The caveat that governs this page
Cagrilintide is investigational and has no approved dose. What follows describes the regimens used in its published clinical trials and the results and adverse events they reported, so that readers can interpret claims about it. It is not a dosing chart or a recommendation. Trial drug was supplied in pre-filled pens; material sold online as cagrilintide is unlicensed and of unverified content, and nothing here applies to it.
Phase 2 monotherapy (Lancet 2021): five doses against liraglutide
The dose-finding trial (Lau et al., Lancet 2021; NCT03856047) randomised 706 adults without diabetes (BMI ≥30, or ≥27 with hypertension or dyslipidaemia) at 57 sites in ten countries to once-weekly subcutaneous cagrilintide at 0.3, 0.6, 1.2, 2.4 or 4.5 mg, once-daily liraglutide 3.0 mg as an active comparator, or placebo. Treatment lasted 26 weeks including a dose-escalation period of up to 6 weeks, followed by 6 weeks off treatment. All cagrilintide doses beat placebo, with weight loss rising with dose from 6.0% to 10.8% versus 3.0% on placebo, and the 4.5 mg dose beat liraglutide 3.0 mg (10.8% vs 9.0%).
| Arm | Weekly dose | Mean weight change |
|---|---|---|
| Placebo | — | −3.0% |
| Cagrilintide, lowest dose | 0.3 mg | −6.0% |
| Cagrilintide, intermediate doses | 0.6 / 1.2 / 2.4 mg | Between −6.0% and −10.8%, rising with dose |
| Cagrilintide, highest dose | 4.5 mg | −10.8% |
| Liraglutide (daily) | 3.0 mg | −9.0% |
With semaglutide: the CagriSema regimen
The phase 1b combination study (Enebo et al., Lancet 2021) co-escalated cagrilintide from 0.16 up to 4.5 mg alongside semaglutide 2.4 mg in 4-week steps over 16 weeks, then held the target dose for 4 weeks; exposure to each drug was unaffected by the other, and at 20 weeks the 1.2 and 2.4 mg cagrilintide arms had lost 15.7% and 17.1%. The phase 3 REDEFINE programme then fixed the combination at cagrilintide 2.4 mg plus semaglutide 2.4 mg once weekly. In REDEFINE 1 (Garvey et al., NEJM 2025; 3,417 adults, 68 weeks) that regimen produced −20.4% body weight versus −3.0% with placebo, though a proportion of participants did not reach the full 2.4/2.4 mg dose — one reason later trials adjusted the escalation.
Side effects: gastrointestinal and injection-site
In the phase 2 monotherapy trial the most frequent adverse events were gastrointestinal — nausea, constipation and diarrhoea — and administration-site reactions, which were more common with cagrilintide than with placebo or liraglutide. Permanent treatment discontinuation was about 10% and similar across groups, with 4% of participants stopping because of adverse events. Amylin agonism at effective doses tends to cause less nausea than GLP-1 agonism at comparable weight loss, which is part of the rationale for pairing it with semaglutide; in REDEFINE 1, however, the combination produced gastrointestinal adverse events in 79.6% of participants versus 39.9% on placebo, mainly transient and mild to moderate — the sum of two mechanisms that both slow gastric emptying.
| Finding | Source | Detail |
|---|---|---|
| GI events most common | Phase 2 monotherapy (Lancet 2021) | Nausea, constipation, diarrhoea; dose-related |
| Injection-site reactions | Phase 2 monotherapy (Lancet 2021) | More frequent than placebo or liraglutide |
| Discontinuation for AEs | Phase 2 monotherapy (Lancet 2021) | ≈ 4% overall, similar across groups |
| GI events with CagriSema | REDEFINE 1 (NEJM 2025) | 79.6% vs 39.9% placebo; mostly transient, mild–moderate |
Why injection-site reactions stand out
Cagrilintide's fatty diacid sits on the N-terminus rather than a side chain, and the peptide is formulated at relatively high concentration for a once-weekly product; both plausibly contribute to local irritation, and administration-site reactions were the one adverse event category where cagrilintide clearly exceeded liraglutide in phase 2. They were generally mild. Pramlintide, the earlier amylin analogue, also lists injection-site reactions as common. This is a class feature worth knowing when reading tolerability comparisons with GLP-1-only drugs.
What glucagon-class and thyroid warnings do and do not apply
Cagrilintide is not a GLP-1 receptor agonist, so the incretin-class label warnings — the rodent thyroid C-cell finding, pancreatitis, gallbladder disease — are not automatically inherited; the relevant comparators are amylin analogues. Pramlintide's label warns chiefly about severe hypoglycaemia when combined with insulin, which reflects its use in insulin-treated diabetes rather than a property of amylin agonism in people without diabetes. CagriSema, however, contains semaglutide and therefore carries the full GLP-1 class profile. Long-term safety for cagrilintide itself rests on the REDEFINE programme, which is still reporting.
Half-life and what it means for escalation
Cagrilintide's half-life is 159–195 hours (about 7–8 days), so once-weekly dosing keeps concentrations in a narrow range and steady state arrives after four to five weeks. That is why the trials escalated in steps of several weeks: each step is only fully expressed once steady state is reached, and gastrointestinal tolerance develops over the same interval. The half-life comparison guide sets cagrilintide alongside the GLP-1 class.
Sources and what they cover
These primary studies, official records and standards cover the topics linked below. The scope notes distinguish laboratory findings, human trials and regulatory records. This is a selected bibliography, not a systematic review or verification of every sentence; absence of a study here does not prove that no study exists.
- Lau et al. (2021) — Cagrilintide for weight management, phase 2 trial
Human monotherapy trial with studied doses and adverse events; distinct from CagriSema.
Relevant sections: Phase 2 monotherapy (Lancet 2021): five doses against liraglutide · Side effects: gastrointestinal and injection-site · Why injection-site reactions stand out
- Garvey et al. (2025) — REDEFINE 1, cagrilintide with semaglutide
Randomized phase 3 obesity trial of the coadministered combination; not evidence for informal mixed research vials.
Relevant sections: With semaglutide: the CagriSema regimen · Side effects: gastrointestinal and injection-site
- Enebo et al. (2021) — Cagrilintide with semaglutide, phase 1b
Early coadministration study; pharmacokinetics and tolerability do not prove long-term outcomes.
Relevant sections: Half-life and what it means for escalation
FAQ
What doses of cagrilintide were used in trials?+
Alone: 0.3, 0.6, 1.2, 2.4 and 4.5 mg once weekly for 26 weeks (phase 2). With semaglutide as CagriSema: 2.4 mg cagrilintide plus 2.4 mg semaglutide once weekly (phase 3 REDEFINE).
What are the side effects of cagrilintide?+
Mainly gastrointestinal (nausea, constipation, diarrhoea) and injection-site reactions, mostly mild to moderate. About 4% of phase 2 participants stopped because of adverse events.
How much weight loss did cagrilintide produce?+
6.0% to 10.8% at 26 weeks depending on dose, versus 3.0% with placebo; the 4.5 mg dose beat liraglutide 3.0 mg (10.8% vs 9.0%). Combined with semaglutide, −20.4% at 68 weeks.
How often is cagrilintide injected?+
Once weekly in every trial, consistent with its 7–8-day half-life.
Is there an approved cagrilintide dose?+
No. Cagrilintide is investigational and not approved anywhere as of September 2026; the doses above are trial regimens, not recommendations.