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity. The New England journal of medicine. 2025;393(7):635-647. PMID: 40544433.
  2. 02Davies MJ, et al. Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes. The New England journal of medicine. 2025;393(7):648-659. PMID: 40544432.
  3. 03Lau DCW, et al. Once-weekly cagrilintide for weight management in people with overweight and obesity: a multicentre, randomised, double-blind, placebo-controlled and active-controlled, dose-finding phase 2 trial. Lancet (London, England). 2021;398(10317):2160-2172. PMID: 34798060.
  4. 04Frias JP, et al. Efficacy and safety of co-administered once-weekly cagrilintide 2·4 mg with once-weekly semaglutide 2·4 mg in type 2 diabetes: a multicentre, randomised, double-blind, active-controlled, phase 2 trial. Lancet (London, England). 2023;402(10403):720-730. PMID: 37364590.
  5. 05Dutta D, et al. Efficacy and Safety of Cagrilintide Alone and in Combination with Semaglutide (Cagrisema) as Anti-Obesity Medications: A Systematic Review and Meta-Analysis. Indian journal of endocrinology and metabolism. 2024;28(5):436-444. PMID: 39676787.
+Show all 60 citations
  1. 06D'Ascanio AM, et al. Cagrilintide: A Long-Acting Amylin Analog for the Treatment of Obesity. Cardiology in review. 2024;32(1):83-90. PMID: 36883831.
  2. 07Kruse T, et al. Development of Cagrilintide, a Long-Acting Amylin Analogue. Journal of medicinal chemistry. 2021;64(15):11183-11194. PMID: 34288673.
  3. 08Enebo LB, et al. Safety, tolerability, pharmacokinetics, and pharmacodynamics of concomitant administration of multiple doses of cagrilintide with semaglutide 2·4 mg for weight management: a randomised, controlled, phase 1b trial. Lancet (London, England). 2021;397(10286):1736-1748. PMID: 33894838.
  4. 09Carvas AO, et al. Cagrilintide lowers bodyweight through brain amylin receptors 1 and 3. EBioMedicine. 2025;118:105836. PMID: 40609154.
  5. 10Yao H, et al. Comparative effectiveness of GLP-1 receptor agonists on glycaemic control, body weight, and lipid profile for type 2 diabetes: systematic review and network meta-analysis. BMJ (Clinical research ed.). 2024;384:e076410. PMID: 38286487.
  6. 11Cao J, et al. Structural and dynamic features of cagrilintide binding to calcitonin and amylin receptors. Nature communications. 2025;16(1):3389. PMID: 40204768.
  7. 12Gabe MBN, et al. Cagrilintide is not associated with clinically relevant QTc prolongation: A thorough QT study in healthy participants. Diabetes, obesity & metabolism. 2024;26(12):5805-5811. PMID: 39279639.
  8. 13Ludwig MQ, et al. A Cross-Species Atlas of the Dorsal Vagal Complex Reveals Neural Mediators of Cagrilintide's Effects on Energy Balance. bioRxiv : the preprint server for biology. 2025. PMID: 39868309.
  9. 14Becerril S, et al. Cagrilintide plus semaglutide for obesity management. Lancet (London, England). 2021;397(10286):1687-1689. PMID: 33894837.
  10. 15Panou T, et al. Amylin analogs for the treatment of obesity without diabetes: present and future. Expert review of clinical pharmacology. 2024:1-9. PMID: 39317404.
  11. 16Ryan DH. Drugs for Treating Obesity. Handbook of experimental pharmacology. 2022;274:387-414. PMID: 34783910.
  12. 17Lnu V, et al. Cagrilintide-Semaglutide in Adults with Overweight or Obesity. The New England journal of medicine. 2025;393(20):2066-2067. PMID: 41259766.
  13. 18Fogacci F, et al. Cagrilintide-Semaglutide in Adults with Overweight or Obesity. The New England journal of medicine. 2025;393(20):2065-2066. PMID: 41259764.
  14. 19Rubio-Herrera MA, et al. Weight management treatment in obesity. Medicina clinica. 2025;165(5):107152. PMID: 40865172.
  15. 20Eržen S, et al. Amylin, Another Important Neuroendocrine Hormone for the Treatment of Diabesity. International journal of molecular sciences. 2024;25(3). PMID: 38338796.
  16. 21Chi H, et al. Cagrilintide-Semaglutide in Adults with Overweight or Obesity. The New England journal of medicine. 2025;393(20):2067. PMID: 41259767.
