Cagrilintide
Long-acting dual amylin and calcitonin receptor agonist (DACRA)
- Class
- Amylin agonist
- Half-life
- ~7 days
- Route
- Subcutaneous (SubQ)
- Cadence
- Weekly
- Evidence
- Human clinical trials
Overview
Cagrilintide is a long-acting amylin analog that works through a completely different mechanism than GLP-1 drugs — it hits amylin and calcitonin receptors instead. On its own, weekly injections produced about 12% body weight loss over 68 weeks in the REDEFINE 1 phase 3 trial. Combined with semaglutide (sold as CagriSema), that number jumps to around 22-23% — one of the biggest weight reductions ever recorded in a late-stage pharmaceutical trial. It's the first amylin-based drug to make it to phase 3 for weight management.
Native amylin is a pancreatic hormone that makes you feel full and slows stomach emptying — the same job GLP-1 does, but through a different receptor pathway in the brainstem and hypothalamus. The original amylin drug (pramlintide) required three injections per day and was only approved for diabetes. Cagrilintide was re-engineered with a fatty-acid tail that binds albumin in your blood, stretching the half-life out to a full week. That single change makes it practical as a weekly weight-loss injection.
Side effects mirror the GLP-1 pattern: nausea, vomiting, diarrhoea, and constipation during the first few months, mostly mild-to-moderate. The trials titrated slowly over 17 weeks to manage this. About 6% of participants in REDEFINE quit because of GI issues. Not approved anywhere yet — Novo Nordisk is running the full phase 3 RENEW program for cagrilintide monotherapy and the REDEFINE/REIMAGINE programs for the semaglutide combination.
Safety considerations
A few of the safety signals worth knowing — the full list, with dosing context and what to monitor, is inside AIx Core.
- Not approved by FDA, EMA, MHRA, or any other regulator as of June 2026. The compound sold in research markets is unregulated — purity and actual peptide content vary widely between suppliers.
- GI side effects (nausea, vomiting, diarrhoea, constipation) are the dominant reason people quit during trials — about 6% of participants in REDEFINE 1 stopped because of this. Slowing the titration helps, but expect to feel off during the first 4-8 weeks.
- Gallbladder disease (stones, inflammation) is more common during rapid weight loss on any weight-loss drug. If you get severe right-side abdominal pain, stop and get checked.
+ 3 more safety notes inside AIx Core →
Commonly monitored
Markers and signals people track when researching Cagrilintide.
- Body weight and composition (track lean mass, not just scale weight)
- Appetite and satiety cues — most users notice rapid appetite suppression in the first 1-2 weeks
- GI symptoms — nausea, vomiting, diarrhoea, constipation (most common in weeks 1-8)
- Resting heart rate — amylin agonists can nudge it up slightly
- Gallbladder symptoms if weight loss is rapid (right upper quadrant pain)
- Blood glucose if you're on insulin or sulfonylureas — risk of hypoglycaemia when combined
Frequently asked questions
What is Cagrilintide?
Long-acting dual amylin and calcitonin receptor agonist (DACRA). Cagrilintide is a long-acting amylin analog that works through a completely different mechanism than GLP-1 drugs — it hits amylin and calcitonin receptors instead. On its own, weekly injections produced about 12% body weight loss over 68 weeks in the REDEFINE 1 phase 3 trial. Combined with semaglutide (sold as CagriSema), that number jumps to around 22-23% — one of the biggest weight reductions ever recorded in a late-stage pharmaceutical trial. It's the first amylin-based drug to make it to phase 3 for weight management.
How is Cagrilintide administered?
Subcutaneous (SubQ), typically weekly.
What is the half-life of Cagrilintide?
~7 days — 159-195 hours — supports once-weekly injection, takes weeks to clear after stopping.
Is Cagrilintide approved for human use?
Cagrilintide is investigational — not approved by the FDA, EMA, or MHRA for human use at the time of writing.
What does the evidence show for Cagrilintide?
Evidence tier: Human clinical trials. Lau 2021 (Lancet, phase 2, n=706, 26 weeks): dose-response monotherapy trial. At 4.5 mg/week, mean weight loss was 10.8% vs 3.0% placebo. The 2.4 mg dose (now the standard) produced about 8-9% loss at 26 weeks — chosen because tolerability fell off at higher doses.
What is commonly monitored when researching Cagrilintide?
Commonly tracked markers + signals: Body weight and composition (track lean mass, not just scale weight), Appetite and satiety cues — most users notice rapid appetite suppression in the first 1-2 weeks, GI symptoms — nausea, vomiting, diarrhoea, constipation (most common in weeks 1-8), Resting heart rate — amylin agonists can nudge it up slightly, Gallbladder symptoms if weight loss is rapid (right upper quadrant pain), Blood glucose if you're on insulin or sulfonylureas — risk of hypoglycaemia when combined.
Related compounds
Open this in AIx Core for the full picture
Mechanism breakdown, receptor pathway diagram, full safety list, monitored items, source citations, and one-tap add-to-protocol. Free with any account.