Weight loss, phase 2 monotherapy dose-finding (clinical trial)
Timing and details
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Some human trialsIn clinical trials
Cagrilintide
Also known as: Cagri · Cag · Cagri peptide · NN9838 · NNC0174-0833
Updated 41 sources
Cagrilintide is a long-acting, lab-made version of amylin, the fullness hormone your pancreas releases with insulin after meals. Novo Nordisk added a fatty-acid chain so one shot lasts about a week. It hits a different receptor family from GLP-1 drugs, so most people use it as an add-on to semaglutide, tirzepatide or retatrutide. Paired with semaglutide it is CagriSema, which has phase 3 data and a pending FDA filing. Cagrilintide on its own is not approved anywhere.
Quick facts
- Half-life
- About 7 to 8 days (159 to 195 hours). Levels peak 1 to 3 days after a dose. Measured at 0.16 to 4.5 mg alongside semaglutide.
- Routes
- Subcutaneous injection
- Reported dose ranges
- 0.1 to 4.5 mg (subcutaneous injection)
- Vial sizes
- 5 mg, 10 mg
- FDA status
- In clinical trials
- WADA
- Not confirmed
What people use Cagrilintide for
- Weight loss on its own, as studied in phase 2 and in the cagrilintide-only arm of REDEFINE 1. Rarely run solo in the community.
- An add-on when a GLP-1 stalls and food noise comes back after a few months on tirzepatide or retatrutide.
- Quieting sweet cravings and binge urges that retatrutide alone does not touch, as community posters describe it.
- Running the main GLP-1 at a lower dose, swapping part of a retatrutide or tirzepatide dose for a small cagrilintide dose.
How it is thought to work. Cagrilintide mimics amylin, a hormone released with insulin after meals. Amylin signals fullness to the brain and slows how fast the stomach empties, so meals feel bigger and last longer. A fatty-acid chain attached by Novo Nordisk stretches its half-life to about a week, so it is dosed once weekly. GLP-1 drugs work on a separate receptor family, which is why the two are combined.
Cagrilintide dosing
13 protocols from studies, guides and community reports, grouped by goal. Tap a source badge to see where a number came from.
Weight loss4
Weight loss, phase 2 4.5 mg arm escalation (as described by dosing guides)
Titration (4 steps) and details
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Weight loss, CagriSema (REDEFINE 1 and 2 phase 3 target dose)
Timing and details
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Weight loss, standard 16-week ramp (dosing guides)
Titration (5 steps) and details
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Other protocols: injected9
Weight loss with semaglutide 2.4 mg, phase 1b dose-ranging (clinical trial)
Timing and details
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Add-on to a GLP-1, gradual escalation (dosing guide)
Timing and details
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Retatrutide stack, separate vials (dosing guide)
Timing and details
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Retatrutide pre-blend, 12.5 mg retatrutide plus 2.5 mg cagrilintide vial (dosing guide)
Timing and details
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Tirzepatide stack (dosing guide)
Timing and details
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Low-dose add-on to retatrutide or tirzepatide (community)
Timing and details
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Split weekly add-on to tirzepatide (community)
Timing and details
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Slow climb from a low start (community)
Timing and details
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Trial-range dose alongside retatrutide (community)
Timing and details
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Doses shown are what sources report, labelled by origin. Not medical advice.
Full Cagrilintide dosage guideEvery titration step in syringe units, missed doses and how to mix.Vial strengths and syringe units
Every Cagrilintide vial size with the water volumes sources use. Units are what to draw on a U-100 insulin syringe, worked out exactly.
| Water | Strength | 0.25 mgdose, units | 2.4 mgdose, units | 4.5 mgdose, units |
|---|---|---|---|---|
| 5 mg vial | ||||
| 2 mLCompetitor guide | 2.5 mg/mL | 100.1 mL | 960.96 mL | 1801.8 mL2 draws |
| 3 mLCompetitor guide | 1.667 mg/mL | 150.15 mL | 1441.44 mL2 draws | 2702.7 mL3 draws |
| 10 mg vial | ||||
| 1 mLCompetitor guide | 10 mg/mL | 2.50.025 mL | 240.24 mL | 450.45 mL |
| 2 mLCompetitor guide | 5 mg/mL | 50.05 mL | 480.48 mL | 900.9 mL |
| 3 mLCompetitor guide | 3.333 mg/mL | 7.50.075 mL | 720.72 mL | 1351.35 mL2 draws |
Units are on a U-100 insulin syringe (100 units = 1 mL). U-50 and U-30 barrels read the same units.Water volumes from
Doses shown are what sources report, labelled by origin. Not medical advice.
Calculate with this peptideYour vial, your water, your dose: Cagrilintide in syringe units, with the math shown.What people report
What Cagrilintide users write on Reddit, counted post by post. These are reports, not measured rates or advice.