  17. 22Krakauer JC, et al. Cagrilintide-Semaglutide in Adults with Overweight or Obesity. The New England journal of medicine. 2025;393(20):2066. PMID: 41259765.
  18. 23Madsbad S, et al. The promise of glucagon-like peptide 1 receptor agonists (GLP-1RA) for the treatment of obesity: a look at phase 2 and 3 pipelines. Expert opinion on investigational drugs. 2025;34(3):197-215. PMID: 40022548.
  19. 24Son JW, et al. Novel GLP-1-based Medications for Type 2 Diabetes and Obesity. Endocrine reviews. 2026;47(2):159-177. PMID: 41054801.
  20. 25Davies MJ, et al. Cagrilintide-Semaglutide in Adults with Overweight or Obesity. Reply. The New England journal of medicine. 2025;393(20):2067-2068. PMID: 41259769.
  21. 26Garvey WT, et al. Cagrilintide-Semaglutide in Adults with Overweight or Obesity. Reply. The New England journal of medicine. 2025;393(20):2067. PMID: 41259768.
  22. 27Patel JP, et al. Comparative Effectiveness of Semaglutide, Liraglutide, Orlistat, and Phentermine for Weight Loss in Obese Individuals: A Systematic Review. Cureus. 2025;17(3):e80321. PMID: 40206909.
  23. 28Gabery S, et al. Characterization of 0839 - A tool compound for pre-clinical mode-of-action studies of amylin analogues such as cagrilintide. Life sciences. 2025;378:123845. PMID: 40628316.
  24. 29Ahmed M, et al. Efficacy and Safety of Cagrilintide and Cagrisema Versus Semaglutide as Anti-Obesity Medications: A Systematic Review, Meta-Analysis and Meta-Regression. Diabetes, obesity & metabolism. 2026;28(6):4828-4836. PMID: 41834765.
  25. 30Bailey CJ, et al. Multifunctional incretin peptides in therapies for type 2 diabetes, obesity and associated co-morbidities. Peptides. 2025;187:171380. PMID: 40081498.
  26. 31Agarwal A, et al. In adults with overweight or obesity, weekly subcutaneous cagrilintide-semaglutide increased weight loss at 68 wk. Annals of internal medicine. 2025;178(10):JC112. PMID: 41052437.
  27. 32Gu YM, et al. Structural and mechanistic insights into dual activation of cagrilintide in amylin and calcitonin receptors. Acta pharmacologica Sinica. 2026;47(1):162-172. PMID: 40847076.
  28. 33Gogineni P, et al. Oral glucagon-like peptide-1 receptor agonists and combinations of entero-pancreatic hormones as treatments for adults with type 2 diabetes: where are we now?. Expert opinion on pharmacotherapy. 2024;25(7):801-818. PMID: 38753454.
  29. 34Briere DA, et al. Eloralintide (LY3841136), a novel amylin receptor agonist for the treatment of obesity: From discovery to clinical proof of concept. Molecular metabolism. 2025;102:102271. PMID: 41109426.
  30. 35Verma S, et al. CagriSema Reduces Blood Pressure in Adults With Overweight or Obesity: REDEFINE 1. Hypertension (Dallas, Tex. : 1979). 2026;83(2):e26055. PMID: 41328546.
  31. 36Jacobsen JM, et al. CagriSema drives weight loss in rats by reducing energy intake and preserving energy expenditure. Nature metabolism. 2025;7(7):1322-1329. PMID: 40629149.
  32. 37Caruso I, et al. Incretin-based therapies for the treatment of obesity-related diseases. npj metabolic health and disease. 2024;2(1):31. PMID: 40604322.
  33. 38Fletcher MM, et al. AM833 Is a Novel Agonist of Calcitonin Family G Protein-Coupled Receptors: Pharmacological Comparison with Six Selective and Nonselective Agonists. The Journal of pharmacology and experimental therapeutics. 2021;377(3):417-440. PMID: 33727283.
  34. 39Larsen AT, et al. Does receptor balance matter? - Comparing the efficacies of the dual amylin and calcitonin receptor agonists cagrilintide and KBP-336 on metabolic parameters in preclinical models. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie. 2022;156:113842. PMID: 36242844.
  35. 40Lutz TA. Creating the amylin story. Appetite. 2022;172:105965. PMID: 35183619.
  36. 41Sidrak WR, et al. Approved and Emerging Hormone-Based Anti-Obesity Medications: A Review Article. Indian journal of endocrinology and metabolism. 2024;28(5):445-460. PMID: 39676791.
