Cagrilintide + Semaglutide (CagriSema) · next-gen weight loss
Novo Nordisk's next-gen weight-loss combination. Amylin-receptor agonism (cagrilintide) plus GLP-1 agonism (semaglutide) for synergistic gastric-emptying delay + central satiety amplification.
Mechanism rationale
GLP-1 (semaglutide) and amylin (cagrilintide) act on overlapping but distinct satiety pathways. Both delay gastric emptying. GLP-1 amplifies satiety primarily via central GLP-1 receptors in hypothalamus + brainstem; amylin amplifies satiety via the area postrema, an independent CNS node. Combining them produces additive (and possibly synergistic) appetite suppression. Novo's REDEFINE Phase 3 program tests CagriSema in obesity and T2D. The 2024 REDEFINE-1 readout showed approximately 22.7 percent mean weight loss at 2.4 mg cagrilintide + 2.4 mg semaglutide weekly over 68 weeks. That number was below pre-trial market expectations (>25 percent) but still competitive with tirzepatide's 22.5 percent in SURMOUNT-1.
Standard dose schedule
Trial protocol: 2.4 mg cagrilintide weekly subcutaneous + 2.4 mg semaglutide weekly. Escalation: 0.25 mg → 0.5 mg → 1.0 mg → 1.7 mg → 2.4 mg over 16 weeks for each component, mirroring semaglutide's titration schedule for tolerability. Research-chem cagrilintide exists but is rare relative to tirzepatide because the lipidation chemistry is harder to synthesise. Most users today running this combination are off-label using research-chem cagrilintide alongside compounded or research-chem semaglutide.
Not medical advice. Reconstitution math at /tools/reconstitution-calculator.
The honest read
Highest-quality evidence base in the peptide-stacks catalog because Novo Nordisk's Phase 3 REDEFINE program is the source. Real Phase 3 data, real safety profile, real weight-loss numbers. Caveats: not yet approved (as of April 2026, regulatory submission underway); off-label research-chem use is the only current access path; cagrilintide quality control in research-chem channels is less mature than tirzepatide.
What both compounds share
GI side effects (nausea, vomiting, constipation) compound when both components are titrated together; slow titration is essential. Pancreatitis risk applies to GLP-1 agonists and may extend to amylin agonism (mechanism is plausible, data is incomplete). Thyroid C-cell tumor signal from rodent semaglutide studies remains a labelled contraindication; same caution applies to combined use. Pregnancy + breastfeeding off-limits. Hypoglycemia risk if combined with insulin or sulfonylureas in T2D users.
Related Panya answers
CagriSema is Novo Nordisk's combination of cagrilintide (amylin agonist) plus semaglutide (GLP-1 agonist). Phase 3 REDEFINE-1 readout 2024 showed about 22.7 percent mean weight los...
For most weight-loss patients, Mounjaro (tirzepatide) is the better first choice if you can get it: higher average loss, similar tolerability. Wegovy (semaglutide) wins on three sp...
Compounded semaglutide from a PCAB-accredited 503A pharmacy with USP-71 sterility testing is clinically similar to brand Wegovy. The variable is the pharmacy, not the molecule. The...
We earn a small commission when you buy through recommended vendors. That is how this stays free. Vendors rank by quality signals, not paid placement.
Last reviewed 2026-04-29. Stack pages refresh when literature, supply, or community practice shifts materially. Email partner@panya.health if you spot something we have wrong.