Investigational long-acting amylin analogue — weekly subcutaneous protocols, the CagriSema combination, reconstitution and safety. For research purposes only — not for human use.
Clean Peptides does not provide advice on dosages or usage. This guide compiles product information from Clean Peptides together with independent educational material from PeptideWiki, for research reference only. It is not medical advice and does not represent recommendations, endorsements, or instructions from Clean Peptides.
What Is Cagrilintide?
Investigational Drug Warning: Cagrilintide (AM833) is NOT FDA-approved. Dosing here is drawn from published clinical trials, not an approved label.
Cagrilintide (AM833) is a long-acting amylin analogue developed by Novo Nordisk. Amylin is a natural hormone released with insulin after meals that signals fullness; cagrilintide copies that signal in a form lasting about a week, so one weekly injection keeps appetite reduced. It is studied alone and combined with semaglutide as a single weekly injection called CagriSema. In the Phase 3 REDEFINE 1 trial, CagriSema reduced body weight by ~20% over 68 weeks.
Key Characteristics
- Long-acting amylin analogue — copies the after-meal fullness hormone; lasts ~a week.
- Appetite and fullness — acts on hunger-control brain regions.
- Slower stomach emptying — prolongs fullness.
- CagriSema combination — paired with semaglutide 2.4 mg as one weekly injection.
- Once-weekly injection — half-life ~7–8 days.
- Investigational — CagriSema under FDA review.
How Dosage Is Determined
Comes directly from controlled trials. Phase 2 monotherapy (Lau et al., Lancet 2021, n=706): dose-dependent weight loss.
| 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% |
Phase 3 CagriSema (REDEFINE 1 & 2, NEJM 2025): cagrilintide 2.4 mg + semaglutide 2.4 mg weekly for 68 weeks.
| Trial | Population | CagriSema | Placebo |
|---|---|---|---|
| REDEFINE 1 | No diabetes | −20.4% | −3.0% |
| REDEFINE 2 | Type 2 diabetes | −13.7% | −3.4% |
The large weight-loss numbers are for CagriSema, not cagrilintide alone.
Dosing Protocols
Cagrilintide Alone (Monotherapy)
| 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 therapeutic range |
| Maintenance | 2.4 mg | Established target (up to 4.5 mg studied) |
CagriSema Combination
Both components co-escalate on the same schedule over ~16 weeks.
| 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 is the most common mistake and causes severe nausea, vomiting and diarrhea.
Cagrilintide vs GLP-1 Drugs
| Feature | Cagrilintide / CagriSema | Semaglutide | Tirzepatide |
|---|---|---|---|
| Mechanism | Amylin (+ GLP-1 in CagriSema) | GLP-1 only | GLP-1 + GIP |
| FDA Status | Investigational (under review) | Approved | Approved |
| Target Dose | 2.4 mg weekly | 2.4 mg weekly | 15 mg weekly |
| Peak Weight Loss (trial) | 20.4% CagriSema, 10.8% alone | ~15–17% at 68 wk | ~22.5% at 72 wk |
| Half-life | ~7–8 days | ~7 days | ~5 days |
Reconstitution & Dosing (with the supplied 3 mL)
Every Clean Peptides vial ships with 3 mL of bacteriostatic water (0.9% benzyl alcohol). All figures below assume you reconstitute with the full 3 mL. On a standard U-100 insulin syringe, 100 units = 1 mL.
Quick formula: concentration = vial strength ÷ 3 mL, and units to draw = dose (mg) × 300 ÷ vial strength (mg).
How to reconstitute
- Wash your hands and lay out the vial, the 3 mL bacteriostatic water, an insulin syringe and alcohol swabs on a clean surface.
- Flip off the caps and swab both rubber stoppers with alcohol; let them air-dry 10–15 seconds.
- Draw the full 3 mL of bacteriostatic water (in three 1 mL passes with an insulin syringe, or in one pass with a 3 mL syringe).
- Add the water slowly, angling the needle so it runs down the inside glass wall — never squirt it directly onto the powder cake.
- Dissolve gently — let the vial sit 1–2 minutes, then swirl or roll it between your palms until the solution is clear. Never shake.
- Label and refrigerate at 2–8 °C. Resulting concentration: 5 mg → 1.67 mg/mL.
Storage: unreconstituted powder refrigerated (2–8 °C); reconstituted solution refrigerated and used within 28–30 days; do not freeze; protect from light and heat.
Draw volumes with 3 mL — Cagrilintide
| Vial (Clean Peptides) | Concentration | 0.6 mg | 1.2 mg | 2.4 mg |
|---|---|---|---|---|
| 5 mg | 1.67 mg/mL | 36 u | 72 u | 144 u* |
* This volume exceeds the 100-unit (1 mL) capacity of a standard insulin syringe — split it into two injections, or draw it with a 3 mL syringe.
