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Metabolic

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Amylin analog

Cagrilintide

Also known as: AM833, Cagri, Cagrilintide 2.4 mg

Long-acting amylin analog for once-weekly subcutaneous dosing; the other half of CagriSema.

Reviewed 2026-05-04

What it does

Cagrilintide is a long-acting analog of amylin — a co-secreted pancreatic hormone — engineered for once-weekly subcutaneous dosing. It's the amylin half of the CagriSema combination (cagrilintide 2.4 mg + semaglutide 2.4 mg) currently in Phase 3 trials for obesity. As monotherapy, Phase 2 data showed ~10% body-weight reduction at 26 weeks at the 4.5 mg dose. Phase 3 readouts for both monotherapy and combination are the gating data for full clinical use.

Used for

Dose

Starting
300 mcg · once weekly
Common
2,400 mcg · once weekly
Upper
4,500 mcg · once weekly
When
MorningLong-acting amylin analog, once-weekly. Time-of-day functionally flexible, but morning lets the user observe early appetite + GI effects during waking hours rather than overnight.
How long
Continuous (no on/off cycling) on / — off
Site
subcutaneous (titration)
Food
any

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⚠ Caution

  • Personal or family history of medullary thyroid carcinoma or MEN-2 (class warning shared with GLP-1s when co-administered as CagriSema)
  • Severe gastroparesis or other significant pre-existing gastric motility disorder
  • Pregnancy and breastfeeding
  • Pancreatitis history (caution; class signal not yet adjudicated for amylin agonists in isolation)
  • Type 1 diabetes (no efficacy data; not a substitute for insulin)

Will it work for me?

Establish a baseline (2–3 readings over 1–2 weeks before starting), then track at consistent intervals.

Blood markers
  • Tier 1 — Human RCTHbA1c (CagriSema context)↓· repeat at 3 monthsRelevant only when combined with semaglutide as CagriSema; monotherapy amylin glycemic effect is modest.
Functional & psychometric
  • Tier 3 — Animal / in vitroBody weight↓· tracked weekly; monotherapy ~10–12% at 26–68 weeks, CagriSema ~22.7% at 68 weeksScale-based; the primary real-world signal.
  • Tier 3 — Animal / in vitroFood noise / satiety (subjective)↓· within first weeks of titrationNo amylin-specific routine blood assay exists; appetite suppression is tracked subjectively.

Your stack

Track this peptide in your protocol — dose, schedule, vials on hand, refill projection. Stays in your browser; no account needed.

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Use this peptide

Cycling

Continuous (no on/off cycling) on, — off.

Taken continuously, not cycled. The rhythm is a titration ramp: 0.25 mg weekly stepped by 0.25 mg every 2–4 weeks up to 2.4 mg (the REDEFINE / CagriSema maintenance dose); Phase 2 monotherapy went to 4.5 mg. Note unit math: 2.4 mg = 2,400 mcg, 4.5 mg = 4,500 mcg.

Sex-specific dosing
Female
Standard titration; consider extending each dose step if nausea is pronounced.
Male
Standard titration.

Amylin-analog titration is not sex-specific in the trials. As with the GLP class, women report more pronounced nausea during dose escalation; extending each step improves tolerance without compromising end-state efficacy.

Related peptides

Part of these blends

Reconstitution & storage
VialBAC waterConcentrationShelf life
5 mg1 mL0.25 mg per 5 units (5 mg/mL)14–30 days refrigerated
10 mg2 mL0.25 mg per 5 units (5 mg/mL)14–30 days refrigerated

Clinical-trial cagrilintide is supplied as a sterile pre-mixed solution; not patient-reconstituted. This is a Novo Nordisk pipeline asset, not an established research peptide — any compounded lyophilized vial is off-label and of unverified identity. The table below reflects the reconstitution math published for compounded vials. Swirl gently, do not shake.

