Cagrilintide Dosage Guide

Investigational long-acting amylin analogue. Weekly subcutaneous protocols from the trials, the CagriSema combination with semaglutide, reconstitution, injection technique, and safety.

Compiled by PeptideWiki Editorial Team·Last reviewed June 23, 2026

What Is Cagrilintide?

Investigational Drug Warning: Cagrilintide (AM833) is NOT FDA-approved. It is an investigational compound. The dosing information in this guide is drawn from published clinical trials, not from an approved drug label. Using an unapproved investigational drug carries inherent risk. Consult a healthcare provider before using any research compound.

Cagrilintide (AM833) is a long-acting amylin analogue developed by Novo Nordisk. Amylin is a natural hormone the pancreas releases together with insulin after meals, and it tells the brain that you are full. Cagrilintide copies that fullness signal in a form that lasts about a week, so one weekly injection keeps appetite reduced across the whole week. This amylin mechanism is different from GLP-1 drugs such as Semaglutide.

Cagrilintide is studied two ways: on its own, and combined with semaglutide as a single weekly injection called CagriSema. The combination pairs two separate fullness signals, amylin and GLP-1, and produced greater weight loss in trials than either medicine alone. In the Phase 3 REDEFINE 1 trial, CagriSema reduced body weight by about 20 percent over 68 weeks.

Use our Peptide Dosage Calculator to work out your exact dose from vial size and concentration.

Key Characteristics:

Long-acting amylin analogue: copies amylin, the after-meal fullness hormone, in a form that lasts about a week
Appetite and fullness: acts on hunger-control regions of the brain to increase fullness, so meals end sooner and between-meal hunger drops
Slower stomach emptying: slows how fast the stomach empties, so the feeling of fullness lasts longer
CagriSema combination: paired with semaglutide 2.4 mg as one weekly injection, adding a GLP-1 signal on top of the amylin signal
Once-weekly injection: given subcutaneously once per week, with a half-life of about 7 to 8 days
Investigational status: developed by Novo Nordisk. NOT FDA-approved. The CagriSema combination is under FDA review

For a complete overview of its mechanism and research, see our full Cagrilintide profile. New to peptides? Start with the Beginner's Guide to Peptides.

How Cagrilintide Dosage Is Determined

Unlike many peptides, cagrilintide dosing comes directly from controlled clinical trials rather than from animal studies and community extrapolation. Two bodies of trial evidence matter: the monotherapy dose-finding work, and the CagriSema combination trials.

Phase 2 Monotherapy (Lau et al., Lancet 2021)

The dose-finding Phase 2 trial enrolled 706 adults with obesity, or overweight with a weight-related condition, and no diabetes. Participants received once-weekly subcutaneous cagrilintide at 0.3, 0.6, 1.2, 2.4, or 4.5 mg, or liraglutide 3.0 mg, or placebo, over 26 weeks. Weight loss was dose-dependent.

Group (weekly)	Mean Weight Loss
Placebo	−3.0%
Cagrilintide 0.3–2.4 mg	−6.0% to −9.7%
Cagrilintide 4.5 mg	−10.8%
Liraglutide 3.0 mg	−9.0%

Cagrilintide 4.5 mg produced more weight loss than liraglutide 3.0 mg, an established daily injection, supporting amylin as a standalone target for weight management.

Phase 3 CagriSema (REDEFINE 1 and 2, NEJM 2025)

The Phase 3 program tested the fixed combination of cagrilintide 2.4 mg plus semaglutide 2.4 mg, once weekly for 68 weeks. REDEFINE 1 enrolled 3,417 adults without diabetes. REDEFINE 2 enrolled 1,206 adults with type 2 diabetes.

Trial	Population	CagriSema	Placebo
REDEFINE 1	No diabetes	−20.4%	−3.0%
REDEFINE 2	Type 2 diabetes	−13.7%	−3.4%

Dosing information in this guide is derived from published clinical trials. The large weight-loss numbers are for the CagriSema combination, not cagrilintide alone.

Cagrilintide Dosing Protocols

Cagrilintide is given by subcutaneous injection once weekly. The dose is raised gradually to limit stomach-related side effects. The schedules below follow the trial protocols. There are two distinct approaches: cagrilintide alone, and the CagriSema combination.

