Cagrilintide and tirzepatide are both weekly injectable compounds studied for weight management, which is why they are compared. Tirzepatide is a dual GLP-1 and GIP receptor agonist, FDA-approved as Mounjaro for type 2 diabetes and Zepbound for weight loss. Cagrilintide is a long-acting amylin analog that remains investigational.
At a glance
| Cagrilintide | Tirzepatide | |
|---|---|---|
| What it is | Investigational long-acting amylin analog studied for weight management, alone and with semaglutide (CagriSema) | Dual GLP-1/GIP receptor agonist sold as Mounjaro for type 2 diabetes and Zepbound for weight loss |
| How it's thought to work | Mimics amylin, a pancreatic hormone that slows gastric emptying and promotes satiety through pathways separate from GLP-1 | Activates both GLP-1 and GIP receptors together, studied for appetite suppression, insulin signaling, and fat metabolism |
| Regulatory status | Investigational; not FDA-approved | FDA-approved as Mounjaro for type 2 diabetes and Zepbound for weight loss |
| Strength of evidence | Phase 2 human trials, alone and as CagriSema, followed by the phase 3 REDEFINE program of the combination | Human trials (the SURMOUNT program) and FDA approval |
| Reported side effects | Nausea, vomiting, decreased appetite, injection site reactions | GI profile similar to semaglutide; injection site reactions; higher hypoglycemia risk when combined with insulin |
| Common vial sizes | 5mg, 10mg | 5mg, 10mg, 15mg, 30mg |
| Mixing math example | 5 mg + 1 mL BAC water = 5,000 mcg/mL, 50 mcg per unit | 10 mg + 2 mL BAC water = 5,000 mcg/mL, 50 mcg per unit |
Key differences
Tirzepatide activates both GLP-1 and GIP receptors and is studied for appetite suppression, insulin signaling and fat metabolism. Cagrilintide mimics amylin, a pancreatic hormone that slows gastric emptying and promotes fullness through receptors separate from those that GLP-1 medicines target.
Tirzepatide is FDA-approved, with phase 3 trials including SURMOUNT behind its weight-management approval. Cagrilintide is not FDA-approved; outside clinical trials it is sold only by unregulated research-chemical suppliers.
Both have gastrointestinal side-effect profiles. Tirzepatide's resembles semaglutide's, with injection site reactions and a higher risk of low blood sugar when combined with insulin. Cagrilintide's includes nausea, vomiting, decreased appetite and injection site reactions.
What the research covers
Tirzepatide has phase 3 trials, including the SURMOUNT program, and FDA approval. Cagrilintide has Phase 2 trials on its own and combined with semaglutide (CagriSema), followed by the phase 3 REDEFINE program of the combination.
Sources
- Once-weekly cagrilintide for weight management in people with overweight and obesity: a multicentre, randomised, double-blind, placebo-controlled and active-controlled, phase 2 trial. Lau DCW et al. The Lancet, 2021. Human trial
- 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. Frias JP et al. The Lancet, 2023. Human trial
- Amylin: Pharmacology, Physiology, and Clinical Potential. Hay DL et al. Pharmacological Reviews, 2015. Review
- Tirzepatide Once Weekly for the Treatment of Obesity. Jastreboff AM et al. N Engl J Med, 2022. Human trial
- LY3298176, a novel dual GIP and GLP-1 receptor agonist for the treatment of type 2 diabetes mellitus: From discovery to clinical proof of concept. Coskun T et al. Molecular Metabolism, 2018. Preclinical
- ZEPBOUND (tirzepatide) injection, for subcutaneous use - Highlights of Prescribing Information. U.S. Food and Drug Administration, 2024. Fda label
Frequently asked questions
What is the difference between cagrilintide and tirzepatide?
Tirzepatide is a dual GLP-1 and GIP receptor agonist and an FDA-approved medicine. Cagrilintide is an investigational amylin analog that acts through a separate appetite pathway.
Is cagrilintide or tirzepatide FDA-approved?
Tirzepatide is FDA-approved as Mounjaro and Zepbound. Cagrilintide is investigational and not FDA-approved.
Do cagrilintide and tirzepatide work the same way?
No. Tirzepatide acts on GLP-1 and GIP receptors, while cagrilintide mimics the hormone amylin, which acts through different receptors.
Which has more human research, cagrilintide or tirzepatide?
Tirzepatide has more, with phase 3 trials and FDA approval. Cagrilintide has Phase 2 trials, and its combination with semaglutide is in phase 3 study.
Both entries, plus the calculator
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