CagriSema
CagriSema (Cagrilintide + Semaglutide)
Also called cagrilintide-semaglutide, cagrilintide/semaglutide, CagriSema, Novo Nordisk 2.4/2.4
The amylin + GLP-1 combo
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. The idea is that hitting hunger through two different channels works better than one. It is not on sale yet.
CagriSema is what happens when you stop treating appetite as one signal. Semaglutide, the molecule behind Ozempic and Wegovy, works on one hunger pathway. Cagrilintide copies amylin, a different hormone your pancreas releases alongside insulin that tells your brain the meal is over. Put both in the same weekly injection and you are pulling two levers instead of one. In the Phase 3 trials that combination took people to roughly 20% of their body weight, more than semaglutide managed alone, though short of the 25% Novo Nordisk had aimed for. The catch is availability: it is under review and not approved, so unlike its two components there is currently no legitimate way to get it.
- Half-life
- About a week for both parts, which is why it is weekly
- Route
- One injection under the skin, once a week
- Typical dose
- 2.4 mg of each, reached slowly over several weeks
- Availability
- Research-only
Human trials published, with more underway
What people use CagriSema for
Reported uses, roughly in order of how often they are the reason someone goes looking. Whether it works for any of them is a separate question, answered under each one.
- Weight loss when one drug has stalled
- The clearest case for it. People who lost weight on semaglutide and then plateaued are the group a second, different appetite signal is meant to help. In the trials it outperformed semaglutide on its own.
- Weight loss with type 2 diabetes
- Tested separately in people with diabetes, because weight loss is reliably smaller in that group. It still worked, just less dramatically, which is worth knowing before you compare headline numbers.
- Blood pressure that travels with weight
- Blood pressure fell alongside weight in the trials. That is typical for this class rather than special to this drug, but it is a real second benefit.
Mechanism of Action
How CagriSema works
Your body has more than one way of telling you to stop eating, and this drug uses two of them.
- The one you already know about. Semaglutide copies GLP-1, a hormone your gut releases when food arrives. It slows how fast your stomach empties and turns down appetite at the source, in the brain. This is the whole mechanism behind Ozempic and Wegovy.
- The second signal. Cagrilintide copies amylin, which your pancreas releases at the same time as insulin. Amylin is the hormone that ends a meal: it tells the brainstem you have had enough. Natural amylin clumps together and is useless as a drug, so this version was engineered not to, with a fatty tail added so one injection lasts a week.
- Why two might beat one. They arrive at the brain by different routes. If your appetite is being driven by something the GLP-1 pathway does not reach, a second lever gives you another chance at it. That is the theory, and the trials support it: the pair outperformed semaglutide by itself.
- The set-point problem. Your body defends a weight it considers normal, and pushes back when you drop below it. Amylin appears to act on that defence rather than only on hunger, which is the argument for why this combination helps people whose weight loss stalled.
Neither part is processed by the liver enzymes that handle most medicines. Both are proteins, so your body takes them apart the way it takes apart any protein.
CagriSema dosage calculator
Opens at 2.4 mg, from the doses reported for CagriSema. Change any box to match your own vial. It works out where to pull the plunger to.
How much is in the vial?
Printed on the label, in milligrams
How much water did you add?
Bacteriostatic water, in millilitres
What dose are you taking?
The dose you already intend to use
Which syringe?
Barrel size, printed on the wrapper
Draw to
48 units
on a 0.5 mL insulin syringe (0.48 mL)
- Strength once mixed
- 5 mg/mL
- Doses in the vial
- 4
10 mg in 2 mL makes 5 mg/mL. A 2.4 mg dose is 0.48 mL of that, which is 48 units.
Want a rounder number? Adding 0.42 mL instead would put this dose at exactly 10 units, which is easier to draw accurately.
This is arithmetic, not advice. It converts a dose you already have into a mark on a syringe. It does not tell you what dose to take, and CagriSema is not prescribed by us. Dosing belongs with a qualified clinician.
CagriSema side effects: what people reported
Two appetite hormones at once does not mean twice the side effects, but it does mean the same stomach complaints as semaglutide, and they arrive in the same pattern: during the build-up, easing after.
What most people notice
- Nausea
- Constipation
- Vomiting, more often than with semaglutide alone
- Appetite dropping off hard, which is the amylin half doing its job
- Reflux
Worth keeping an eye on
- Eating so little that protein intake collapses, which costs muscle
- Low blood sugar if you also take insulin or a sulfonylurea
Dose matters. Both components are raised together over several weeks, and that period is where nearly all of it lands.
Source: REDEFINE Phase 3 programme. This is a summary of published findings, not a complete safety profile and not medical advice. CagriSema should only be considered with a qualified 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.
LEPR · ••
The Gln223Arg variant impairs leptin-receptor signaling, blunting the 'I'm full' signal. CagriSema's amylin arm helps restore leptin sensitivity, so carriers of the impairing allele are mechanistically the people a pure GLP-1 most under-serves — and where the combo earns its place.
FTO · ••
FTO risk alleles raise the body's defended weight set-point and appetite drive. A higher set-point is exactly the case where adding the amylin/leptin arm to GLP-1 is most justified.