Cagrilintide Alone (Monotherapy)

The Phase 2 trial escalated over up to 6 weeks toward a target dose of 2.4 mg, with a maximum studied dose of 4.5 mg weekly. A practical step-up toward the 2.4 mg target:

Period	Weekly Dose	Purpose
Step 1	0.3 mg	Initial tolerance; stomach acclimation
Step 2	0.6 mg	First increase
Step 3	1.2 mg	Approaching the therapeutic range
Maintenance	2.4 mg	Established target dose

CagriSema Combination

CagriSema co-escalates both cagrilintide and semaglutide in roughly 4-week steps over about 16 weeks, until each reaches the 2.4 mg target. Because it is two medicines in one injection, both are increased together on the same schedule.

Period	Each Component (weekly)	Duration
Step 1	0.25 mg	Weeks 1–4
Step 2	0.5 mg	Weeks 5–8
Step 3	1.0–1.7 mg	Weeks 9–16
Maintenance	2.4 mg	Week 17+

Do not skip titration. Starting at the full 2.4 mg dose without stepping up is the most common mistake. It leads to severe nausea, vomiting, and diarrhea that can force you to stop. The gradual increase is part of every trial protocol, not optional.

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Cagrilintide vs GLP-1 Weight-Loss Drugs

Cagrilintide works through amylin, a different mechanism from the GLP-1 drugs most people know. The table below compares it, and the CagriSema combination, with Semaglutide, Tirzepatide, and Retatrutide. Weight-loss figures come from different trials with different populations and durations, so they are indicative rather than head-to-head.

Feature	Cagrilintide / CagriSema	Semaglutide	Tirzepatide
Mechanism	Amylin (plus GLP-1 in CagriSema)	GLP-1 only	GLP-1 + GIP
FDA Status	Investigational (under review)	Approved (Wegovy / Ozempic)	Approved (Zepbound / Mounjaro)
Target Dose	2.4 mg weekly	2.4 mg weekly	15 mg weekly
Frequency	Once weekly	Once weekly	Once weekly
Peak Weight Loss (trial)	20.4% CagriSema, 10.8% alone	~15–17% at 68 weeks	~22.5% at 72 weeks
Half-life	~7–8 days	~7 days	~5 days
Availability	Research only	Prescription (branded)	Prescription (branded)

Cross-trial comparison caveat: These weight-loss numbers come from separate trials with different designs. They are useful context but not equivalent to a direct head-to-head study. CagriSema is the only one of these still investigational.

For dosing protocols of the FDA-approved alternatives, see our Semaglutide Dosage Guide and Tirzepatide Dosage Guide.

Calculate Your Cagrilintide Dose

Research cagrilintide is supplied as a lyophilized (freeze-dried) powder in a vial. You reconstitute it with bacteriostatic water, then draw your dose with an insulin syringe. The concentration depends on how much water you add. Because cagrilintide doses are small, accurate math matters.

Worked Example:

Vial size: 5 mg (5,000 mcg) of cagrilintide
Bacteriostatic water added: 1 mL
Concentration: 5 mg ÷ 1 mL = 5.0 mg per mL
Target dose: 2.4 mg
Volume to draw: 2.4 ÷ 5 = 0.48 mL = 48 units on an insulin syringe

Quick Reference: 5 mg Vial

Bac Water Added	Concentration	0.6 mg Dose	1.2 mg Dose	2.4 mg Dose
1 mL	5 mg/mL	12 units	24 units	48 units
2 mL	2.5 mg/mL	24 units	48 units	96 units

Double-check the units. Cagrilintide doses are small, so a misplaced decimal or the wrong concentration easily doubles or halves your dose. Confirm your concentration and the units to draw before every injection.

Skip the Math: Use Our

Enter your vial size, water volume, and desired dose to get instant calculations with zero manual math.

How to Reconstitute Cagrilintide

Research cagrilintide comes as a lyophilized (freeze-dried) powder. There is no branded pre-filled pen, so reconstitution with bacteriostatic water is required before injection. The process is standard for peptide reconstitution.

Research-compound warning: Unlike an FDA-approved injectable that comes in a pre-filled pen with a precise dose, research cagrilintide requires manual reconstitution and dose calculation. Errors in reconstitution directly change the dose you receive. Follow the steps below carefully.

Supplies Needed:

Cagrilintide lyophilized vial
Bacteriostatic water (contains 0.9% benzyl alcohol as preservative)
Insulin syringes (29 to 31 gauge, 0.5 mL or 1 mL) for injection
Alcohol swabs (70% isopropyl alcohol)
Clean, flat workspace
Optional: a larger syringe (1 to 3 mL) for drawing bacteriostatic water

Steps

Wash Hands & Prepare Workspace

Wash hands thoroughly with soap and water. Lay out supplies on a clean surface: the cagrilintide vial, bacteriostatic water, an insulin syringe, and alcohol swabs.

