CagriSema peptide vial
⚖️ Weight Management

CagriSema

CagriSema (Cagrilintide + Semaglutide)

Also called cagrilintide-semaglutide, cagrilintide/semaglutide, CagriSema, Novo Nordisk 2.4/2.4

An investigational amylin and GLP-1 combination

CagriSema is two weight-loss drugs in one weekly injection: semaglutide, the same molecule as Ozempic and Wegovy, plus cagrilintide, which copies a second appetite hormone. In phase 3 it produced roughly 20% body-weight loss. It is investigational and not approved.

CagriSema treats appetite as more than one signal. Semaglutide, the molecule behind Ozempic and Wegovy, works on one hunger pathway. Cagrilintide copies amylin, a different hormone the pancreas releases alongside insulin that signals the meal is over. The combination is given as one weekly injection. In the REDEFINE 1 phase 3 trial it produced roughly 20% body-weight loss, more than semaglutide alone, though short of the 25% Novo Nordisk had aimed for. It is under regulatory review and not approved.

Half-life
About a week for both parts
Route studied
Subcutaneous injection (trials)
Status
Investigational; under regulatory review
Emerging Evidence

Human trials published, with more underway

What CagriSema has been studied for

The reasons people look it up, roughly in order of how often, and what research exists for each. Interest in a use is not evidence that it works; the evidence is stated under each one.

Weight loss (investigational)
In REDEFINE 1 (68 weeks, adults with overweight or obesity), the combination produced roughly 20% body-weight loss and outperformed semaglutide alone. The argument for it is a second, different appetite signal.
Weight loss with type 2 diabetes
Tested separately in REDEFINE 2 in people with type 2 diabetes, where weight loss is reliably smaller. The result was smaller than in REDEFINE 1, which matters when comparing headline numbers.
Blood pressure
Blood pressure fell alongside weight in REDEFINE 1. That is typical for this class rather than specific to this drug.

Mechanism of Action

How CagriSema works

The body has more than one way of signalling fullness, and this drug uses two of them.

  • The familiar one. Semaglutide copies GLP-1, a hormone the gut releases when food arrives. It slows stomach emptying and turns down appetite in the brain. This is the mechanism behind Ozempic and Wegovy.
  • The second signal. Cagrilintide copies amylin, which the pancreas releases at the same time as insulin. Amylin ends a meal by signalling the brainstem. Natural amylin clumps together and cannot be used as a drug, so this version was engineered not to, with a fatty tail added so it lasts about a week.
  • Why two might beat one. They reach the brain by different routes. That is the theory, and REDEFINE 1 supports it: the pair outperformed semaglutide by itself.
  • The set-point question. The body defends a weight it considers normal. Amylin appears to act on that defence rather than only on hunger, which is a hypothesis drawn from its biology.

Neither part is processed by the liver enzymes that handle most medicines. Both are proteins, broken down the way the body breaks down any protein.

CagriSema side effects: what studies reported

The same stomach complaints as semaglutide, in the same pattern: most frequent during dose escalation in the trials.

Most commonly reported

  • Nausea
  • Constipation
  • Vomiting, more often than with semaglutide alone
  • Sharply reduced appetite
  • Reflux

Worth keeping an eye on

  • Muscle loss alongside fat
  • Low blood sugar when combined with insulin or a sulfonylurea

Dose-related findings. In REDEFINE 1, both components were escalated together over several weeks, and most gastrointestinal effects occurred in that period.

Source: REDEFINE phase 3 programme. This is a summary of published findings, not a complete safety profile and not medical advice. Questions about CagriSema belong with a licensed clinician who knows your history.

Your Genetics & CagriSema

The genes involved in how CagriSema works

CagriSema works through the receptors these genes build, and the genes vary from person to person. Researchers have linked some of that variation to differences in how people respond. A DNA report tells you which versions you carry.

Chromosome 1Leptin receptor signaling

LEPR · ••

The Gln223Arg variant in the leptin receptor has been studied for its association with body weight, with mixed results. Amylin interacts with leptin signalling in preclinical work. No study has tested whether this variant changes response to CagriSema.

Chromosome 16Energy-balance set-point

FTO · ••

FTO risk alleles are associated with higher body weight and appetite in population studies. No study has tested whether FTO genotype changes response to CagriSema.

Chromosome 10Beta-cell insulin secretion

TCF7L2 · ••

The common variant most strongly linked to type 2 diabetes risk; T-allele carriers tend to release less insulin after meals. Not studied as a modifier of CagriSema response.

Chromosome 6GLP-1 receptor sensitivity

GLP1R · ••

Builds the receptor the semaglutide half acts on. Some cohort studies of GLP-1 drugs have associated the Gly168Ser variant with differences in weight loss, with inconsistent results. Not studied with CagriSema.

