Cagrilintide
Long-Acting Amylin Analog (Novo Nordisk)
Evidence grade 3 of 5, Mixed. Read how the Atlas grades evidence.
Cagrilintide is an investigational long-acting amylin analog, not an approved drug. The strongest evidence for cagrilintide as monotherapy is a single dose-finding Phase 2 trial (Lau et al., Lancet 2021), where the 4.5 mg weekly dose was associated with roughly 10.8 percent weight loss over 26 weeks versus about 3.0 percent for placebo. Most later data study it in fixed combination with semaglutide (CagriSema), where the Phase 3 REDEFINE 1 trial reported about 22.7 percent weight loss at 68 weeks; the combination missed its 25 percent target and, in REDEFINE 4, did not show non-inferiority to tirzepatide. Novo Nordisk filed a CagriSema NDA on 18 December 2025, but as of mid-2026 neither cagrilintide nor CagriSema is FDA-approved, and the combination data grade the combination, not cagrilintide alone.
- FDA
- Investigational; CagriSema NDA filed 18 Dec 2025, FDA decision expected late 2026. Not approved as of mid-2026.
- WADA
- Not listed on the WADA Prohibited List
Reference only. Not medical advice.
What can go wrong
Investigational; combination gastrointestinal and safety profile still being characterized in Phase 3. Compounded or gray-market cagrilintide is unapproved, illegal to sell for human use, and of unverified content.
Talk to a clinician before taking this. The Atlas can tell you what has been studied about Cagrilintide. It cannot tell you how it would interact with your body, your history, or anything else you are taking, and nothing on this page is a reason to start.
A long-acting amylin analog from Novo Nordisk, studied mostly in fixed combination with semaglutide as CagriSema. In Phase 3 REDEFINE 1 the combination was associated with about 22.7 percent weight loss at 68 weeks, which fell short of its 25 percent target; cagrilintide alone produced about 10.8 percent over 26 weeks in Phase 2. It is investigational and not FDA-approved, and any compounded or research-market cagrilintide sold today is unapproved and outside legal channels.
What people take it for
These are the reasons people give for taking it. They are not effects it has been shown to have.
How it is supposed to work
Cagrilintide is a long-acting copy of amylin, a hormone the pancreas releases alongside insulin after eating. Amylin promotes fullness, slows how fast the stomach empties, and dampens the sugar-raising hormone glucagon, working through amylin receptors in the brainstem and hypothalamus. Cagrilintide also activates the related calcitonin receptor, making it a dual amylin/calcitonin agonist. Engineered to last a week, it provides a steady satiety signal that, on its own, produces moderate weight loss and, combined with a GLP-1 drug, produces a great deal more.
Cagrilintide is a synthetic amylin analog of about 36 amino acids, modified with a lipophilic side chain so it binds proteins in the blood and can be dosed once weekly, a major advance over the older amylin drug pramlintide, which had to be injected at every meal. It is a non-selective agonist, hitting both amylin and calcitonin receptors. Developed by Novo Nordisk, it entered trials in the mid-2010s and is best known as the amylin half of the combination CagriSema, though it has also been studied on its own.
- Type
- Long-acting amylin analog
- Size
- ~36 amino acids
- Targets
- Amylin + calcitonin receptors
- Dosing
- Once weekly
- Monotherapy
- ~11.8%
- Status
- Investigational
Modest Alone, A Pillar As A Class
The honest thing to say about cagrilintide is that as a solo drug it is unremarkable, and that this misses the point. On its own it produces roughly 11 to 12% weight loss, less than semaglutide, so it would never be a headline product alone. Its real importance is as proof that amylin works in humans and as the lead molecule of what the industry now calls the amylin renaissance. Amylin is the only mechanism shown to add weight loss on top of GLP-1, and that single fact has triggered a land rush: by 2026 some 40 amylin programs were in development with around $19 billion in deals, spanning nearly every major drugmaker. So cagrilintide matters less for what it does in one vial than for the door it opened, and the question it raises is which form of amylin, a combination, a single dual-acting molecule, or a selective agonist, ultimately wins.
Safety in detail
The FDA has indicated cagrilintide cannot lawfully be used in compounding, so clinics or online sellers offering compounded or research-grade cagrilintide are operating outside federal boundaries. Product from that channel has no assurance that label matches contents.
- Nausea is the main effect, reported in about a quarter of cagrilintide monotherapy users, consistent with the amylin mechanism.
- Other gastrointestinal effects typical of satiety drugs occur, and its calcitonin-receptor activity is of uncertain long-term significance.
- As an investigational compound used mainly within the CagriSema combination, its standalone long-term safety is not fully characterized.
- It is a regulated pharmaceutical candidate, not a gray-market peptide, so the relevant risks are clinical rather than sourcing-related.