Remove the Vial Caps

Flip off the plastic caps from both the cagrilintide vial and the bacteriostatic water vial. Swab both rubber stoppers with alcohol pads and let them air-dry for 10 to 15 seconds.

Draw Bacteriostatic Water

Using a fresh insulin syringe, draw your chosen volume of bacteriostatic water. For a 5 mg vial, 1 mL is a convenient choice because it yields 5.0 mg per mL and keeps the dose math simple.

Add Water to the Cagrilintide Vial

Insert the needle into the cagrilintide vial through the rubber stopper. Angle the needle so the water runs down the inside glass wall rather than squirting directly onto the powder. Release the plunger slowly.

Dissolve Gently

Remove the syringe. Let the vial sit for 1 to 2 minutes, then gently swirl or roll it between your palms until the powder is fully dissolved. The solution should be clear and colorless. Never shake.

Label & Refrigerate

Write the reconstitution date and concentration on the vial. Store refrigerated at 2 to 8 degrees Celsius and use within 28 to 30 days.

Storage

Unreconstituted (powder): store refrigerated (2 to 8 degrees Celsius) for maximum shelf life. Room temperature is acceptable for short periods but reduces potency over time
Reconstituted (in bacteriostatic water): keep refrigerated at 2 to 8 degrees Celsius and use within 28 to 30 days
Do not freeze: freezing can damage the peptide structure through ice crystal formation
Protect from light and heat: keep the vial in its box or wrapped in foil, away from direct sunlight and heat

For a detailed visual walkthrough, see our Reconstitution Guide.

Cagrilintide Dosage by Goal

All trial data is for weight management in adults with obesity or overweight. The two practical approaches below reflect the two ways cagrilintide was studied.

Maximum Weight Loss: CagriSema (2.4 mg + 2.4 mg/week)

The combination with semaglutide produced the largest results: about 20.4 percent body weight at 68 weeks in adults without diabetes, and 13.7 percent in adults with type 2 diabetes. This is the lead program now under FDA review.

Target dose: cagrilintide 2.4 mg plus semaglutide 2.4 mg, once weekly
Titration: both components co-escalated over about 16 weeks
Duration: 68 weeks in the trials
Side effects: gastrointestinal effects are common during titration but mostly mild to moderate and transient

Amylin-Only Approach: Cagrilintide Alone (up to 2.4–4.5 mg/week)

Cagrilintide on its own reduced body weight up to about 10.8 percent over 26 weeks at the 4.5 mg dose, with 2.4 mg as the carried-forward target. An option for an amylin-only approach without a GLP-1 component.

Target dose: 2.4 mg weekly (up to 4.5 mg studied)
Titration: step up from 0.3 mg over several weeks
Duration: 26 weeks in the trial
Notes: outperformed liraglutide 3.0 mg at the top dose

Choosing an approach: CagriSema produced roughly double the weight loss of cagrilintide alone, but it adds a second medicine (semaglutide) with its own dosing and side-effect profile. Treat any CagriSema protocol as two co-escalated medicines.

Cagrilintide Injection Guide

Subcutaneous (SubQ) Injection, Step by Step

Wash Hands

Wash hands thoroughly with soap and water. Prepare a clean workspace with your syringe, alcohol swab, and reconstituted cagrilintide vial.

Swab the Vial Stopper

Wipe the rubber stopper of the cagrilintide vial with an alcohol swab. Let it air-dry for 10 to 15 seconds.

Draw Your Dose

Pull back the plunger to draw air equal to your dose volume. Insert the needle into the vial, push in the air, invert the vial, and slowly draw out your calculated dose. Tap out any air bubbles.

Choose the Injection Site

Cagrilintide is injected subcutaneously. Preferred sites: lower abdomen (2 to 3 inches from the navel), upper thigh, or back of the upper arm. Rotate sites each week.

Clean the Injection Site

Swab the chosen site with a fresh alcohol pad. Allow it to air-dry completely before injecting.

Inject

Pinch a fold of skin between thumb and forefinger. Insert the needle at a 45 to 90 degree angle into the pinched fold. Push the plunger slowly and steadily, then withdraw and apply light pressure if needed.

Dispose Safely

Place the used syringe immediately into a sharps container. Never recap or reuse needles.

