Peptide guide

Cagrilintide

A long-acting amylin analog studied for appetite suppression and weight loss, most often paired with semaglutide as CagriSema.

Cagrilintide is a lab-made, long-acting version of amylin, a gut hormone your pancreas releases with insulin to signal fullness. It's given as a once-weekly subcutaneous injection and has reached large phase 3 weight-loss trials, mostly as half of the combination drug CagriSema. It isn't FDA-approved. Novo Nordisk filed CagriSema for approval in December 2025, and the review is pending. People run it for appetite control, so the practical questions are how to handle it correctly and how not to get scammed buying it.

By the Zapify Research team

Reviewed against 9 clinical & research sources · Updated June 2026 · Educational use only

Type: Amylin analogacylated peptide
Route: Subcutaneous
Typical dose: 2.4 mg/wktitrated up
Cycle: Titrate to maintain16-wk ramp
Storage: Mixed: ~4 wksSealed: months
Status: Not FDA-approvedfiled Dec 2025

What is Cagrilintide?

A long-acting amylin analog whose fatty-acid chain stretches its half-life to about a week, given once-weekly; not FDA-approved, with a CagriSema filing pending since December 2025.

Cagrilintide is a long-acting version of amylin, a hormone your pancreas releases alongside insulin after you eat. Amylin tells the brain you're full, slows how fast the stomach empties, and holds back glucagon, the hormone that pushes blood sugar up. Native amylin does its job and disappears within minutes, which makes it useless as a weekly medicine.

Cagrilintide solves that with chemistry. A fatty-acid chain is attached to the peptide, which lets it cling to albumin in the blood and stay in circulation far longer. That single change stretches the half-life to roughly a week, around 159 to 195 hours, so one injection covers seven days. It acts on the same amylin and calcitonin receptors native amylin uses, in the appetite-regulating regions of the brainstem and hypothalamus.

Most of the attention around it comes from CagriSema, a fixed-dose combination of cagrilintide and semaglutide, the GLP-1 drug in Ozempic and Wegovy. The two hormones suppress appetite through different pathways, and the trials were built to see whether stacking them beats either one alone.

Cagrilintide isn't FDA-approved, on its own or as part of CagriSema. Novo Nordisk filed CagriSema with the FDA in December 2025 and the review is pending, so it may be approved later. As of now there's no approved standalone cagrilintide product, and what's sold in research vials is not a finished medicine. Treat it as an investigational compound.

What is it studied for?

It carries unusually strong human data for appetite and weight loss, with cagrilintide 2.4 mg giving roughly 11.8% and the CagriSema combination reaching 22.7% in REDEFINE 1.

Cagrilintide has a much stronger human record than most peptides sold in research vials, because a pharmaceutical company has run it through large registration trials. That evidence is about weight and appetite, not the tissue-repair or recovery claims that belong to other compounds.

Evidence base, by subject

ThousandsHuman trial participants

None yetApproved for sale

The headline numbers come from controlled trials. As monotherapy over 26 weeks, cagrilintide 4.5 mg produced about 10.8% weight loss in a phase 2 study, beating the liraglutide comparator it was tested against. In the 68-week REDEFINE 1 phase 3 trial, cagrilintide 2.4 mg alone gave roughly 11.8% mean weight loss, while the CagriSema combination reached 22.7%, with semaglutide 2.4 mg alone landing in between at about 16.1%. These are the full-adherence figures; measured regardless of whether people stayed on the drug, the CagriSema number was about 20.4%.

Appetite & satietyThe core effect: less hunger, earlier fullness, smaller portions. This is where nearly all the human data sits.

Weight lossDouble-digit percentage reductions in phase 2 and phase 3 trials, larger when combined with semaglutide.

Metabolic markersStudied alongside semaglutide in type 2 diabetes for blood-sugar and weight outcomes in the REDEFINE 2 trial.

The mechanism is unusually well understood for this category. Cagrilintide acts on amylin and calcitonin receptors in the area postrema and hypothalamus, the same brain regions that read native amylin, to dial down appetite. What's still open is the long-term safety picture across years of use and how the standalone drug performs against the combination outside the controlled trial setting.

Why people use it

People use it for appetite control through a satiety pathway separate from GLP-1 drugs, but the research vials aren't the studied product and the biggest numbers came from the combination, not cagrilintide alone.

Most people who try cagrilintide are chasing appetite control and weight loss. These are the reasons they reach for it, not a promise it delivers outside a supervised trial:

Wanting a different lever than GLP-1 drugs pull, since amylin works through a separate satiety pathway.
Stacking it with semaglutide or tirzepatide to push appetite suppression further than one drug manages alone, the same logic behind CagriSema.
Hitting a plateau on a GLP-1 alone and looking for an add-on rather than a switch.
Reaching for a once-weekly schedule that fits the rhythm of the GLP-1 they're already running.

