Semaglutide and cagrilintide are compared mostly because of CagriSema, an investigational combination of the two. Semaglutide is a GLP-1 receptor agonist and an FDA-approved medicine, sold as Ozempic for type 2 diabetes and Wegovy for chronic weight management. Cagrilintide is a long-acting analog of amylin, a different appetite-related hormone, and it is still investigational.
At a glance
| Semaglutide | Cagrilintide | |
|---|---|---|
| What it is | GLP-1 receptor agonist sold as Ozempic for type 2 diabetes and Wegovy for chronic weight management | Investigational long-acting amylin analog studied for weight management, alone and with semaglutide (CagriSema) |
| How it's thought to work | Activates GLP-1 receptors, studied for suppressing appetite, slowing gastric emptying, and enhancing the body's own insulin secretion | Mimics amylin, a pancreatic hormone that slows gastric emptying and promotes satiety through pathways separate from GLP-1 |
| Regulatory status | FDA-approved as Wegovy for chronic weight management and Ozempic for type 2 diabetes | Investigational; not FDA-approved |
| Strength of evidence | Human trials (the STEP program) and FDA approval | Phase 2 human trials, alone and as CagriSema, followed by the phase 3 REDEFINE program of the combination |
| Reported side effects | Nausea, vomiting, diarrhea, constipation, abdominal pain; rare pancreatitis; thyroid C-cell tumors seen in rodent studies | Nausea, vomiting, decreased appetite, injection site reactions |
| Common vial sizes | 2mg, 5mg (lyophilized) | 5mg, 10mg |
| Mixing math example | 5 mg + 2 mL BAC water = 2,500 mcg/mL, 25 mcg per unit | 5 mg + 1 mL BAC water = 5,000 mcg/mL, 50 mcg per unit |
Key differences
Semaglutide activates GLP-1 receptors and is studied for suppressing appetite, slowing gastric emptying and enhancing the body's own insulin secretion after meals. Cagrilintide mimics amylin, a hormone the pancreas releases alongside insulin, which slows gastric emptying and promotes fullness through receptors separate from the GLP-1 receptor. That separation is the proposed rationale for studying the two together.
Semaglutide is FDA-approved, with the STEP phase 3 trials 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. Semaglutide's include nausea, vomiting, diarrhea, constipation and abdominal pain, with rare pancreatitis and thyroid C-cell tumors seen in rodent studies. Cagrilintide's include nausea, vomiting, decreased appetite and injection site reactions.
What the research covers
Semaglutide has the STEP phase 3 program and FDA approval. Cagrilintide has a Phase 2 trial on its own (Lau et al., 2021) and a Phase 2 trial in people with type 2 diabetes that compared CagriSema with each component alone (Frias et al., 2023). The phase 3 REDEFINE program of the combination followed.
Sources
- Once-Weekly Semaglutide in Adults with Overweight or Obesity. Wilding JPH et al. N Engl J Med, 2021. Human trial
- Glucagon-like peptide 1 (GLP-1). Müller TD et al. Molecular Metabolism, 2019. Review
- WEGOVY (semaglutide) injection, for subcutaneous use - Highlights of Prescribing Information. U.S. Food and Drug Administration, 2024. Fda label
- 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
Frequently asked questions
What is the difference between semaglutide and cagrilintide?
Semaglutide is a GLP-1 receptor agonist and an FDA-approved medicine. Cagrilintide is an investigational amylin analog that acts through a separate appetite pathway.
What is CagriSema?
CagriSema is an investigational combination of cagrilintide and semaglutide, studied in Phase 2 trials and in the phase 3 REDEFINE program.
Is cagrilintide FDA-approved?
No. Cagrilintide is investigational and not FDA-approved. Semaglutide is FDA-approved as Ozempic and Wegovy.
Do semaglutide and cagrilintide work on the same receptor?
No. Semaglutide acts on the GLP-1 receptor, while cagrilintide mimics amylin, which acts through different receptors.
Both entries, plus the calculator
The PeptidesAI app covers Semaglutide, Cagrilintide and 68 other compounds, with a reconstitution calculator, a dose log and reminders. Free to download on iPhone.
Download on the App Store