Community-reportedFrom 900 Reddit posts and comments, last mined Oct 23, 2026r/Retatrutide, r/Peptidesource, r/Peptides, r/PeptideDiscussion
Doses people report for Cagrilintide
Weight loss149 mentions
| Reported | Mentions |
|---|---|
| 0.25 mg | 33 |
| 1 mg | 33 |
| 0.5 mg | 20 |
| 250 mcg | 9 |
| 2 mg | 8 |
Goal not stated36 mentions
| Reported | Mentions |
|---|---|
| 0.25 mg | 6 |
| 1 mg | 6 |
| 2.5 mg | 6 |
| 1.5 mg | 3 |
| 0.5 mg | 2 |
How often
| Reported | Mentions |
|---|---|
| Once a week | 49 |
| Twice a week | 8 |
| As needed | 2 |
Most mentioned alongside
- Retatrutide222
- Tirzepatide53
- MOTS-c11
- Semaglutide8
- Tesamorelin7
- Human growth hormone6
Side effects people mention
Fatigue24 mentions
Most common fixes: stop taking cagrilintide (3), lower the dose (2)
Nausea12 mentions
Most common fix: lower the dose (2)
Reduced appetite9 mentions
Side effects4 mentions
Vomiting4 mentions
Constipation4 mentions
Doses shown are what sources report, labelled by origin. Not medical advice.
Cagrilintide side effects
What trials and labels report, kept apart from what users and guides report. Frequencies are worded as each source states them.
Reported in studies and labels3
From clinical trials and regulatory documents.
Constipation and diarrhoea
Named among the most frequent adverse events in the phase 2 trial. The abstract gives no separate rates.
Stomach and gut side effects with CagriSema
GI events in 79.6% vs 39.9% on placebo in REDEFINE 1, and 72.5% vs 34.4% in REDEFINE 2 (type 2 diabetes).
Stopping treatment because of side effects
4% (30 people) across all phase 2 arms. With CagriSema in REDEFINE 1, 5.9% vs 3.5% on placebo, per press coverage of the results.
Reported by users and guides6
From community reports and dosing guides. Not measured rates.
Stomach and gut side effects (overall)
GI adverse events in 41 to 63% on cagrilintide 0.3 to 4.5 mg vs 32% on placebo in the 26-week phase 2 trial.
How people manage it
- If stomach side effects are intense, step back to the previous dose until they settle.
Nausea
Nausea in 20 to 47% on cagrilintide vs 18% on placebo in the phase 2 trial.
How people manage it
- If stomach side effects are intense, step back to the previous dose until they settle.
Injection-site reactions
A dosing guide attributes 43% at 4.5 mg to the phase 2 trial; we could not confirm that figure. The trial abstract lists administration-site reactions among the most frequent.
Fatigue (dosing guide figure)
A dosing guide attributes fatigue in 20% at 4.5 mg to the phase 2 trial; we could not confirm that figure in the abstract.
Fatigue and low energy
The most common community complaint. In an r/cagrilintide poll of 40 people, 60% reported more fatigue, 37.5% no change and 2.5% more energy.
How people manage it
- Eat planned meals instead of skipping them; posters say this blunts the early tiredness.
Strong reaction to a first 0.25 mg dose on top of a GLP-1
Community posts describe lethargy, bloating, constant burping and fewer bowel movements, and in one case vomiting and one meal a day for a week on semaglutide.
How people manage it
- Start lower when adding to an existing GLP-1. Posters often wish they had started at 0.125 mg, and many start at 0.1 to 0.25 mg.
Storage
Powder (before mixing)
- Temperature
- 2 to 8 °C
Keep the powder in the fridge at 2 to 8 °C. Guides disagree on freezing: one lists -20 °C for up to 24 months, another says never freeze. There is no approved label for cagrilintide alone.
Mixed vial
- Temperature
- 2 to 8 °C
- Use within
- 28 days
Keep the mixed vial at 2 to 8 °C, away from light, and use it within about 28 to 30 days. That window is borrowed from semaglutide labels. Do not shake it: amylin analogues can clump into fibrils, so throw out any cloudy solution.
Mixed with: Bacteriostatic water
Mixing. Very concentrated mixes make small starting doses hard to draw accurately, so guides warn against using too little water in a 10 mg vial. At low add-on doses a 10 mg vial lasts far longer than the usual 28 days after mixing. Blended vials also exist, such as 12.5 mg retatrutide plus 2.5 mg cagrilintide mixed with 2.5 mL. Do not shake. Some users add dilute acetic acid before the water to lower pH; no study supports this.
Stacks people report
Combinations from guides and community posts, with the reason given.
The only pairing with human data. Together they are CagriSema: 17.1% weight loss at 20 weeks vs 9.8% on semaglutide plus placebo in phase 1b, and 20.4% at 68 weeks in REDEFINE 1.
The most searched pairing. Posters say retatrutide leaves some appetite and cravings untouched, and amylin adds fullness. The common pattern is retatrutide first, cagrilintide later on a different day. Evidence is one rat study from 2026; no human trial.
Used to break plateaus at tirzepatide 15 mg. Evidence is one rat abstract; no human trial has tested the pairing.