Dosage by Goal
- Maximum weight loss: CagriSema (2.4 mg + 2.4 mg/week): ~20.4% at 68 weeks (no diabetes), 13.7% (type 2 diabetes). Co-escalate both components over ~16 weeks; 68-week duration.
- Amylin-only: cagrilintide alone (up to 2.4–4.5 mg/week): up to ~10.8% over 26 weeks at 4.5 mg. Step up from 0.3 mg.
CagriSema produced roughly double the weight loss of cagrilintide alone but adds a second medicine (semaglutide).
Injection Guide
- Wash hands & prepare.
- Swab the vial stopper; air-dry.
- Draw your dose; tap out bubbles.
- Choose the site — lower abdomen (2–3 in from navel), upper thigh, or back of upper arm; rotate weekly.
- Clean the site; air-dry.
- Inject into a pinched fold at 45–90°.
- Dispose in a sharps container.
Timing: once weekly, same day, any time. Half-life ~7–8 days. Missed dose ≤1–2 days late: inject ASAP; more than a few days late: skip and resume next scheduled day.
Treatment Duration
| Phase | Weeks | Description |
|---|---|---|
| Titration | Weeks 1–16 | Gradual increase to 2.4 mg; GI tolerability focus |
| Active Weight Loss | Weeks 16–68 | Full dose; most weight loss occurs here |
| Maintenance | Week 68+ | Stabilization; long-term data still being collected |
Discontinuation typically leads to significant weight regain — plan for long-term use if maintenance is the goal.
CagriSema & Combinations
The only evidence-based combination is cagrilintide + semaglutide 2.4 mg (CagriSema), tested in large Phase 3 trials. Amylin + GLP-1 signals act through different pathways, adding their effects. There is no clinical evidence for pairing cagrilintide with other compounds — stick to what was studied.
Safety, Side Effects & Contraindications
Investigational; long-term and rare adverse events still being characterized.
Gastrointestinal (most common): nausea (peaks during titration), vomiting (more likely if titration is rushed), diarrhea, constipation, decreased appetite. Largely mild-to-moderate and transient.
Heart & blood pressure: cagrilintide 4.5 mg did not cause clinically relevant QT prolongation; CagriSema lowered blood pressure in REDEFINE 1 (monitor if on antihypertensives).
Expected contraindications: history of pancreatitis; gallbladder disease; pregnancy/breastfeeding; type 1 diabetes. The CagriSema combination adds semaglutide’s GLP-1 class warning (medullary thyroid cancer / MEN2 history).
Baseline labs: fasting glucose & HbA1c; CMP with liver function; lipid panel; lipase and amylase; resting heart rate and blood pressure.
Common Mistakes
- Starting at full target dose without titrating.
- Assuming monotherapy gives CagriSema-level results (~10% vs ~20%).
- Treating cagrilintide like a GLP-1 drug (it is an amylin analogue).
- Forgetting CagriSema contains two medicines.
- Expecting approved-drug safety data.
- Reconstitution/dose-math errors at small doses.
Key Takeaways
- Long-acting amylin analogue — a different mechanism from GLP-1 drugs.
- CagriSema (cagrilintide 2.4 mg + semaglutide 2.4 mg) produced ~20.4% weight loss at 68 weeks.
- Cagrilintide alone: up to 10.8% over 26 weeks, beating liraglutide 3.0 mg.
- Once-weekly SubQ, ~7–8 day half-life; titration mandatory.
- NOT FDA-approved — CagriSema under FDA review (decision anticipated 2026 per public reporting).
Download & Related Resources
Shop Cagrilintide: Cagrilintide 5 mg
Related guides: Retatrutide Dosage Guide
References
- Garvey WT, et al. “Coadministered Cagrilintide and Semaglutide in Overweight or Obesity.” N Engl J Med. 2025;393(7):635-647.
- Davies MJ, et al. “Cagrilintide-Semaglutide in Overweight/Obesity and Type 2 Diabetes.” N Engl J Med. 2025;393(7):648-659.
- Lau DCW, et al. “Once-weekly cagrilintide for weight management: a Phase 2 trial.” Lancet. 2021;398(10317):2172.
- Enebo LB, et al. “Cagrilintide with semaglutide 2.4 mg: a Phase 1b trial.” Lancet. 2021;397(10286):1736-1748.
- Gabe MBN, et al. “Cagrilintide and QTc: a thorough QT study.” Diabetes Obes Metab. 2024;26(12):5805-5811.
For research purposes only — not for human use. Educational reference compiled from PeptideWiki (peptidewiki.co).