  37. 42Bailey CJ, et al. An update on peptide-based therapies for type 2 diabetes and obesity. Peptides. 2023;161:170939. PMID: 36608818.
  38. 43Al Lawati A, et al. Current and Emerging Parenteral and Peroral Medications for Weight Loss: A Narrative Review. Diseases (Basel, Switzerland). 2025;13(5). PMID: 40422561.
  39. 44Old V, et al. Mitochondrial Adaptations in Skeletal Muscle Following Incretin-Based Therapies: In Vitro. Journal of cachexia, sarcopenia and muscle. 2026;17(2):e70254. PMID: 41852165.
  40. 45Yamauchi T, et al. Efficacy and safety of co-administered cagrilintide and semaglutide versus semaglutide alone in adults with overweight or obesity with or without type 2 diabetes in Japan and Taiwan (REDEFINE 5): a multicentre, randomised, active-controlled, phase 3a trial. The lancet. Diabetes & endocrinology. 2026;14(6):450-462. PMID: 42009015.
  41. 46Muskiet MHA, et al. Amylin and the renin-angiotensin system: risk or opportunity in amylin-based therapy?. Lancet (London, England). 2026;406(10522):2980-2983. PMID: 41207308.
  42. 47Martínez-Castelao A, et al. Diabetes Mellitus and Chronic Kidney Disease: The Future Is Being Surpassed. Journal of clinical medicine. 2025;14(23). PMID: 41375628.
  43. 48Thakker J, et al. The Obesity Paradox of Cardiovascular Outcomes in Patients with Diabetes Mellitus. Current diabetes reports. 2025;25(1):35. PMID: 40481922.
  44. 49Dehestani B, et al. Amylin as a Future Obesity Treatment. Journal of obesity & metabolic syndrome. 2021;30(4):320-325. PMID: 34929674.
  45. 50Sun X, et al. Identification and utility exploration of a highly potent and long-acting bullfrog GLP-1 analogue in GLP-1 and amylin combination therapy. Peptides. 2024;177:171203. PMID: 38582303.
  46. 51Li H, et al. Efficacy and safety of GLP-1RAs for people with obesity: A systematic review based on RCT and Bayesian network meta-analysis. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie. 2024;171:116150. PMID: 38242040.
  47. 52Hankir MK, et al. Central nervous system pathways targeted by amylin in the regulation of food intake. Biochimie. 2025;229:95-104. PMID: 39426704.
  48. 53Lima LMTR, et al. Amyloidogenicity of peptides targeting diabetes and obesity. Colloids and surfaces. B, Biointerfaces. 2022;209(Pt 1):112157. PMID: 34715595.
  49. 54Abdalla Ahmed MA, et al. Advancements in the management of obesity: a review of current evidence and emerging therapies. Expert review of endocrinology & metabolism. 2024;19(3):257-268. PMID: 38685693.
  50. 55Mathiesen DS, et al. Long-acting amylin analogues for the management of obesity. Current opinion in endocrinology, diabetes, and obesity. 2022;29(2):183-190. PMID: 35066542.
  51. 56Rejili M, et al. Amylin receptors as therapeutic targets in obesity: Emerging peptide-based strategies. Vascular pharmacology. 2026;162:107563. PMID: 41344603.
  52. 57Hadid S, et al. Advancing Diabetes Management and Glycemic Control While Exploring CagriSema's Impact on Obesity Management. Cardiology in review. 2025. PMID: 40327810.
  53. 58El-Sheikh M, et al. Cardiovascular effects of incretin-based drugs in patients with and without a history of heart failure: a protocol for a systematic review, meta-analysis and trial sequential analysis of randomised controlled trials. BMJ open. 2025;15(9):e103668. PMID: 40976663.
  54. 59Chung CW, et al. Amylin Revisited: A 5-Year Perspective on Its Emerging Role in the Treatment of Diabesity. Journal of obesity & metabolic syndrome. 2026;35(1):38-48. PMID: 41549439.
  55. 60Al-Harbi FA, et al. Synthetic target trial emulation and predictive modeling of amylin-pathway therapies for obesity and type 2 diabetes. Metabolism open. 2025;28:100414. PMID: 41255585.
The Cagrilintide Report · $19

Everything you need to start.

Dose, sourcing, safety, our verdict. One purchase. Yours forever.

Built from 60 cited studies.

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