Compare Cagrilintide
Evidence and legal status
Evidence: some human trials
Cagrilintide alone: a 706-person phase 2 trial plus a monotherapy arm in phase 3 REDEFINE 1. CagriSema (with semaglutide): strong, from several phase 3 trials. With tirzepatide or retatrutide: no human data, only rat studies.
FDA and WADA
In clinical trials
Under FDA-regulated trials; not approved yet.
Not FDA approved. Cagrilintide alone has no approval. Novo Nordisk filed an NDA for CagriSema (cagrilintide plus semaglutide) on December 18, 2025. Secondary reports place the decision in Q4 2026; we found no approval announcement as of 2026-10-23.
Cagrilintide is not named on the FDA list of bulk substances that may pose safety risks in compounding, and we found no legal compounding pathway. Online sellers market it as research use only. WADA does not name it on any page we could retrieve; as an unapproved drug it would likely fall under S0 (non-approved substances), but this is unconfirmed.
WADA: Not confirmed
Cagrilintide questions
What is the starting dose of cagrilintide?
Dosing guides start at 0.25 mg once a week. The lowest phase 2 trial arm was 0.3 mg. People adding it to a GLP-1 often go lower, around 0.1 to 0.25 mg, because a first 0.25 mg dose on top of a GLP-1 hits some people hard.
What doses were used in the clinical trials?
Phase 2 tested 0.3, 0.6, 1.2, 2.4 and 4.5 mg once weekly for 26 weeks. CagriSema trials use 2.4 mg cagrilintide with 2.4 mg semaglutide for 68 weeks.
How much bacteriostatic water goes in a 5 mg vial?
Dosing guides use 2 or 3 mL for a 5 mg vial. More water makes small doses easier to measure. Use our calculator to turn your dose into syringe units.
Can I take cagrilintide with tirzepatide or retatrutide?
People do, and dosing guides publish ladders for both. No human trial has tested either pairing. The evidence is one rat study for retatrutide and one rat abstract for tirzepatide. The only combination with human data is semaglutide (CagriSema).
Should I inject cagrilintide on the same day as my GLP-1?
Dosing guides say the same day is fine if you use separate sites. Many community users split days instead, for example two days after retatrutide, to spread out side effects.
Why does cagrilintide make me so tired?
Fatigue is the most reported community side effect. In a 40-person r/cagrilintide poll, 60% said they felt more tired. Some say it fades and some quit over it. Posters report that eating planned meals helps early on.
How much weight do people lose on cagrilintide alone?
Phase 2 reported 6.0 to 10.8% at 26 weeks across 0.3 to 4.5 mg, against 3.0% on placebo. In REDEFINE 1 the cagrilintide-only arm is reported at 11.8% at 68 weeks in people who stayed on treatment.
Is CagriSema approved?
No. Novo Nordisk filed an NDA with the FDA in December 2025, and secondary reports expect a decision in Q4 2026. We found no approval as of October 2026.
Eloralintide or cagrilintide?
Eloralintide reached 20% weight loss at 9 mg over 48 weeks in phase 2. Users report it causes less fatigue, but that is anecdotal: the trial showed fatigue in up to 46% depending on arm. There is no head-to-head trial.
Why shouldn't I shake cagrilintide?
Amylin analogues can clump into fibrils when agitated. Throw out any solution that turns cloudy.
Why do I see both 20.4% and 22.7% for CagriSema?
They come from the same REDEFINE 1 trial measured two ways. 20.4% counts everyone who was randomised, including people who stopped. 22.7% counts only people who stayed on treatment. Neither number is wrong.
Ask about Cagrilintide
Answers come from this site's pages only, with a link to each source.
Sources
41 sources, each checked by date. Record updated Oct 23, 2026. Numbers are restated in our own words and labelled by where they came from.
Clinical study10
- Lau et al. Once-weekly cagrilintide for weight management: phase 2 (Lancet 2021)PubMed · checked Oct 23, 2026
- NCT03856047 resultsClinicalTrials.gov · checked Oct 23, 2026
- Enebo et al. Cagrilintide with semaglutide 2.4 mg: phase 1b (Lancet 2021)PubMed · checked Oct 23, 2026
Regulatory7
- CagriSema did not meet primary end point of noninferiority to tirzepatideDrug Topics · checked Oct 23, 2026
- Novo Nordisk submits NDA to FDA for CagriSemaPharmExec · checked Oct 23, 2026
- Novo Nordisk files for FDA approval of CagriSemaBioSpace · checked Oct 23, 2026
Competitor guide6
- Cagrilintide Peptide Dosing Guidepeptidedosingprotocols.com · checked Oct 23, 2026
- Cagrilintide + Retatrutide Stack Guidepeptidedosingprotocols.com · checked Oct 23, 2026
- Cagrilintide + Tirzepatide Stack Guidepeptidedosingprotocols.com · checked Oct 23, 2026
Community-reported18
- I find that I still crave junk food on reta (comment)r/Biohacking · checked Oct 23, 2026
- 4mg changed it all (comment)r/Biohacking · checked Oct 23, 2026
- Reta or tirz (comment)r/Tirzeglutide · checked Oct 23, 2026