Cagrilintide has real human trial data behind it, which sets it apart from most research peptides. But it isn't approved, the research vials people buy aren't the studied product, and the combination that produced the biggest numbers was semaglutide plus cagrilintide, not cagrilintide alone. The appetite effect is genuine and well-documented. Running an unapproved injectable without medical supervision, at a dose you titrated yourself, is a different proposition than taking the drug a trial gave under monitoring.

How to reconstitute Cagrilintide

A 10 mg vial mixed with 2 mL bacteriostatic water gives 5 mg/mL, which puts a 2.4 mg dose at 48 units on a U-100 syringe.

Cagrilintide research vials arrive as a small puck of dry powder. Before use, you mix it into a liquid, a step called reconstitution. It's the same process used for most injectable peptides, and it's simpler than it looks.

Step 1Start with powderWipe the rubber stopper with an alcohol swab.

Step 2Add bac. waterRun it slowly down the inside wall — never shake.

Step 3Draw your doseThe calculator gives the exact units to draw to.

Wipe the rubber stopper with an alcohol swab first, every time.
Use bacteriostatic water, not plain sterile water and not saline. The trace of benzyl alcohol in it holds back bacteria, which matters because you'll be drawing from the same vial across weeks of weekly doses.
Add the water slowly, running it down the inside glass wall. Don't blast it straight onto the powder.
Don't shake it. Swirl gently and let it dissolve on its own. Shaking foams the solution and can damage the peptide.

A clean setup is a 10 mg vial mixed with 2 mL of bacteriostatic water, which gives 5 mg/mL. On a U-100 insulin syringe, a 2.4 mg dose is then 48 units. The water doesn't change how much peptide is in the vial; it only sets the concentration, which decides how many units you draw. More water means a more dilute mix and a bigger draw for the same dose. You can't ruin it with too much or too little, you only change the draw math, and that's exactly what the calculator handles.

Calculate your exact Cagrilintide reconstitution →

Dose & units

No standalone dose is FDA-approved; the most-studied maintenance is 2.4 mg weekly, reached by stepping up over four-week blocks from 0.25 mg to avoid making yourself sick.

There is no FDA-approved dose for cagrilintide; the filed CagriSema product is a fixed-dose combination, not a standalone you titrate yourself. Everything below is what the trials and clinics report, not a medical standard. Cagrilintide must be titrated slowly to be tolerable, and getting that wrong is how people end up vomiting. Decide what goes into your body with a licensed provider, not with this page.

Typical range

The most-studied maintenance dose is 2.4 mg once weekly, the level used in REDEFINE 1 and the dose inside CagriSema. Phase 2 explored higher monotherapy doses up to 4.5 mg per week, which produced more weight loss but also markedly more nausea.

Titration

Cagrilintide is started low and stepped up over four-week blocks, which is what keeps the gut side effects manageable. The schedule trials use runs 0.25 mg for weeks 1 to 4, then 0.5 mg, then 1.0 mg, then 1.7 mg, reaching the 2.4 mg maintenance dose from week 17 onward. Climbing faster than this is the main way people make themselves sick.

Rampwks 1–16

Maintainwk 17+

For the exact mark to draw to on your insulin syringe at each step of the ladder, don't eyeball it. The calculator turns your vial size, water, and target dose into the precise number of units.

Get your exact units →

Storage

Sealed powder keeps for months at room temperature; once mixed, refrigerate at 2-8 C and use within about four weeks.

Sealed & dryDry, unmixed vial stays stable for months at room temperature and tolerates shipping heat.

ReconstitutedRefrigerate at 2-8 C in the main compartment, use within about 4 weeks, never freeze, and discard if cloudy.

You'll see longer windows quoted for peptide vials. Those figures are beyond-use dates for a sealed, unmixed vial that a compounding pharmacy has stability-tested, and they stop applying the moment you add water. A mixed vial runs on the roughly four-week clock instead, because that's how long the preservative in bacteriostatic water reliably keeps the solution clean once you're drawing from it.

That four-week limit is about sterility, not strength — the peptide itself often stays good well beyond it. Reconstitute with plain sterile water instead of bacteriostatic and you drop to a day or two, since there's no preservative holding bacteria back.

Don't freeze a reconstituted vial, keep it out of direct light, write the mix date on the label, and throw it out if the solution ever turns cloudy or discolored, whatever the date says.

Side effects & safety

The profile is gut-dominated from large human trials, with nausea in about a quarter at 2.4 mg rising to 55% in CagriSema, plus injection-site reactions, constipation, and vomiting.

The side-effect profile is dominated by the gut, and unlike most research peptides, this picture comes from large human trials rather than scattered anecdotes. The effects are mostly mild to moderate and tend to ease as the body adjusts, but they're common, especially early and at higher doses.