The dots after each gene are where your own result goes. Your report fills them in with the two letters you carry at that position.

Which of these variants do you carry?

Your report reads the DNA file you already have against this research.

Read my DNA, $99

Often discussed alongside

Compounds that come up next to CagriSema in research and discussion. Each has its own page. None of this is a suggestion to combine them.

Semaglutide

componentStrong Evidence

Semaglutide (GLP-1 Receptor Agonist)

A weekly injection sold as Ozempic for diabetes and Wegovy for weight loss. It is a rebuilt copy of a hormone your gut releases after eating, the one that tells your brain you are full, engineered to last a week instead of minutes. Its SELECT trial also showed fewer heart attacks and strokes in people with heart disease and obesity, which became an approved use for Wegovy.

4

Gene variants

200+

Studies

Cagrilintide

componentEmerging Evidence

Cagrilintide (Long-acting Amylin Analog)

A long-acting copy of amylin, a fullness hormone your pancreas releases alongside insulin that works through a completely different route from the GLP-1 drugs. It is mostly discussed as half of CagriSema, where it is paired with semaglutide so that two separate fullness signals are pushed at once.

3

Gene variants

12+

Studies

Access

Access and legal status

CagriSema: Investigational; under regulatory review. Decisions about any prescription medicine belong to a prescriber. We don't link to any seller, and nothing on this page is a recommendation to obtain or use it.

Your DNA and CagriSema: see which of the variants studied alongside it you carry, and what that research does and does not show. Read my DNA, $99 →

Educational information only, not medical advice. Most peptides are not FDA-approved. Do not start, stop or change any medication or peptide because of this page; talk to a licensed clinician.

Worth knowing about CagriSema

Interactions and situations where there is a specific reason to be careful. Where the honest answer is that nobody has studied something, it says so and says what that leaves open.

Investigational, with no lawful consumer source
It is still in regulatory review, so there is no prescription route. Anything sold online under this name is not the tested product.
Stomach side effects are the common complaint
Nausea, constipation and reflux, most frequent during dose escalation in the trials. They are the main reason people stop drugs in this class.
It did not hit its own target
Novo aimed for 25% body-weight loss and landed around 20%. That is still a large number, larger than semaglutide alone, but the trial fell short of what was promised rather than beat it.
Weight comes back when you stop
As with every drug in this family studied so far, appetite returns to where it was after stopping, and so does the weight.

The evidence behind CagriSema

Unusually strong for an unapproved compound: two phase 3 trials in the New England Journal of Medicine and a head-to-head against its own components in Lancet Diabetes & Endocrinology. It is under regulatory review and not approved, so there is no lawful route to it outside a trial.

Every source behind this page5
  1. Cagrilintide-semaglutide versus semaglutide or cagrilintide in people with type 2 diabetes (REIMAGINE 2)Buse JB, Bajaj HS, Dalskov SM, et al. · Lancet Diabetes & Endocrinology · 2026 · Phase 3Human
  2. CagriSema Reduces Blood Pressure in Adults With Overweight or Obesity: REDEFINE 1REDEFINE 1 investigators · Hypertension · 2026 · Phase 3Human
  3. Efficacy and Safety of Cagrilintide Alone and in Combination with Semaglutide (CagriSema) as Anti-Obesity Medications: A Systematic Review and Meta-AnalysisDutta D, Nagendra L, Harish BG, et al. · Indian Journal of Endocrinology and Metabolism · 2024Review

Everything we cite for CagriSema, including preclinical work and early research. Each link goes to the source itself, so you can judge it rather than take our word for it.

Last updated

Frequently Asked Questions

What is CagriSema?

CagriSema is an investigational weight-management combination of cagrilintide (an amylin analogue) and semaglutide (GLP-1), given as one weekly injection in trials. In REDEFINE 1 it produced about 20.4% average body-weight loss over 68 weeks.

Do genes affect CagriSema response?

No study has tested whether any genotype changes response to CagriSema. LEPR and FTO variants have been associated with body weight, and TCF7L2 and GLP1R with blood sugar and GLP-1 drug response, in human studies. A DNA report can show which versions you carry and what that research does and does not show.

Is CagriSema approved?

Not yet. As of 2026 CagriSema is investigational: a new drug application has been filed on the REDEFINE programme and it is under review. Its phase 3 result (about 20.4%) came in below its 25% target. It is not an available prescription.

Your DNA and CagriSema

What the research says about your variants.

The report

Which CagriSema variants do you carry?

Your report reads the DNA file you already have against the published research on 31 peptides, marker by marker, and says what that research does and does not show.

Read my DNA, $99
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