Injection Timing & Frequency

Frequency: once weekly, on the same day each week
Time of day: any time. Consistency matters more than the specific hour
Half-life: about 7 to 8 days, which supports the once-weekly schedule
Missed dose: if you miss a dose by 1 to 2 days, inject as soon as you can and resume your normal schedule. If more than a few days late, skip it and resume on your next scheduled day

Site rotation: rotate injection sites each week to protect the fat tissue under the skin. Alternate, for example, between the left and right sides of the abdomen.

Cagrilintide Treatment Duration

The Phase 3 CagriSema trials ran for 68 weeks, and the Phase 2 monotherapy trial ran for 26 weeks. As with other weight-loss injections, the medicine is designed for sustained use rather than a short course.

Phase	Weeks	Description
Titration	Weeks 1–16	Gradual dose increase to the 2.4 mg target. Focus on stomach tolerability. Early weight loss begins
Active Weight Loss	Weeks 16–68	Full target dose. Steady, significant weight reduction. Most weight loss occurs during this phase
Maintenance	Week 68+	Weight stabilization or continued gradual loss. Long-term data is still being collected

Weight regain on discontinuation: based on extensive data from GLP-1-based treatments, stopping these medicines typically leads to significant weight regain. Plan for long-term use if weight maintenance is the goal. The optimal long-term strategy for cagrilintide has not been established.

CagriSema & Combinations

The one evidence-based combination: cagrilintide plus semaglutide 2.4 mg, known as CagriSema, is the most-studied use of cagrilintide and was tested in large Phase 3 trials. This is a validated pairing, not informal stacking.

Cagrilintide supplies an amylin fullness signal, and semaglutide supplies a GLP-1 signal. Because the two act through different pathways, combining them adds their effects rather than duplicating one mechanism. That is why CagriSema produced more weight loss than either medicine alone.

Combinations Without Trial Data

Outside the studied CagriSema combination, there is no clinical evidence for pairing cagrilintide with other compounds. The combinations below are sometimes discussed but carry no supporting trial data.

Compound	Rationale Discussed	Caution
Tirzepatide or other GLP-1 drugs	Adding a separate incretin signal	No data with cagrilintide outside CagriSema. Overlapping appetite suppression raises gastrointestinal risk
BPC-157	Gut-comfort support during side effects	No interaction data with cagrilintide. Purely speculative

Stick to what was studied. The only combination with clinical evidence is CagriSema (cagrilintide plus semaglutide 2.4 mg). Any other combination is at your own risk.

Explore peptide combinations in our Peptide Stack Builder.

Safety, Side Effects & Contraindications

Investigational Compound: Cagrilintide is NOT FDA-approved. Its safety has been studied in clinical trials, but long-term safety and rare adverse events are still being characterized. You are assuming risk that is not yet fully defined.

Gastrointestinal Side Effects (Most Common)

Stomach-related side effects are the most common. They are more frequent during titration and generally improve over time. In the Phase 3 CagriSema trials they affected most participants but were largely mild to moderate.

Side Effect	Notes
Nausea	Most common. Peaks during titration, improves over time
Vomiting	More likely if titration is skipped or rushed
Diarrhea	Usually mild to moderate
Constipation	Increase fiber and water intake
Decreased appetite	Expected effect. Ensure adequate nutrition despite reduced hunger

Heart and Blood Pressure

A dedicated heart-rhythm study found that cagrilintide at 4.5 mg did not cause clinically relevant prolongation of the heart QT interval, meaning no signal for increased arrhythmia risk. In the REDEFINE 1 trial, CagriSema lowered blood pressure, and many users reduced or stopped blood-pressure medication. Monitor blood pressure if you take antihypertensives, since doses may need adjustment.

Expected Contraindications (Based on the Incretin Drug Class)

Because cagrilintide does not have an approved label, formal contraindications have not been set. Based on how injectable appetite-reducing therapies in the broader incretin class are handled, the following are expected cautions:

History of pancreatitis: incretin-based therapies have been associated with pancreatitis risk
Gallbladder disease: rapid weight loss and these therapies can raise gallbladder problems
Pregnancy and breastfeeding: no safety data. Avoid entirely
Type 1 diabetes: cagrilintide has not been studied in type 1 diabetes
The CagriSema combination adds semaglutide: when used as CagriSema, the semaglutide component carries the GLP-1 class warning about thyroid C-cell tumors seen in rodent studies, so a personal or family history of medullary thyroid cancer or MEN2 is a contraindication for that combination

Recommended Baseline Labs

Before starting, baseline bloodwork helps you track changes and catch problems early:

Fasting glucose and HbA1c
Complete metabolic panel including liver function (ALT, AST)
Lipid panel
Lipase and amylase (pancreatic markers)
Resting heart rate and blood pressure

Regulatory status: cagrilintide is investigational. The CagriSema combination has been submitted for FDA review, with a decision anticipated in 2026 according to public reporting. Until any approval, there is no FDA-regulated commercial product and no standardized dosing label. Any use is inherently investigational.