TCF7L2 · ••
The strongest common type 2 diabetes variant. T-allele carriers have blunted insulin secretion that the semaglutide component of CagriSema can partly compensate for.
GLP1R · ••
Affects the efficiency of the GLP-1 arm. Weak-signaling variants shift more of the benefit onto the amylin component.
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 variants do you carry?
Upload your DNA data, or get tested through our partner, to find out.
Commonly combined with
What CagriSema is most often paired with, and why:
Semaglutide
componentStrong EvidenceSemaglutide (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. It is also the only weight-loss drug shown to cut heart attacks and strokes rather than just weight.
Cagrilintide
componentEmerging EvidenceCagrilintide (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
Tesamorelin
Visceral Fat StackStrong EvidenceTesamorelin (GHRH Analog)
A stabilized growth-hormone-releasing-hormone (GHRH) analog and the only GH-axis peptide with an FDA approval (Egrifta, for visceral fat in HIV-associated lipodystrophy). It stimulates your own pulsatile GH release, which drives IGF-1 and preferential breakdown of visceral (deep belly) fat — backed by real randomized trial data on VAT reduction. Off-label use for visceral fat is common. WADA-banned in sport.
3
Gene variants
40+
Studies
Sourcing & access
Where to buy CagriSema
CagriSema is sold as a research compound, not a licensed medicine, so quality and legal status vary widely by country and vendor. If you're sourcing it, treat independent purity testing as non-negotiable.
- Insist on a recent third-party Certificate of Analysis (COA) for the exact batch — labs like Janoshik verify purity and identity.
- Check the legal status where you live before ordering — it differs from country to country.
- Reconstitute correctly with bacteriostatic water and start at a conservative dose.
Before you buy: see whether your DNA actually responds to CagriSema, and at what dose. Analyze my DNA — $99 →
Educational information only, not medical advice. Some outbound links are affiliate links (disclosed, at no extra cost to you). Most peptides are not FDA-approved — consult a qualified professional and check your local laws before purchasing.
Worth knowing before you consider 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.
- You cannot legally buy it
- This is the practical headline. It is still going through regulatory review, so there is no prescription route and no pharmacy that can make it. Anything sold online under this name is somebody's own mixture of two separate compounds, not the tested product.
- Stomach side effects are the common complaint
- Nausea, constipation and reflux, worst while the dose is being raised and easing after. It is the main reason people stop on this class of drug, and doubling up on appetite hormones does not make it gentler.
- 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
- Same as every drug in this family. Appetite returns to where it was, and so does the weight, unless something else has changed. Treat it as ongoing rather than as a course.
The evidence behind CagriSema
Unusually strong for a compound people cannot yet buy: two Phase 3 trials in the New England Journal of Medicine and a head-to-head against its own components in Lancet Diabetes & Endocrinology. The caveat is availability rather than evidence. It is under regulatory review and not approved, so there is no legitimate route to it outside a trial.
Studied in people
2 of 4The only kind that directly answers whether it works in humans.New England Journal of Medicine · 2025
HumanCoadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity
Garvey WT, Blüher M, Osorto Contreras CK, et al.
REDEFINE 1, the trial the headline weight-loss figure comes from. 68 weeks, placebo-controlled and also compared against an active drug rather than placebo alone, which is the harder test.
Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity — source for CagriSema (opens in a new tab)Phase 3 · 68 weeks
Read the paperNew England Journal of Medicine · 2025
HumanCagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes
Davies MJ, Bajaj HS, Broholm C, et al.
The same combination tested in people who also have type 2 diabetes, run across 12 countries. Weight loss is consistently smaller in diabetes than without it, which is why this is reported separately.
Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes — source for CagriSema (opens in a new tab)Phase 3 · 68 weeks
Read the paper
Every source behind this page53 more
- 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
- CagriSema Reduces Blood Pressure in Adults With Overweight or Obesity: REDEFINE 1REDEFINE 1 investigators · Hypertension · 2026 · Phase 3Human
- 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 animal 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 used for?
CagriSema is an investigational weight-management combination of cagrilintide (amylin) and semaglutide (GLP-1). It's designed for people who need more than a GLP-1 alone — particularly those with leptin resistance and a high genetic set-point, where the added amylin arm helps restore satiety signaling.
Does genetics affect CagriSema response?
Yes — and in a specific way. LEPR (leptin receptor) and FTO (set-point) variants are what make the amylin arm worth adding; if your genetics point to leptin resistance and a high set-point, CagriSema's combo is more justified than a GLP-1 alone. TCF7L2 and GLP1R shape the semaglutide side.
Is CagriSema approved?
Not yet. As of 2026 CagriSema is investigational — an NDA has been filed under the REDEFINE programme and it's under review. Its Phase 3 result (~20.4% ITT) came in below its 25% target, which is part of the ongoing regulatory picture. It is not an available prescription.
Your next move
Two ways forward with CagriSema.
Not sure it's for you?
How does CagriSema relate to your genes?
Your report scores CagriSema against your receptor, pharmacogene and pathway variants and shows the genetic markers relevant to it, with commonly cited dosing information to review with a clinician.
Analyze my DNA — $99