- Amylin analogs are not prohibited in sport.
Children and teenagers
Cagrilintide is investigational and has no pediatric data, approval or rationale. Like the rest of the amylin class, its use is confined to adult obesity trials. Pediatric questions are premature and would, as with other incretin and satiety drugs, require their own dedicated trials and regulatory review; this is a development-stage molecule, not a gray-market one that minors might misuse.
What people get wrong
Nothing recorded here yet. There is almost certainly something people get wrong about this one, and the blank space means we have not written it down, not that the record is clean.
Who profits, and who pushes back
Nobody is named here yet, because we have not done that work on this entry. Read that as unfinished. Somebody almost certainly sells this, and somebody almost certainly disputes it. Assume both until we have checked.
Cagrilintide's value to Novo Nordisk is both as a product component and as a platform: it anchors CagriSema and informs the company's single-molecule successor amycretin. More broadly, it sits at the center of a roughly $19 billion wave of amylin dealmaking, with Lilly (eloralintide), Roche (petrelintide via Zealand), Pfizer, AbbVie and AstraZeneca all pursuing the mechanism. This is concentrated, regulated pharmaceutical value, not a gray-market trade; the money is in who builds the best amylin drug, not in vials sold online.
How we got here
Cagrilintide is a Novo Nordisk long-acting amylin analog developed under the codes AM833 and NNC0174-0833, engineered with acylation technology for once-weekly dosing. It has been studied on its own for weight management and in fixed combination with semaglutide as CagriSema. It remains investigational.
Cagrilintide's story is the amylin story. The hormone was validated in obesity by the short-acting analog pramlintide (approved for diabetes as Symlin), which showed modest weight loss but required injection at every meal. Novo Nordisk re-engineered amylin into a non-aggregating, weekly molecule, cagrilintide, which entered trials in the mid-2010s and became the first practical once-weekly amylin analog. Paired with semaglutide as CagriSema, it demonstrated strong combination efficacy, and that success set off the amylin renaissance, with Lilly's eloralintide, Zealand and Roche's petrelintide, Novo's own amycretin and many others racing to build the next pillar of obesity medicine.
- 1990s-2000sAmylin biology validated; pramlintide approved for diabetes, showing modest weight loss.
- Mid-2010sNovo develops cagrilintide, the first weekly amylin analog; it enters trials.
- 2021Monotherapy dose-ranging data confirm cagrilintide works for weight loss.
- 2024-2025As the amylin half of CagriSema, it shows strong combination efficacy in REDEFINE.
- 2025-2026The amylin renaissance accelerates: eloralintide, petrelintide, amycretin and dozens more advance.
The numbers behind the grade
- Type
- Amylin analog
- Monotherapy
- ~11.8%
- Role
- Amylin half of CagriSema
- Class
- 40+ programs
- Deals
- ~$19B
- Status
- Investigational
The people taking it
Individually low-profile, but collectively pivotal: cagrilintide is the lead molecule of the amylin renaissance, the hottest new mechanism in obesity medicine after GLP-1 and GIP, and the validation point that drew the entire industry into the field.
Cagrilintide's populations are trial-defined, primarily adults with obesity, often studied as the amylin component within CagriSema rather than as a standalone therapy. If amylin drugs reach market broadly, their demographics would mirror the obesity-drug population, with particular relevance to people who respond poorly to GLP-1 drugs, since amylin offers a different mechanism. There is no self-sourcing community, because this is a regulated pipeline molecule.
Used only within Novo Nordisk's trials, chiefly as the amylin component of CagriSema; not marketed as a standalone drug. Its significance is as the proof and lead of a fast-emerging class. Not prohibited in sport.
Set against the alternatives
Compared head-to-head, cagrilintide alone (about 11.8%) trails semaglutide (16.1%) and is far below the CagriSema combination (22.7%) that it is part of, which is exactly why its destiny is combination rather than monotherapy. Within its own class it now has company: Lilly's eloralintide reached roughly 20% at the top dose as a selective amylin agonist, Zealand and Roche's petrelintide offers an even longer half-life, and Novo's own amycretin folds amylin and GLP-1 into a single molecule. Whether dual amylin/calcitonin agonism like cagrilintide's, selective amylin agonism like eloralintide's, or unimolecular combos like amycretin win out is the live debate, and there is no Phase 3 head-to-head yet to settle it.
| Pramlintide | Amylin (3x daily) | ~3 to 5% | Approved (diabetes) |
|---|---|---|---|
| Cagrilintide | Amylin (weekly) | ~11.8% | Investigational |
| Eloralintide | Selective amylin | ~9 to 20% | Phase 2 |
| CagriSema | Amylin + GLP-1 | ~22.7% | NDA filed |
| Amycretin | Amylin + GLP-1 (one molecule) | high (early) | Phase 2 |
What we do not know
- Whether amylin monotherapy ever has a standalone role, or whether its future is purely in combinations.