Common Cagrilintide Dosing Mistakes

Avoid these errors when using cagrilintide:

Starting at the full target dose without titrating: Skipping the gradual dose increase sharply raises the risk of severe nausea, vomiting, and diarrhea. Every trial used a step-up schedule for good reason. Start low and increase over several weeks.

Assuming monotherapy gives the same results as CagriSema: The headline figure of about 20 percent weight loss is for CagriSema, which is cagrilintide plus semaglutide. Cagrilintide on its own produced roughly 10 percent over 26 weeks. Do not expect combination results from the single molecule.

Treating cagrilintide like a GLP-1 drug: Cagrilintide is an amylin analogue, a different mechanism from semaglutide or tirzepatide. It supplies a fullness signal through the amylin pathway, not the GLP-1 pathway. Dosing, titration, and how it is combined all differ.

Forgetting that CagriSema contains a second medicine: CagriSema is two drugs in one injection. If you build a CagriSema protocol you are dosing both cagrilintide and semaglutide, each titrated to 2.4 mg. Treat it as two co-escalated medicines, not one.

Expecting approved-drug safety data: Cagrilintide is investigational. Long-term safety, rare adverse events, and effects in diverse populations are still being characterized in ongoing trials. You are using a compound that does not yet have an approved label.

Reconstitution and dose-math errors at small doses: Cagrilintide doses are small (well under 5 mg), so a reconstitution or unit-counting mistake easily doubles or halves the dose. Confirm your concentration and the units to draw before every injection.

Frequently Asked Questions

Key Takeaways

Cagrilintide is a long-acting amylin analogue: it copies the after-meal fullness hormone amylin, a different mechanism from GLP-1 drugs
CagriSema is the headline program: cagrilintide 2.4 mg plus semaglutide 2.4 mg produced about 20.4 percent weight loss at 68 weeks in REDEFINE 1
Cagrilintide alone is weaker but real: up to 10.8 percent over 26 weeks, beating liraglutide 3.0 mg
Once-weekly subcutaneous injection: same day each week, about a 7 to 8 day half-life
Titration is mandatory: step up gradually to the 2.4 mg target to limit stomach side effects
CagriSema is two medicines: dose both cagrilintide and semaglutide, each co-escalated to 2.4 mg
Side effects are mostly gastrointestinal: nausea, vomiting, diarrhea, common during titration but largely transient
NOT FDA-approved: the CagriSema combination is under FDA review, with a decision anticipated in 2026 per public reporting

This article is for educational and informational purposes only. See our Disclaimer.

References

Garvey WT, et al. “Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity.” N Engl J Med. 2025;393(7):635-647. PubMed
Davies MJ, et al. “Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes.” N Engl J Med. 2025;393(7):648-659. PubMed
Lau DCW, et al. “Once-weekly cagrilintide for weight management in people with overweight and obesity: a dose-finding phase 2 trial.” Lancet. 2021;398(10317):2160-2172. PubMed
Enebo LB, et al. “Safety, tolerability, pharmacokinetics, and pharmacodynamics of cagrilintide with semaglutide 2.4 mg for weight management: a phase 1b trial.” Lancet. 2021;397(10286):1736-1748. PubMed
Frias JP, et al. “Efficacy and safety of co-administered once-weekly cagrilintide 2.4 mg with semaglutide 2.4 mg in type 2 diabetes: a phase 2 trial.” Lancet. 2023;402(10403):720-730. PubMed
Gabe MBN, et al. “Cagrilintide is not associated with clinically relevant QTc prolongation: A thorough QT study.” Diabetes Obes Metab. 2024;26(12):5805-5811. PubMed
Verma S, et al. “CagriSema Reduces Blood Pressure in Adults With Overweight or Obesity: REDEFINE 1.” Hypertension. 2025;83(2):e26055. PubMed

Next Steps

Continue your research with these resources.

Dosage Calculator

Calculate your exact cagrilintide dose based on vial size and reconstitution volume.

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Semaglutide Dosage Guide

Dosing protocols for the GLP-1 medicine that forms the other half of CagriSema.

Read Guide

Retatrutide Dosage Guide

Another next-generation weight-loss compound, the GLP-1/GIP/glucagon triple agonist.