Cagrilintide
Also known as: NN9838 · CagriSema component
Contents
MW
3949.57 Da
Amino Acids
37 AA
Half-Life
7 days
Route
SubQ
CAS
2375217-89-5
Mechanism of Action
Cagrilintide is a long-acting acylated amylin analog designed for once-weekly subcutaneous injection. Amylin is a 37-amino acid peptide co-secreted with insulin from pancreatic β-cells.
PRIMARY MECHANISM — AMYLIN RECEPTOR ACTIVATION: Binds amylin receptors (heterodimers of calcitonin receptor [CALCR] with RAMP1, RAMP2, or RAMP3) in the area postrema and hypothalamus. Activation reduces appetite through central satiety signaling — a pathway distinct from and complementary to GLP-1.
GASTRIC EMPTYING: Slows gastric emptying, extending post-meal satiety and reducing postprandial glucose excursions.
GLUCAGON SUPPRESSION: Reduces post-meal glucagon secretion, contributing to glycemic control.
CagriSema COMBINATION: The major clinical development is CagriSema — cagrilintide combined with semaglutide in a single injection. This exploits dual amylin + GLP-1 pathways for additive appetite suppression. Early data suggests ~25% body weight loss — potentially exceeding either agent alone. Phase III REDEFINE trials are ongoing.
The amylin pathway represents a distinct metabolic signaling axis from GLP-1, explaining why combining both produces greater weight loss than maximizing either pathway alone.
Dosing Protocol
Low Dose
███ – ███ mcg/day
Standard Dose
███ mcg/day
High Dose
███ – ███ mcg/day
Dosing protocols are for paid members
Get exact dosing ranges, injection frequency, timing rationale, and reconstitution math.
Get Clinical Access — $79/moFrequency
Once weekly SubQ.
Half-Life
7 days
Reconstitution Guide
Full reconstitution protocol with BAC water volumes, concentration math, and units-to-draw per dose is available on the Clinical plan.
Unlock reconstitution guide →Clinical Warnings
Investigational — not yet approved anywhere.
GI side effects (nausea, vomiting) expected.
Same class concerns as pramlintide.
Amylin receptor biology less characterized than GLP-1.
Contraindications
Absolute
Pregnancy
MEN2 syndrome
Personal/family medullary thyroid cancer
Relative Cautions
Gastroparesis
Gallbladder disease
Pancreatitis history
Side Effect Profile
Mild
- ●Nausea
- ●Injection site reaction
- ●Diarrhea
Moderate
- ●Vomiting
- ●Constipation
- ●Abdominal pain
Severe (Rare)
- ●Pancreatitis
- ●Gallbladder events
Synergistic Peptides
Common Stacks
Semaglutide
Research Status
PHASE III (REDEFINE trials, NCT05394259). Phase II (PMID 37516273, Lau 2023): Significant dose-dependent weight loss. CagriSema showing ~25% weight loss in combination trials. Not yet FDA approved.
Frequently Asked Questions
How does Cagrilintide work?
Cagrilintide is a long-acting acylated amylin analog designed for once-weekly subcutaneous injection. Amylin is a 37-amino acid peptide co-secreted with insulin from pancreatic β-cells. PRIMARY MECHANISM — AMYLIN RECEPTOR ACTIVATION: Binds amylin receptors (heterodimers of calcitonin receptor [CALCR] with RAMP1, RAMP2, or RAMP3) in the area postrema and hypothalamus. Activation reduces appetite through central satiety signaling — a pathway distinct from and complementary to GLP-1. GASTRIC EMPT
What is the standard dose of Cagrilintide?
Cagrilintide dosing protocols are available with a ClinPep Clinical subscription. Dosing varies by indication and patient factors — consult a licensed healthcare provider. General frequency: Once weekly SubQ.
What is the half-life of Cagrilintide?
The half-life of Cagrilintide is 7 days. This determines optimal dosing frequency and timing.
Who should not use Cagrilintide?
Cagrilintide is absolutely contraindicated in: Pregnancy; MEN2 syndrome; Personal/family medullary thyroid cancer. Use with caution in: Gastroparesis; Gallbladder disease; Pancreatitis history.
What are the side effects of Cagrilintide?
Common mild side effects include: Nausea, Injection site reaction, Diarrhea. Moderate effects: Vomiting, Constipation, Abdominal pain.
What peptides stack well with Cagrilintide?
Cagrilintide is commonly stacked with: Semaglutide, Tirzepatide.
