Cagrilintide + Retatrutide (10mg + 10mg)
Investigational stack targeting 4 receptors, combining Cagrilintide (long-acting amylin/calcitonin analog) with Retatrutide (GIP/GLP-1/Glucagon triple agonist). Combined targeting of 4 distinct receptors (Amylin + GIP + GLP-1 + Glucagon) represents the latest 2026 investigational approach for severe obesity. Investigational — no approved indication. Presented for educational purposes only, based on published Phase 2 cagrilintide and Phase 3 TRIUMPH-4 retatrutide data.
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**, as a long-acting amylin analog, activates the calcitonin receptor/RAMP complex (CTR/RAMP), inducing satiety via the area postrema, slowing gastric emptying, and regulating post-meal glucose. **Retatrutide**, a triple agonist, simultaneously activates GIP, GLP-1, and Glucagon receptors — reducing appetite (GIP+GLP-1) while increasing thermogenesis and hepatic lipolysis (Glucagon). The combination activates **4 distinct receptors simultaneously** (Amylin/Calcitonin + GIP + GLP-1 + Glucagon), complementing pathways for satiety, incretin action, and energy expenditure.
Quick Start
- Stack Design: Ratio ~5:1 (cagrilintide : retatrutide) — separate vials.
- Cagrilintide: 0.5–2.4 mg weekly (titration).
- Retatrutide: 0.5–8 mg weekly (staggered co-titration).
- Status: Investigational — not commercially available as a stack.
Staggered Co-Titration (5:1 reference ratio)
Route: Subcutaneous — two separate injections. | Frequency: Once weekly (each peptide).
| Week | Dose | Units (per injection) |
|---|---|---|
| Weeks 1–4 | Cagri 0.5 mg + Reta 0.5 mg | 10 Units (0.10 mL) |
| Weeks 5–8 | Cagri 1.0 mg + Reta 1.0 mg | 20 Units (0.20 mL) |
| Weeks 9–12 | Cagri 1.7 mg + Reta 2.0 mg | 34 Units (0.34 mL) |
| Weeks 13–16 | Cagri 2.4 mg + Reta 4.0 mg | 48 Units (0.48 mL) |
| Weeks 17+ (maintenance) | Cagri 2.4 mg + Reta 6–8 mg | 120–160 Units (1.20–1.60 mL) |
Staggered co-titration every 4 weeks; where severe GI side effects occur, the literature describes holding the current level for 2–4 additional weeks. The two peptides are administered separately. Same day each week.
Related compounds
Reconstitution Steps
Dilution Selection
Peptides come in 3 mL, 5 mL or 10 mL vials. If your vial is smaller, the water amount adjusts automatically.
Cagrilintide 10 mg (10 mg)
Retatrutide 10 mg (10 mg)
⚠️ Units change depending on BAC water — always verify before administration. Based on
- Cagrilintide 10 mg: Add 2.0 mL bacteriostatic water → 5 mg/mL.
- Retatrutide 10 mg: Add 1.0 mL bacteriostatic water → 10 mg/mL.
- Gently swirl until fully dissolved in each vial — do not shake.
- Label reconstituted vials with date; use within 4 weeks.
- Refrigerate at 2–8 °C, protect from light.
Protocol Overview
- Goal: Parallel activation of 4 receptor targets (Amylin + GIP + GLP-1 + Glucagon) for investigational exploration of synergistic metabolic effects.
- Schedule: 16–24 week weekly subcutaneous injections with staggered co-titration.
- Reference Ratio: 5:1 (cagrilintide : retatrutide) based on peptidedosingprotocols.com 2026.
- Status: Purely investigational — no commercial availability or formal clinical trial of the exact combination.
Dosing Protocol
- Initiation: Cagri 0.5 mg + Reta 0.5 mg weekly × 4 weeks.
- Co-titration: Double every 4 weeks up to Cagri 2.4 mg + Reta 4–8 mg.
