Cagrilintide
Long-Acting Amylin Analog
aka NN9838 · AM833 · amylin analogue
A long-acting amylin analog researched for satiety promotion and enhanced weight loss, particularly alongside semaglutide.
Sequence
KCNTATCATQRLAEFLRHSSNNFGPILPPTNVGSNTP-NH2
Lys-Cys-Asn-Thr-Ala-Thr-Cys-Ala-Thr-Gln-Arg-Leu-Ala-Glu-Phe-Leu-Arg-His-Ser-Ser-Asn-Asn-Phe-Gly-Pro-Ile-Leu-Pro-Pro-Thr-Asn-Val-Gly-Ser-Asn-Thr-Pro-NH2
Mechanism of action
Cagrilintide is an acylated analog of amylin, a hormone co-secreted with insulin by pancreatic beta cells. It binds to amylin receptors in the brain, particularly in the area postrema and nucleus tractus solitarius, to promote feelings of fullness and reduce food intake. Additionally, it slows gastric emptying, which prolongs the sensation of satiety and helps regulate blood glucose levels.
What the evidence actually shows
There are several Phase III human trials that demonstrate cagrilintide's efficacy in promoting weight loss and enhancing the effects of semaglutide. These studies show significant reductions in body weight and improvements in glycemic control. However, long-term safety data and studies on diverse populations are still needed.
Regulatory status
Cagrilintide is currently under investigation in the UK and is not yet approved for general medical use. It is considered an emerging treatment for obesity.
Source ↗Pharmacokinetics
Dosing — what backs each figure
Cagrilintide is a Novo Nordisk investigational long-acting amylin analogue with well-documented trial regimens: subcutaneous once weekly, titrated over 6-16 weeks from 0.16-0.3 mg up to 2.4 or 4.5 mg, and maintained continuously for 20-26 weeks or longer, including in combination with semaglutide 2.4 mg (CagriSema, now in phase 3). It has no marketing approval. Titration is not optional — every trial escalated gradually, and no trial used cycling or planned breaks.
Subcutaneous self-injection once weekly at 0.3, 0.6, 1.2, 2.4 or 4.5 mg, over a 26-week treatment period including a dose-escalation period of up to 6 weeks, then 6 weeks follow-up off treatment; comparators were once-daily liraglutide 3.0 mg and placebo
Adults without diabetes, BMI >= 30, or >= 27 with hypertension or dyslipidaemia; 57 sites in 10 countries · subcutaneous
Once-weekly subcutaneous cagrilintide 0.16, 0.30, 0.60, 1.2, 2.4 or 4.5 mg co-administered with once-weekly subcutaneous semaglutide 2.4 mg; both co-escalated at 4-week intervals to target dose over 16 weeks, then 4 weeks at target dose, then 5 weeks follow-up
Otherwise healthy individuals aged 18-55 with BMI 27.0-39.9 kg/m2 · subcutaneous
Randomised multiple-ascending-dose phase 1b trial, The Lancet 2021 ↗
Cagrilintide 2.4 mg once weekly co-administered with semaglutide 2.4 mg once weekly (CagriSema)
Adults with type 2 diabetes · subcutaneous
Multicentre randomised double-blind active-controlled phase 2 trial, The Lancet 2023 ↗
Handling and storage
Safety
- ·Nausea
- ·Vomiting
- ·Diarrhea
- ·Pancreatitis
- ·"Severe hypoglycemia when used with insulin"
- ·Severe gastrointestinal disease
- ·History of pancreatitis
- ·Pregnancy
- ·GLP-1 receptor agonists: Enhanced weight loss effects due to complementary mechanisms
Nausea, injection-site reactions
Reported combinations
- ·Semaglutide
- ·Prokinetic agents: May counteract the gastric emptying delay
Combination claims in this dataset are largely unsourced and should be treated as folk knowledge until a citation appears beside them.
References (2)
- Lau DCW, et al. (2021) 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. ↗The LancetPMID 34798060DOI
Phase 2 dose-finding trial at 57 sites in 10 countries. Adults without diabetes (BMI >=30, or >=27 with hypertension or dyslipidaemia) were randomised 6:1 to once-weekly subcutaneous cagrilintide 0.3, 0.6, 1.2, 2.4 or 4.5 mg, once-daily liraglutide 3.0 mg, or placebo over a 26-week treatment period; primary endpoint was percentage bodyweight change at week 26.
- Enebo LB, et al. (2021) Safety, tolerability, pharmacokinetics, and pharmacodynamics of concomitant administration of multiple doses of cagrilintide with semaglutide 2.4 mg for weight management: a randomised, controlled, phase 1b trial. ↗The LancetPMID 33894838DOI
Phase 1b multiple-ascending-dose trial in otherwise healthy adults aged 18-55 with BMI 27.0-39.9 kg/m2 at a single US centre, assessing cagrilintide co-administered with semaglutide 2.4 mg (the CagriSema combination).
Data provenance
Chemistry and citations on this page were checked against primary sources on 2026-08-14. Values that could not be verified were left blank rather than filled with a plausible guess.
Could not verify
storage.lyophilized, storage.reconstituted, storage.lightSensitive, reconstitution.solvent, regulatory.wada