Cagrilintide

Long-acting amylin analog · Also known as CagriSema (combination with semaglutide)

What is cagrilintide?

A long-acting synthetic analog of amylin, a hormone co-secreted with insulin that promotes satiety. Studied both as monotherapy and in combination with semaglutide (CagriSema), where it has produced over 20% average weight loss.

Developed by Novo Nordisk, cagrilintide targets the amylin pathway, which is distinct from GLP-1 signaling. When combined with semaglutide as CagriSema, it achieved weight loss results exceeding either agent alone. Novo Nordisk submitted an NDA to the FDA in December 2025, making CagriSema the first GLP-1 plus amylin combination to seek approval for weight management.

Key takeaway: CagriSema (cagrilintide plus semaglutide) produced 20.4% average weight loss in the REDEFINE 1 trial, with 60% of participants losing at least 20% of body weight.

Benefits & evidence

Weight loss High confidence
Appetite suppression High confidence
Blood sugar control High confidence
Reduced postprandial glucagon Moderate confidence
Cardiovascular benefit (under investigation) Preliminary confidence

How it works

Amylin is a hormone released alongside insulin from pancreatic beta cells after meals. It works in the brain's area postrema and other hindbrain regions to produce feelings of fullness, slow gastric emptying, and suppress postprandial glucagon release. Natural amylin is cleared from the body in minutes. Cagrilintide is engineered with fatty acid acylation to extend its half-life, enabling once-weekly dosing.

Because amylin and GLP-1 act through different receptor systems and brain regions, combining cagrilintide with semaglutide produces additive appetite suppression. The amylin pathway primarily signals through hindbrain satiety centers, while GLP-1 acts on hypothalamic and reward circuits. Together, they reduce hunger more effectively than either pathway alone.

Dosing information

Typical dosing protocol
Starting dose

0.25 mg/week

Weeks 1-4 (titrate every 4 weeks)
Maintenance dose

2.4 mg/week

After titration (typically 16-20 weeks)

In the REDEFINE 1 trial, cagrilintide was titrated from 0.25 mg to 2.4 mg over 16 weeks. CagriSema combines cagrilintide 2.4 mg with semaglutide 2.4 mg in a single weekly injection. NDA submitted December 2025; FDA review pending.

Side effects

Most side effects tend to improve as your body adjusts.

Nausea Common
Diarrhea Common
Constipation Common
Injection site reactions Common
Vomiting Moderate
Pancreatitis Rare