Cagrilintide
Cagrilintide (long-acting amylin analog)
Long-acting amylin analog — appetite control via different pathway than GLP-1
About
Novo Nordisk's long-acting amylin analog. Slows gastric emptying and suppresses appetite via amylin receptors. Studied as monotherapy and as the cagri component of CagriSema.
Mechanism
Selective amylin receptor (AMY1-3) agonist; pancreatic amylin co-secreted with insulin. Slows gastric emptying, suppresses post-meal glucagon, reduces appetite via hindbrain area postrema.
Dosage
Draw to 6 units on a U-100 insulin syringe
5 mg · 1 mL BAC
When to take: Same day each week. Independent of meals.
Reconstitution
Vial size (mg): 5 mg · BAC water (mL): 1 mL · Concentration: 5 mg/mL
Compounded version. Clinical product is pre-filled pen.
Dosing reference
Units to draw at the typical dose range, per vial size.
| Vial | Water | Typical draw |
|---|---|---|
| 5 mg | 1 mL | 6–90 units |
| 10 mg | 1 mL | 3–45 units |
Benefits
- 10-12% weight loss as monotherapy in Phase 2
- Different mechanism than GLP-1 (complementary or alternative)
- Less nausea than semaglutide
- Smooth appetite control without 'food noise' crashes
- Pairs synergistically with semaglutide (see CagriSema)
Side effects
- Nausea (mild, less than GLP-1)
- Decreased appetite (intended)
- Injection-site reactions
- Hypoglycemia (if combined with other diabetes meds)
Gender notes
Cautions
- Pregnancy and breastfeeding
- Severe gastroparesis
- Personal history of pancreatitis
- Type 1 diabetes (limited data)
Research
- Lau DCW et al: Cagrilintide monotherapy in obesity
The Lancet · 2021
26-week Phase 2 trial: ~10% weight loss with cagrilintide alone at 2.4 mg weekly.
- Enebo LB et al: Cagrilintide + Semaglutide (CagriSema)
The Lancet · 2021
20-week proof-of-concept showed 15.6% combined weight loss.