- Whether selective amylin agonism (eloralintide) outperforms dual amylin/calcitonin agonism (cagrilintide) in humans.
- Whether single molecules that combine amylin and GLP-1, like amycretin, make two-drug combinations obsolete.
- What the long-term safety of sustained amylin and calcitonin receptor activation looks like.
- How high the amylin class can push weight loss when optimally combined or dosed.
What could change
The amylin renaissanceRoughly 40 programs and $19 billion in deals make amylin the field’s next major pillar.Single-molecule amylin-GLP-1 drugsAmycretin and similar molecules may combine both mechanisms in one agent.Selective versus dual agonismWhether eloralintide’s selective approach beats cagrilintide’s dual one is a defining open question.CagriSema approvalThe first amylin-based product to reach the FDA, carrying cagrilintide into the market.
Legal status
Cagrilintide is not approved as a standalone drug anywhere. It reaches patients only within Novo Nordisk's trials and, as the amylin half of CagriSema, within that combination's December 2025 FDA filing. There is no legitimate or gray-market route to obtain cagrilintide on its own; it exists as a pharmaceutical molecule in development. Its future availability is tied to CagriSema and to the broader amylin class rather than to any standalone launch.
Status current as of July 2026. Regulatory positions change, sometimes quickly.
The market for this
What follows describes how this is bought and sold. It is not a buying guide and it is not an endorsement of any seller.
Cagrilintide cannot be bought on its own; it is an investigational pharmaceutical, not a research-vendor product. Future access would come through approved amylin-based medicines like CagriSema, by prescription, rather than through any direct-to-consumer or gray-market channel.
There is no standalone price, since cagrilintide is not sold on its own. Its commercial expression is through CagriSema and potential future amylin products, which would be priced as branded obesity medicines, with real-world cost shaped by insurance and the usual access dynamics of the class.
The only source is Novo Nordisk's regulated manufacturing for trials and combination products. Unlike the single peptides elsewhere in this library, cagrilintide has no gray-market sourcing dimension, which reflects its status as a pipeline drug rather than a research chemical.
Novo Nordisk (regulated)Manufactured under cGMP for trials and, within CagriSema, for future commercial supply; a controlled chain.Not a gray-market productCagrilintide is a pharmaceutical investigational molecule, not a research-vendor item, so it does not circulate as gray-market vials.A whole class in developmentParallel regulated supply chains are being built across the industry for competing amylin analogs.
What this entry does not yet cover
What follows is unfinished work on our side, not a finding about Cagrilintide.
Nothing outstanding on this one.
Sources
Cagrilintide monotherapy 4.5 mg gave ~10.8% weight loss over 26 weeks vs ~3.0% placebo in a Phase 2 dose-finding trial
Phase 2 co-administration of once-weekly cagrilintide 2.4 mg with semaglutide 2.4 mg in type 2 diabetes
REDEFINE 1 Phase 3: CagriSema ~22.7% weight loss vs cagrilintide 11.8%, semaglutide 16.1%, placebo 2.3% at 68 weeks
CagriSema fell short of the 25% weight loss target in patients with obesity or overweight
REDEFINE 1 combination delivered over 20% weight loss in the majority of patients
CagriSema achieved ~23% weight loss but failed to show non-inferiority to tirzepatide in REDEFINE 4
Novo Nordisk filed the CagriSema NDA with the FDA on 18 December 2025, based on REDEFINE 1 and REDEFINE 2
CagriSema is not yet FDA approved; it is under FDA review with a decision anticipated by late 2026
CagriSema significantly improved blood pressure, waist circumference, lipids, and glycemic control in REDEFINE 1
Cagrilintide is not FDA approved and cannot lawfully be used in compounding; gray-market vials are unapproved and of unverified content
The studies that matter
Lau et al, cagrilintide dose-ranging2021
Established weekly cagrilintide monotherapy as effective for weight loss across doses, the proof that a long-acting amylin analog works.
REDEFINE 1 monotherapy arm2024-2025
Cagrilintide 2.4 mg alone produced about 11.8% weight loss over 68 weeks (with nausea in roughly a quarter), less than semaglutide but confirming a real standalone effect.
Pramlintide proof-of-concept (Aronne)2007
The short-acting amylin analog showed about 3 to 5% weight loss in obesity, first validating the amylin mechanism but limited by thrice-daily dosing.
Eloralintide Phase 2 (Lilly), Lancet2025
A selective amylin-receptor agonist showed roughly 9 to 20% weight loss depending on dose, suggesting the class ceiling may be higher than cagrilintide alone.