Cagrilintide Reference

Long-acting amylin analog · Phase 3 investigational

ClassLong-acting amylin analog
StatusPhase 3 investigational
Typical vials5 mg, 10 mg
Dose range0.25 mg to 2.4 mg
FrequencyOnce weekly
Half-life~7.5 days
Dosing unitmilligrams
RouteSubcutaneous injection

What Cagrilintide is

Cagrilintide is a long-acting amylin analog from Novo Nordisk. Amylin slows gastric emptying and promotes satiety through a different receptor family than GLP-1, which is why cagrilintide is most often studied and used alongside semaglutide as the CagriSema combination.

It is not FDA approved as a standalone. The escalation below is the Phase 2 monotherapy schedule; combination protocols typically run both compounds on the same weekly clock.

What we do not know

  • Most published evidence is for the combination with semaglutide. Monotherapy data is comparatively thin.
  • Not approved. No long-term safety dataset.

Reconstitution math

Concentration is everything: the same 5 mg vial gives a different draw for every amount of bacteriostatic water you add. The table uses the common 2 mL setup for each vial size, which puts every unit on a U-100 insulin syringe at 25 mcg for the default vial. Dashes mark draws too small to measure or larger than the syringe.

VialBAC waterConcentration0.25 mg0.5 mg1 mg1.7 mg2.4 mg
5 mg2 mL2.5 mg/mL10 u20 u40 u68 u96 u
10 mg2 mL5 mg/mL5 u10 u20 u34 u48 u
Cagrilintide syringe drawsDRAW GUIDEEach dose as a filled syringe5 mg vial + 2 mL bacteriostatic water = 0.25 mg per 0.1 mL (10 units).0102030405060708090100units on a U-100 insulin syringe0.25 mg10 u (0.1 mL)0.5 mg20 u (0.2 mL)1 mg40 u (0.4 mL)1.7 mg68 u (0.68 mL)2.4 mg96 u (0.96 mL)peprecon.com
Draw positions for the common doses at the default setup.

Dosing and protocol

Phase 2 monotherapy escalation, 0.25 to 2.4 mg weekly.

With the longest half-life in this library (about 7.5 days), cagrilintide accumulates for roughly five weeks before leveling off. If you model it in the Planner stacked with semaglutide, a same-day weekly schedule for both matches how the trials dosed the pair.

Cagrilintide titration scheduleDOSINGThe published escalation, step by stepDose per injection (weekly), from the schedule cited below.012mg159131721week0.250.511.72.4maintenancepeprecon.com
Each step is held before escalating; the final dose continues as maintenance.

Pharmacokinetics

Cagrilintide has published human pharmacokinetics: half-life about 7.5 days via a fatty di-acid albumin binder. The curves below are normalized one-compartment models built from the cited half-life, the same math the Planner uses. They show shape and timing, not absolute blood levels.

Cagrilintide single-dose curvePHARMACOKINETICSOne dose, start to finishRelative level after one subcutaneous dose. Half-life ~7.5 days; about 97% cleared by 39 days.0%25%50%75%100%0102030days after injectionpeak ~3 dayshalf of peakpeprecon.com
Cagrilintide accumulation with weekly dosingPHARMACOKINETICSThe same weekly dose builds for weeksRelative level with the same dose every week. Levels stop climbing around week 6.0%25%50%75%100%012345678weeks on the same weekly dosesteady statemarkers = weekly injectionspeprecon.com
Why week-one effects understate the eventual dose: levels build for weeks.

How it is thought to work

A long-acting amylin analog. Amylin is co-secreted with insulin and promotes satiety through a pathway separate from GLP-1, which is why it is studied combined with semaglutide rather than against it.

How Cagrilintide is thought to workMECHANISMCagrilintide: the proposed chainA proposed pathway. The last step is the one that needs evidence in people.1Weekly subcutaneous injection2Amylin and calcitonin receptorsAmylin is co-secreted with insulin. This is a satiety pathway separate fromGLP-1.3Satiety signaling independent of the incretin axisWhich is why it is studied combined with semaglutide rather than against it.4Weight loss, mostly as half of a combinationSTRONGEST PUBLISHED EVIDENCE FOR ANY CLAIMED OUTCOMEHuman RCTOutcome by outcome, see the table below.peprecon.com

What the evidence supports

This table grades how well each outcome has been studied in humans, not how well Cagrilintide works. A strong grade means the question was asked properly, and the answer may still have been negative. Nothing here is inherited from a drug class, a close analog, or the parent molecule of a fragment.

OutcomeStrongest published evidence
Weight loss as monotherapyHuman RCT
Weight loss, combined with semaglutideHuman RCT
Long-term safetyNo data
Human RCTAt least one randomized controlled trial in people reports this outcome. The result may still have been negative.
No dataNo published evidence at any level that we could find.

Storage and handling

Lyophilized vials keep best cold, dark, and dry; refrigeration is the community default and freezing lyophilized powder is common for long holds. After reconstitution, refrigerate at 2 to 8 C, do not freeze the solution, and date the vial. Bacteriostatic water's preservative keeps multi-dose use practical for about 28 days by USP convention, though our 120-day stability study found the preservative itself outlasts that window.

Got a certificate of analysis with your vial? Run it through our COA Reader: it reads the report in plain English, checks purity and mass against the label claim, and links the testing lab’s own verification page. Our guide to reading a COA explains what the numbers do and do not tell you.

Sources

  1. Lau et al., Once-weekly cagrilintide for weight management, Lancet 2021PMID 34798060
  2. Frias et al., CagriSema in type 2 diabetes, Lancet 2023

Related references: Semaglutide · Tirzepatide