How do you reconstitute Cagrilintide?
Cagrilintide is reconstituted with bacteriostatic water. Exact volumes, concentrations, and units-to-draw calculations are available in the ClinPep Clinical plan. Always follow your compounding pharmacy's instructions.
How long should you cycle Cagrilintide?
Cagrilintide cycle protocols vary by indication. Detailed cycle length, on/off schedules, and monitoring guidelines are available with ClinPep Clinical access. Consult your healthcare provider for personalized cycling guidance.
References & Citations
10 PubMed studies · 3 clinical trials
Amylin receptors as therapeutic targets in obesity: Emerging peptide-based strategies.
Rejili Mokhtar, Hussain Md Sadique, Khan Yumna, Haouala Faouzi et al.. Vascular pharmacology. 2026
Obesity is a chronic, relapsing metabolic disorder driven by complex genetic and environmental factors, leading to an imbalance in energy regulation. Despite the presence of GLP-1 receptor agonists wi
CagriSema Reduces Blood Pressure in Adults With Overweight or Obesity: REDEFINE 1.
Verma Subodh, Böttcher Morten, Brown Paul, Dicker Dror et al.. Hypertension (Dallas, Tex. : 1979). 2026
Fixed-dose combination of semaglutide/cagrilintide (CagriSema 2.4 mg/2.4 mg) has demonstrated significant and clinically relevant body weight reductions in adults with overweight or obesity compared w
Synthetic target trial emulation and predictive modeling of amylin-pathway therapies for obesity and type 2 diabetes.
Al-Harbi Faisal A, Alsaif Ahmed K, Almutairi Atheer G, Alshehri Hussam J et al.. Metabolism open. 2025
Amylin-pathway therapies represent a novel therapeutic class for obesity and type 2 diabetes, however head-to-head comparative data and long-term outcome predictions remain limited. We conducted targe
Amylin and the renin-angiotensin system: risk or opportunity in amylin-based therapy?
Muskiet Marcel H A, Nardone Massimo, Rensen Patrick C N, Cherney David Z I et al.. Lancet (London, England). 2026
We hypothesise that amylin receptor agonists (eg, pramlintide) and dual amylin and calcitonin-receptor agonists (eg, cagrilintide), which are emerging treatments for obesity and type 2 diabetes, can a
Eloralintide (LY3841136), a novel amylin receptor agonist for the treatment of obesity: From discovery to clinical proof of concept.
Briere Daniel A, Qu Hongchang, Lansu Katherine, He Minxia Michelle et al.. Molecular metabolism. 2025
Eloralintide (LY3841136), a novel amylin analog, was evaluated in translational studies to characterize its therapeutic potential for treating obesity. In vitro assays were performed in cell lines sel
Novel GLP-1-based Medications for Type 2 Diabetes and Obesity.
Son Jang Won, le Roux Carel W, Blüher Matthias, Nauck Michael A et al.. Endocrine reviews. 2026
The approvals of semaglutide and tirzepatide have set new benchmarks in the treatment of type 2 diabetes and obesity. Building on their success, novel glucagon-like peptide-1 (GLP-1)-based therapeutic
Weight management treatment in obesity.
Rubio-Herrera Miguel A, Mera-Carreiro Sara. Medicina clinica. 2025
Obesity is a chronic and relapsing disease associated with medical complications and mortality. Our improved understanding of the relevance of the gut-brain axis in regulating appetite and body weight
Structural and mechanistic insights into dual activation of cagrilintide in amylin and calcitonin receptors.
Gu Yi-Min, Yuan Qing-Ning, Li Xin, He Qian et al.. Acta pharmacologica Sinica. 2026
The global obesity epidemic and its associated metabolic disorders urgently require more effective therapeutic interventions, particularly multi-pathway targeting therapies. Cagrilintide (Cagri), func
Registered Clinical Trials
A Research Study to See How Much CagriSema Lowers Blood Sugar and Body Weight Compared to Tirzepatide in People With Type 2 Diabetes Treated With Metformin With or Without an SGLT2 Inhibitor
A Research Study to See How Well CagriSema Helps People in East Asia With Excess Body Weight Lose Weight
A Research Study to See How Well CagriSema Helps People With Excess Body Weight Lose Weight
Symptom Indications
Full Clinical Access
Complete Cagrilintide Protocol
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This information is for educational and research reference purposes only. ClinPep does not provide medical advice, diagnosis, or treatment recommendations. All protocols should be reviewed by a licensed healthcare provider.