Cagrilintide

What it is

Cagrilintide is a long-acting amylin analog investigated for weight management. It is often studied paired with semaglutide in a combination sometimes referred to as "CagriSema." Amylin is a hormone that works alongside GLP-1 to enhance satiety, the feeling of fullness after eating.

In the PeptidesAI encyclopedia it is categorized under weight management, the same category as semaglutide and tirzepatide, though unlike those two compounds it has not yet completed the regulatory review needed for a prescription product.

How it's thought to work

Cagrilintide is studied for mimicking amylin, a pancreatic hormone normally co-secreted with insulin, which slows gastric emptying and promotes satiety through central (brain) and peripheral pathways described as complementary to GLP-1 signaling. This dual-pathway approach is presented as additive rather than duplicative, since amylin's effect on satiety is described as acting through different receptors than the ones GLP-1 medicines target, which is the proposed rationale for pairing it with a GLP-1 medicine such as semaglutide.

What the research says

A dose-finding Phase 2 trial (Lau et al., 2021) studied cagrilintide on its own and reported dose-dependent weight reduction. A separate Phase 2 trial in people with type 2 diabetes (Frias et al., 2023) compared the CagriSema combination with each component alone: over 32 weeks, mean body weight fell 15.6% with CagriSema, 8.1% with cagrilintide and 5.1% with semaglutide. Larger Phase 3 trials of the combination, the REDEFINE program, followed. Cagrilintide is not yet FDA-approved.

Reported side effects

Reported side effects include nausea, vomiting, decreased appetite, and injection site reactions, a profile broadly similar to other compounds that affect appetite and gastric emptying.

Reconstitution

Cagrilintide is supplied as a lyophilized (freeze-dried) powder and is typically reconstituted with bacteriostatic (BAC) water before use. It commonly comes in 5 mg and 10 mg vials. The amount of peptide in the vial is fixed; the water added only changes how concentrated the solution is.

Worked example. A 5 mg vial is 5,000 mcg. Reconstituted with 1 mL of BAC water, that works out to 5,000 mcg ÷ 1 mL = 5,000 mcg/mL. On a U-100 insulin syringe, where each unit is 0.01 mL, each unit holds 5,000 × 0.01 = 50 mcg. Use the peptide reconstitution calculator to work out the concentration and units for any vial size and water volume.

Important notes

Cagrilintide is an investigational compound and is not FDA-approved. Outside of clinical trials, it is sold only by unregulated research-chemical suppliers, a different regulatory situation from an approved prescription medicine. That distinction matters because an unregulated supplier does not undergo the manufacturing, purity, or safety oversight that an FDA-approved product does.

Sources

1. 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
2. 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
3. Amylin: Pharmacology, Physiology, and Clinical Potential. Hay DL et al. Pharmacological Reviews, 2015. Review

How we choose and check sources

Frequently asked questions

These questions cover the same ground as the sections above, in a shorter format.

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