- Maintenance: Weeks 17+ target Cagri 2.4 mg + Reta 6–8 mg.
- Duration: Minimum 16 weeks; clinical reference 24+ weeks.
- Break between cycles: Following the cycle, an 8–12 week pause is recommended. The 4-receptor combination with both long-acting peptides (~6-day half-life for retatrutide, ~7 days for cagrilintide) necessitates prolonged clearance and metabolic axis restoration.
Washout & Cycle Restart
When can I restart?
Following the cycle, an 8–12 week pause is recommended. The 4-receptor combination with both long-acting peptides (~6-day half-life for retatrutide, ~7 days for cagrilintide) necessitates prolonged clearance and metabolic axis restoration.
Minimum wait period: 8 weeks
Storage Instructions
- Lyophilized vials: −20 °C in dry, dark conditions.
- Reconstituted: 2–8 °C protected from light; use within 4 weeks.
- Allow vials to reach room temperature before reconstitution.
- Avoid freeze-thaw cycles for each vial.
Important Notes
- Investigational stack — no approved indication or formal clinical trial of the exact combination.
- GI symptoms can be additive — slower individual titration may be required compared to each peptide alone.
- Monitor glucose, heart rate, liver enzymes, and thyroid hormones.
- Contraindicated in history of MTC, MEN2, pancreatitis, or severe gastroparesis.
Regulatory Status
The Cagrilintide + Retatrutide combination appears in the research-protocol literature (peptidedosingprotocols.com 2026, realpeptides.co 2026) as a next-generation 4-receptor stack. **There is no formal clinical trial** of this exact combination — the doses come from the individual clinical trial data of the two peptides. Purely educational content.
Peptide Dosing Protocols (2026)Potential Benefits & Side Effects
Potential Benefits:
- 4-receptor coverage: Amylin + GIP + GLP-1 + Glucagon in one combination regimen.
- Potentially additive weight loss (theoretical) based on individual peptide data — Cagrilintide ~10% (Phase 2) + Retatrutide ~28.7% (TRIUMPH-4 Phase 3).
- Parallel glycemic control via GIP/GLP-1.
- Increased energy expenditure via Glucagon action.
- Weekly regimen for both — high compliance.
Potential Side Effects:
- Additive nausea/vomiting (amylin + GLP-1 + GIP).
- Diarrhea or constipation.
- Transient heart rate increase (Glucagon component).
- Potential hyperglycemia from Glucagon — monitoring required.
- Injection site reactions (×2 sites).
- Long-term safety profile of the combination unknown.
⚠️ 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.govPotential thyroid C-cell risk
As a triple GLP-1/GIP/Glucagon agonist, the same class-effect warning as semaglutide/tirzepatide is expected.
📄 Phase 2 Trial — NEJM 2023References
- Peptide Dosing Protocols (2026) — Cagrilintide + Retatrutide stack reference ratio 5:1 and co-titration schedule.
View Source - TRIUMPH-4 Phase 3 (2026) — Retatrutide Phase 3: 28.7% weight loss in 68 weeks.
View Source - NEJM Cagrilintide (2021) — Cagrilintide as an amylin analog for obesity — Phase 2.
View Source - NEJM Retatrutide (2023) — Triple agonist Retatrutide for obesity — Phase 2 (24% weight loss in 48 wks).
View Source - Real Peptides — Cagrilintide vs Survodutide (2026) — Comparative analysis of next-generation peptides 2026.
View Source
Recommended Supplements
Multivitamin (High-Quality)
Magnesium Glycinate
Vitamin D3 + K2
Omega-3 Fish Oil (EPA/DHA)
Probiotics (Multi-Strain)
Electrolytes (Na, K, Mg)
Liver Support (NAC / Milk Thistle)
External Sources & Regulatory Status
Regulatory Approvals
Obesity / Type 2 diabetes
Obesity / Type 2 diabetes
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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