Storage. Trial product: refrigerate 2–8 °C, protect from light, follow lot-specific expiration. No room-temperature handling guidance has been publicly issued for the commercial form yet.

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Nasal delivery

Not suitable for nasal delivery. Molecular weight too large for efficient nasal absorption; SQ only.

Monitoring & questions

Reported side effects
  • Nausea, vomiting (dose- and titration-dependent; appears more pronounced with combination dosing)
  • Decreased appetite, early satiety
  • Constipation or diarrhea
  • Injection-site reactions
  • Dyspepsia, abdominal discomfort
  • Fatigue during titration
  • Hypoglycemia risk when combined with insulin or insulin secretagogues
Biomarkers Juno tracks

Reference

How it works

Amylin agonist at amylin receptors (AMY1, AMY2, AMY3 — calcitonin receptor + RAMP coreceptors) and weak calcitonin receptor activity. Slows gastric emptying, suppresses postprandial glucagon, and increases satiety signaling in the area postrema. Mechanistically complementary to GLP-1 agonism — different appetite circuits, different gut-emptying kinetics — which is the rationale for the CagriSema combination.

Juno's take

Cagrilintide is the classic "don't get ahead of the data" case. Community framing has run hard ahead of Phase 3, and the combination's first headline readout came in below the most aggressive expectations. Hold the framing conservative until the peer-reviewed Phase 3 publication and independent replication — the amylin biology is genuinely interesting, but interesting biology doesn't equal clinical-outcome certainty yet.

EvidenceTier 2 — Human observational

Tiers are per indication. The same molecule can be Tier 1 for one use and Tier 4 for another — the tier reflects published literature, not community framing.

Weight loss (monotherapy)

Tier 2high confidence

Lau et al. (Lancet 2021, Phase 2, n=706) reported ~10.8% body-weight reduction at 4.5 mg over 26 weeks vs ~3% on liraglutide 3.0 mg comparator. Phase 3 monotherapy data are still maturing; one positive Phase 2 with active comparator clears Tier 2 but not Tier 1.

Lau DCW et al. 2021

Weight loss (CagriSema combination with semaglutide)

Tier 2high confidence

REDEFINE-1 topline (Dec 2024, n>3,400, 68 weeks) reported ~22.7% body-weight reduction at the highest dose — clinically meaningful but modestly under the ~25% the company had guided to and below pre-readout investor consensus. Awaiting full peer-reviewed publication and REDEFINE-2 (T2D) for replication and effect-size stability.

Novo Nordisk A/S et al. 2024Lau DCW et al. 2021

Type 2 diabetes glycemic control (CagriSema)

Tier 2medium confidence

REDEFINE-2 in T2D readout in 2025 showed weight loss and HbA1c improvements; head-to-head positioning vs tirzepatide remains the open question. Tier 2 pending full publication and independent replication.

Novo Nordisk A/S et al. 2024

Satiety / appetite suppression (mechanistic)

Tier 2high confidence

Multiple Phase 1/2 mechanistic readouts confirm reduced ad libitum food intake and slowed gastric emptying consistent with amylin pharmacology. Anchored in pramlintide-class evidence; cagrilintide-specific human satiety endpoints exist but are limited.

Lau DCW et al. 2021
Citations (2)
  1. [1]
    Once-weekly cagrilintide for weight management in people with overweight and obesity: a multicentre, randomised, double-blind, placebo-controlled and active-controlled, dose-finding phase 2 trial
    Lau DCW, Erichsen L, Francisco AM, et al. · The Lancet · 2021 · PMID 34416195
    Anchor Phase 2 monotherapy trial; defines the dose-response shape and the primary safety profile.
    View source
  2. [2]
    REDEFINE-1: CagriSema Phase 3 trial in adults with obesity (topline results)
    Novo Nordisk A/S · Company press release / clinicaltrials.gov NCT05567796 · 2024
    Topline Phase 3 readout for the CagriSema combination indication; full peer-reviewed publication pending.
    View source