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Fat loss

CagriSema

Cagrilintide plus semaglutide, both at 2.4 mg, once weekly, from a single dual-chamber pen. This is a pharmaceutical product in late-stage development, not a community stack. It is the only combination in this library with genuine Phase 3 data behind the combination itself.

At a glance

What is in it
Sold as
One blended vial
The evidence
REDEFINE 1 (68 weeks, n=3,417, without diabetes): −20.4% versus −3.0% on placebo under the treatment-policy estimand, −22.7% under ideal adherence; 91.9% reached at least 5% loss. Adverse-event discontinuation 5.9% versus 3.5%; nausea 55%, constipation 30.7%, vomiting 26.1%. REDEFINE 2 (NEJM 2025, n=1,206, type 2 diabetes): −13.7% versus −3.4%; 73.5% reached HbA1c at or below 6.5%; GI adverse events 72.5% versus 34.4%. An independent BMJ network meta-analysis puts it at −14.8% at one year and names it among the highest adverse-event-discontinuation agents, with a fatigue risk ratio of 3.2. Both sets of numbers are true and they answer different questions.Combination-specific research is limited. Treat each compound’s evidence as separate unless a study of the combination itself is named here, and review the complete plan with a qualified clinician.
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Running this stack, with the schedule, the vials it takes and a log of what you took, happens in the app: Claritide for iPhone.

Context

Why people explore it

Common reasons for exploring it

  • People following the incretin pipeline who want the trial numbers rather than the press release
  • Anyone weighing efficacy against tolerability across the class

Where clinician input matters

  • Anyone looking for something they can obtain. It is not approved and not marketed.
  • Personal or family history of medullary thyroid carcinoma, or MEN 2
  • Anyone already on another GLP-1 receptor agonist
  • Pregnant, nursing or planning pregnancy within two months
Mechanism

The science

Each compound's mechanism, in plain English. The rationale for combining them is pharmacologic, not proven.
Read the compound mechanisms
CagrilintideThe Amylin Half of CagriSema

Amylin is a hormone co-secreted with insulin by pancreatic beta cells, and its job is meal termination: it signals that enough has been eaten, slows gastric emptying and suppresses glucagon release after a meal. Cagrilintide is a long-acting analogue that engages the same receptors on a weekly rather than a meal-by-meal timescale. That is a different appetite pathway from GLP-1, which is the entire rationale for combining the two: two independent brakes rather than one applied harder. Cagrilintide’s pharmacokinetics are unaffected by renal or hepatic impairment, which is an unusually clean profile for a weekly injectable.

SemaglutideThe Established GLP-1

Semaglutide mimics GLP-1, a hormone your gut releases after eating, with 94% homology to the human peptide. Activating GLP-1 receptors in the brain reduces appetite and increases fullness. It slows gastric emptying, so meals feel filling for longer. And it both increases insulin secretion and reduces glucagon secretion in a glucose-dependent way, which is why the same molecule treats type 2 diabetes. A C18 fatty di-acid chain at position 26 binds it to albumin, which is what stretches the half-life to about a week; position 8 is modified to resist the DPP-4 enzyme that clears natural GLP-1 in minutes. It is a single-receptor drug. That is the difference from tirzepatide and retatrutide, and it is why its weight-loss figure is smaller.

The protocol

Commonly researched ranges

Commonly researched ranges reported in our material. Not a recommendation, and not a prescription.
  • Cagrilintide2.4 mg

    Once weekly · Subcutaneous, from a dual-chamber pen. One injection delivers both

  • Semaglutide2.4 mg

    Once weekly · Same injection as the cagrilintide component

    Prescription
  • Cagrilintide: A long-acting amylin receptor agonist. Meal termination and delayed gastric emptying via a different appetite pathway from GLP-1. A 1.0 mg / 1.0 mg arm also ran in REIMAGINE 3.
  • Semaglutide: The GLP-1 half of the pen. Same dose as Wegovy maintenance.
Duration
The pivotal trials ran 68 weeks. Weight returns on discontinuation across this entire class. These are maintenance medications.
Reconstitution

Mixing each compound

Concentration (mg/mL) = vial mg ÷ BAC water mL. Never mix two peptides in the same syringe: we found no study showing it is safe, and mixed drugs can lose activity even when they look unchanged.
Cagrilintide

Not established in available literature. Use the figures printed on your own vial.

Semaglutide

Not established in available literature. Use the figures printed on your own vial.

Expectations

Week by week

What our material describes people reporting for each compound. Nobody has published a timeline for the combination itself.

Semaglutide

  1. Week 1–16

    Escalation through four steps. Nausea is most likely here and settles: it affected 44% of people against 16% on placebo, and it is the reason the schedule climbs slowly rather than starting at the target.

  2. Week 17

    Maintenance dose reached, 2.4 mg or 1.7 mg weekly depending on what it was prescribed for.

  3. Week 60–68

    Weight loss flattens around here. STEP 1 showed 14.9% mean reduction at 68 weeks on 2.4 mg, against 2.4% on placebo.

Budget

What it costs

Combined, where our sources publish a figure
$349–$1349
per month
  • Cagrilintide: Not established in available literature
  • Semaglutide: $349–1349 per month

The combined figure excludes Cagrilintide, for which our sources publish no price.

Before you start

Cautions

  • This is not approved. Novo Nordisk submitted its new drug application to FDA on 18 December 2025 and there is no US label as of 3 August 2026. Anything sold as "CagriSema" today is not the trial product.
  • The GI burden is the headline harm. Nausea 55%, constipation 30.7%, vomiting 26.1% in REDEFINE 1, and 72.5% versus 34.4% GI adverse events in the diabetes trial.
  • The independent meta-analysis puts the fatigue risk ratio at 3.2 and groups it with the highest discontinuation agents. Read that column next to the efficacy number, not after it.
  • The GLP-1 class boxed warning for medullary thyroid carcinoma applies. Personal or family history of MTC, or MEN 2, is a hard contraindication.
  • Do not run this alongside any other GLP-1 receptor agonist. The Wegovy label states concomitant use with other semaglutide-containing products or any other GLP-1 receptor agonist is not recommended.
  • Cagrilintide has no US label either. A DailyMed search returns nothing, so it cannot be prescribed in the US as a single agent.
  • Two combination claims worth correcting: cagrilintide plus tirzepatide is not a combination. Those registry entries are CagriSema-versus-tirzepatide head-to-head comparators. Cagrilintide plus retatrutide does not exist in the trial registry at any phase.
  • Discontinue at least two months before a planned pregnancy.

Absence from this list does NOT mean safety. It means lack of research.

Every stack here is free to read, and it stays free. Your own schedule, vials and log live in the app: Claritide for iPhone.