Cagrilintide + Semaglutide (10mg)
Mixture of Cagrilintide (5 mg, a long-acting amylin analogue) and Semaglutide (5 mg, a GLP-1 agonist) in a single 10 mg vial. Phase 2 clinical trials (CagriSema) show superior weight loss (~15.6% in 32 wk) compared to either agent alone. Administered subcutaneously once weekly with a gradual 16+ week titration schedule.
Reviewed by the AllPeptides.eu Editorial Team·Last reviewed: 2026-06-16
Educational information. Not medical advice, and no efficacy claim is implied. Regulatory approval is not a use recommendation by AllPeptides.eu.
⚠️ For informational/educational purposes only. Not medical advice. We do not sell any products. Self-treatment carries serious risks — consult a healthcare professional. Disclaimer
How It Works
Cagrilintide is a long-acting amylin analogue that acts on CTR/RAMP receptors (calcitonin receptor complex), reducing appetite via hypothalamic signaling, delaying gastric emptying, and regulating postprandial glucose. Semaglutide is an approved GLP-1 agonist that activates GLP-1R receptors in the brain (area postrema, NTS), reducing food intake, enhancing satiety, and improving glycemic control via its insulinotropic action. The combination targets **complementary satiety pathways** — amylin + GLP-1 — producing superior weight loss results compared to monotherapy.
Quick Start
- Reconstitution: Add 3.0 mL of bacteriostatic water → ~3.33 mg/mL (1.67 mg/mL per peptide).
- Typical weekly range: 0.25–2.4 mg per peptide (16+ week gradual titration).
- Storage: Lyophilized: freeze at −20 °C · after reconstitution: refrigerate at 2–8 °C · use within 30 days.
Gradual Titration (3 mL = ~3.33 mg/mL)
Route: Subcutaneous | Frequency: Once weekly
| Week | Dose | Units (per injection) |
|---|---|---|
| Weeks 1–4 | 0.25 mg/peptide (0.5 mg total) | 7.5 Units (0.07 mL) |
| Weeks 5–8 | 0.50 mg/peptide (1.0 mg total) | 15 Units (0.15 mL) |
| Weeks 9–12 | 1.0 mg/peptide (2.0 mg total) | 30 Units (0.30 mL) |
| Weeks 13–16 | 1.7 mg/peptide (3.4 mg total) | 51 Units (0.51 mL) |
| Week 17+ | 2.4 mg/peptide (4.8 mg total) | 72 Units (0.72 mL) |
Studies report administration once weekly subcutaneously, on the same day each week. Gradual titration every 4 weeks significantly reduces gastrointestinal side effects (nausea, diarrhea). If side effects are severe, remain at the current dose level for an additional 2–4 weeks before increasing.
Reconstitution Steps
- Withdraw 3.0 mL of bacteriostatic water with a sterile syringe (ideally a 3 mL syringe with a 21–23 gauge needle).
- Inject slowly down the side of the vial; avoid foaming.
- Swirl gently until fully dissolved (do not shake violently).
- Note the reconstitution date and concentration (~3.33 mg/mL); refrigerate at 2–8 °C; use within 30 days.
Protocol Overview
- Goal: Significant weight loss via dual action of amylin (satiety, gastric emptying) + GLP-1 (satiety, glycemic control).
- Schedule: Weekly subcutaneous injections for 16+ weeks, with gradual titration every 4 weeks.
- Storage: Lyophilized frozen; reconstituted refrigerated; avoid freeze-thaw cycles.
Dosing Protocol
- Start: 0.25 mg per peptide weekly (15 units) for 4 weeks.
- Increase: Every 4 weeks: 0.50 → 1.0 → 1.7 mg per peptide.
- Target: 2.4 mg per peptide from week 17+ (corresponds to CagriSema clinical trials).
- Frequency: Once weekly on a consistent day.
- Important: If nausea is severe, remain at the current level for 2–4 weeks before increasing.
- Break between cycles: After the cycle, a 6–8 week pause is recommended. The cagrilintide + semaglutide combination has a powerful dual action — a longer washout and recovery period is required.
Washout & Cycle Restart
When can I restart?
After the cycle, a 6–8 week pause is recommended. The cagrilintide + semaglutide combination has a powerful dual action — a longer washout and recovery period is required.
Minimum wait period: 6 weeks
Storage Instructions
- Lyophilized: Store at −20 °C in dry, dark conditions.
- Reconstituted: Refrigerate at 2–8 °C; use within 30 days; avoid freeze-thaw.
- Allow frozen vials to reach room temperature before opening.
Important Notes
- Gradual titration every 4 weeks is critical for reducing gastrointestinal side effects.
- Monitor body weight and blood glucose (especially in diabetics).
Potential Benefits & Side Effects
Potential Benefits:
- Superior weight loss (~15.6% in 32 weeks) compared to monotherapy in clinical trials.
- Improved glycemic control (HbA1c, fasting glucose).
- Reduced appetite via a dual mechanism (amylin + GLP-1).
- Weekly administration — high compliance compared to daily regimens.
- Cardiovascular benefits (reduced MACE risk) documented for semaglutide.
Potential Side Effects:
- Nausea, vomiting (usually transient, reduced with gradual titration).
- Diarrhea or constipation.
- Reduced appetite (a therapeutic effect, but can lead to inadequate nutrient intake).
- Rare: pancreatitis, cholelithiasis (gallstones) — monitor if there is a history.
⚠️ Serious Warnings & Long-Term Risks
The following warnings are based on published literature, FDA labels, and post-marketing surveillance. They do not constitute medical advice. Consult a healthcare professional.
Under evaluation: C-cell risk (in CagriSema combination)
Cagrilintide alone showed no signal, but the CagriSema combination is being evaluated in Phase 3.
📄 CagriSema Phase 3 — clinicaltrials.govThyroid C-cell tumors (medullary thyroid carcinoma)
In rodents, semaglutide caused dose-dependent thyroid C-cell tumors (medullary carcinoma). Contraindicated in patients with personal/family history of MTC or MEN 2.
📄 FDA Boxed Warning — Ozempic® / Wegovy® LabelAcute pancreatitis
Reports of acute pancreatitis, including necrotizing. Discontinue if suspected. Increased risk with history of pancreatitis.
📄 FDA Label — Ozempic®Cholelithiasis & cholecystitis
Increased risk of gallstones due to rapid weight change. 1.5–3% incidence in clinical trials.
📄 STEP Trials — NEJM 2021References
- The Lancet — CagriSema: phase 2 clinical trial — superior weight loss
View Source - Semaglutide 2.4 mg in Obesity: STEP Trials — 14.9% Weight Loss at 68 Weeks — JAMA — Semaglutide 2.4 mg: STEP trials — 14.9% weight loss at 68 weeks
View Source - Diabetes Care — Cagrilintide long-acting amylin: pharmacokinetics & results
View Source - N Engl J Med — Semaglutide in non-diabetics: SELECT trial
View Source
External Sources & Regulatory Status
Regulatory Approvals
Obesity
Obesity
Phase III clinical trials
Educational information. Not medical advice, and no efficacy claim is implied. Regulatory approval is not a use recommendation by AllPeptides.eu.
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