Most common: nausea, reported in roughly a quarter of people on 2.4 mg monotherapy and climbing to about 47% at the 4.5 mg dose; in the CagriSema combination it ran higher still, around 55%.
Frequent: injection-site reactions (around 43% at the high monotherapy dose), constipation, and vomiting.
Also reported: reduced appetite to the point of eating too little, fatigue, and occasional dizziness.

Talk to a doctor before starting, especially if you have a history of pancreatitis, gallbladder disease, thyroid C-cell tumors, or any eating disorder. Cagrilintide blunts appetite hard, and combined with a GLP-1 it can blunt it further, which makes undereating and dehydration real risks. Don't use it if you're pregnant or breastfeeding. The gut effects also affect how other medications absorb.

On anti-doping, cagrilintide isn't individually named on the WADA list, but as a non-approved investigational drug it falls under the S0 non-approved-substances category, which is prohibited at all times in tested sport. Athletes should treat it as banned and confirm against the current WADA list and their federation's rules before going near it.

The trial side effects came from a known, controlled product. With a research vial, the biggest risk isn't really the molecule. It's whether what's in the vial is actually cagrilintide, at the strength on the label. That comes down to where you buy it.

How to vet a source

Despite real pharmaceutical backing it only sells on the unregulated market, so demand a batch-specific, third-party COA and match the lot number to your vial.

Cagrilintide sits in an odd spot: a drug with serious pharmaceutical backing that you still can't buy as an approved product, so the only way to get it is the same unregulated research-chemical market that sells everything else. A real share of independently tested vials come back underdosed, impure, or not even the compound on the label, and you can't see any of that in the powder. Where you buy matters more than almost anything else here. The one document that separates a real seller from a gamble is a certificate of analysis: a third-party lab's report on what's actually in the vial.

A real COA shows

An identity test (usually mass spectrometry) confirming the peptide is what the label says.
A purity figure from HPLC, typically 98% or higher.
A lot or batch number that matches the number printed on your vial.
A named, independent accredited lab and a recent test date.

Walk away if

There’s no COA, or it’s a generic image with no lot number.
The “certificate” comes from the seller instead of a third-party lab.
The lot number doesn’t match your vial, or there isn’t one at all.
It’s a flat image you can’t trace back to the lab that issued it.

That's the standard worth holding any seller to, ours included. Ask for the batch-specific COA before you buy, match the lot number to your vial, and don't accept a screenshot in place of a traceable report.

See the Zapify compound catalog →

Common questions about Cagrilintide

Is cagrilintide approved or proven to work in people?

It's proven to cause weight loss in large human trials, but it isn't approved. Cagrilintide alone produced about 11.8% mean weight loss over 68 weeks in REDEFINE 1, and the CagriSema combination reached 22.7%. Novo Nordisk filed CagriSema with the FDA in December 2025 and the review is pending. There's no approved standalone cagrilintide, so research vials are not the finished, regulated product the trials used.

What is CagriSema, and is it the same as cagrilintide?

No. CagriSema is a fixed-dose combination of two drugs: cagrilintide (the amylin analog) and semaglutide (the GLP-1 in Ozempic and Wegovy), each at 2.4 mg, in one weekly injection. Cagrilintide on its own is one half of it. The biggest weight-loss numbers came from the combination, not cagrilintide alone.

How is cagrilintide different from a GLP-1 like semaglutide?

They suppress appetite through different hormones. Semaglutide mimics GLP-1; cagrilintide mimics amylin, a separate satiety hormone your pancreas releases with insulin. Because the pathways are distinct, the two can be combined, which is the whole idea behind CagriSema. Both are once-weekly subcutaneous injections.

Why does cagrilintide need such a slow titration?

Nausea and other gut effects are the main side effects, and they're worst when you start high or climb fast. The trial schedule steps up every four weeks, from 0.25 mg to a 2.4 mg maintenance dose over about 16 weeks, to let the body adjust. Nausea ran around a quarter of people at 2.4 mg monotherapy and near 47% at the higher 4.5 mg dose, so the ramp is what keeps it tolerable.

Why bacteriostatic water and not saline or sterile water?

Because you'll be drawing from the same vial across weeks of weekly doses. Bacteriostatic water carries a trace of benzyl alcohol that holds back bacteria between draws; plain sterile water and saline have no preservative. On a multi-dose peptide vial, the professional sources all point the same way: bacteriostatic.

References

This page is for research and educational purposes only. It is not medical advice or a recommendation to use any compound. The dose ranges shown are reported by clinics and research literature, not validated medical standards, and Cagrilintide is not FDA-approved. Talk to a licensed medical provider about anything you put in your body.