Not really an either-or. Cagrilintide is an amylin analog acting on a satiety pathway separate from GLP-1, which is why the trial program studies the two combined rather than against each other.
Side by side
| Cagrilintide | Semaglutide | |
|---|---|---|
| Class | Long-acting amylin analog | GLP-1 agonist |
| Status | Phase 3 investigational | FDA approved |
| Route | Subcutaneous injection | Subcutaneous injection |
| Typical vials | 5 mg, 10 mg | 2 mg, 5 mg, 10 mg, 15 mg |
| Dose range | 0.25 mg to 2.4 mg | 0.25 mg to 2.4 mg |
| Frequency | Once weekly | Once weekly |
| Half-life | ~7.5 days | ~7 days |
| Dosing unit | milligrams | milligrams |
Pharmacokinetics
What the evidence supports
These grade how well each outcome has been studied in humans, never how well either compound works. A strong grade can sit on a negative result.
Both top out at the same tier of evidence: Human RCT. Where they differ is in which outcomes have been asked about, not in how well either has been studied overall.
Cagrilintide
| Outcome | Evidence |
|---|---|
| Weight loss as monotherapy | Human RCT |
| Weight loss, combined with semaglutide | Human RCT |
| Long-term safety | No data |
Semaglutide
| Outcome | Evidence |
|---|---|
| Cardiovascular event reduction | Human RCT |
| Chronic kidney disease progression | Human RCT |
| Glycemic control in type 2 diabetes | Human RCT |
| MASH / liver histology | Human RCT |
| Weight loss | Human RCT |
How to choose
Semaglutide alone has the complete evidence base
Cagrilintide has no approved standalone indication.
The combination is what is actually being developed
CagriSema pairs them deliberately, on the theory that two separate satiety pathways add up.
Cagrilintide alone is the least supported option here
Monotherapy data exist but are limited, and it is not approved in any form.
At the syringe
At the default setup on each compound's own page, a 5 mg vial in 2 mL puts 25 mcg on every insulin unit, while a 5 mg vial in 2 mL puts 25 mcg on every unit. That is the number that decides whether a dose lands on a readable mark, and it is set by how much water goes in, not by the compound.