Cagrilintide is a long-acting, lipidated analog of amylin, a 37-amino-acid pancreatic hormone, developed by Novo Nordisk for weight management research (Kruse 2021). It activates both amylin receptors and the calcitonin receptor, and a 2026 structural study describes it as a dual amylin and calcitonin receptor agonist, or DACRA (Gu 2026). In clinical trials it has been tested alone and combined with semaglutide as CagriSema. Research-grade cagrilintide peptide for laboratory use is a separate material sold for in vitro and animal work only.
Amylin is a 37-amino-acid peptide made by pancreatic beta cells. A 2015 review describes it mainly as a glucoregulatory hormone and a regulator of energy metabolism, acting chiefly in the circumventricular organs of the brain (Hay 2015). The pramlintide label adds that amylin is stored with insulin in the same secretory granules and released with it after food intake (SYMLIN label). The same label notes that people with type 1 and type 2 diabetes secrete less amylin after meals.
Amylin receptors are G protein-coupled receptors formed when the core calcitonin receptor (CTR) is co-expressed with a receptor activity-modifying protein (Hay 2015). Each of the three RAMPs yields a different subtype, called AMY1R, AMY2R and AMY3R. Because amylin and calcitonin receptors share the same core protein, selectivity between them is an active research question for amylin analogs.
Native human amylin readily forms amyloid fibrils, which makes it a difficult starting point for drug design (Kruse 2021). Pramlintide swaps three residues for proline, at positions 25, 28 and 29 (SYMLIN label).
The SYMLIN label lists an initial U.S. approval of 2005, as an adjunct in type 1 or type 2 diabetes for people using mealtime insulin. According to the label, pramlintide slows gastric emptying, reduces the post-meal rise in glucagon, and modulates satiety. It carries a boxed warning for severe hypoglycemia with insulin. Its half-life is roughly 48 minutes, and cagrilintide’s developers cite that short half-life as the limitation they set out to address (Kruse 2021).
Novo Nordisk scientists described the development of cagrilintide in the Journal of Medicinal Chemistry in 2021. They reported a stable, lipidated amylin analog selected through a structure-activity program for clinical development in obesity (Kruse 2021).
DACRA stands for dual amylin and calcitonin receptor agonist. A cryo-electron microscopy study, published online in August 2025 and in print in January 2026, describes cagrilintide as a DACRA (Gu 2026). It reports structures of the peptide bound to AMY1R and to CTR, each in complex with the Gs protein. Cagrilintide adopted a similar binding mode in both receptors and activated Gs signaling through each without meaningful selectivity.
The authors link this to three features. A phenylalanine at position 23 anchors the peptide near the transmembrane bundle. A salt bridge between residues 14 and 17 stabilizes the helix. A C-terminal proline contacts the receptor’s extracellular domain.
The trials below were sponsored by Novo Nordisk. Each defined its own population, duration and statistical estimand, so numbers from different trials are not directly comparable.
This trial ran at 57 sites in ten countries. It enrolled adults without diabetes who had a BMI of at least 30, or at least 27 with hypertension or dyslipidemia (Lau 2021). Participants were randomized to once-weekly cagrilintide at 0.3, 0.6, 1.2, 2.4 or 4.5 mg, once-daily liraglutide 3.0 mg, or placebo, for 26 weeks. In all, 706 participants were randomized.
Under the trial product estimand, mean weight reductions ranged from 6.0% to 10.8% across cagrilintide doses, compared with 3.0% for placebo. The 4.5 mg group lost 10.8% versus 9.0% with liraglutide 3.0 mg, an estimated difference of 1.8 percentage points (p=0.03). Gastrointestinal adverse events occurred in 41% to 63% of cagrilintide groups versus 32% with placebo, driven mainly by nausea.
This 32-week, double-blind trial at 17 U.S. sites randomized 92 adults with type 2 diabetes and a BMI of 27 or higher, all on metformin with or without an SGLT2 inhibitor (Frias 2023). They received CagriSema (n=31), semaglutide (n=31) or cagrilintide (n=30), each escalated to 2.4 mg. It compared the two components with each other and with the combination.
REDEFINE 1 was a 68-week, double-blind trial published in the New England Journal of Medicine in 2025 (Garvey 2025). It randomized 3,417 adults without diabetes in a 21:3:3:7 ratio, all with lifestyle intervention. The arms were CagriSema 2.4 mg/2.4 mg (n=2,108), semaglutide 2.4 mg alone (n=302), cagrilintide 2.4 mg alone (n=302) and placebo (n=705).
The primary analysis used the treatment-policy estimand, which counts participants regardless of whether they stayed on treatment. On that basis, mean weight change was -20.4% with CagriSema and -3.0% with placebo, an estimated difference of -17.3 percentage points (95% CI -18.1 to -16.6). CagriSema participants were more likely to reach every prespecified threshold, including reductions of 20%, 25% and 30% or more. Gastrointestinal adverse events affected 79.6% of the CagriSema group and 39.9% of the placebo group, mainly transient and mild to moderate.
A 2026 secondary analysis reports all four arms under the trial product estimand, which assumes treatment was taken as intended without rescue intervention (Busetto 2026). On that basis, mean weight change at week 68 was -22.7% with CagriSema, -16.1% with semaglutide alone, -11.8% with cagrilintide alone and -2.3% with placebo. The two sets of numbers come from different estimands and should not be mixed.
REDEFINE 2 enrolled adults with type 2 diabetes, a BMI of 27 or more and an HbA1c of 7% to 10% in 12 countries (Davies 2025). It randomized 1,206 participants 3:1 to CagriSema 2.4 mg/2.4 mg (n=904) or placebo (n=302) for 68 weeks. Mean weight change was -13.7% with CagriSema and -3.4% with placebo, an estimated difference of -10.4 percentage points (95% CI -11.2 to -9.5). An HbA1c of 6.5% or less was reached by 73.5% of the CagriSema group and 15.9% of the placebo group. Gastrointestinal adverse events were reported in 72.5% and 34.4%, respectively.
REDEFINE 1 and REDEFINE 2 enrolled different populations, so the smaller weight change in REDEFINE 2 is not a head-to-head comparison between the trials.
The table places cagrilintide next to the compounds it is most often compared with. The cagrilintide and CagriSema rows come from REDEFINE 1. Semaglutide and tirzepatide results come from their own phase 3 obesity trials, STEP 1 and SURMOUNT-1.
| Compound | Class and receptor targets | Developer | Key trial | Reported result |
|---|---|---|---|---|
| Cagrilintide | Lipidated amylin analog; agonist at amylin receptors and CTR (DACRA) | Novo Nordisk | REDEFINE 1 cagrilintide-only arm, 68 weeks (Busetto 2026) | Weight -11.8% vs -2.3% placebo (trial product estimand) |
| Semaglutide | GLP-1 receptor agonist | Novo Nordisk | STEP 1, 68 weeks, 2.4 mg weekly (Wilding 2021) | Weight -14.9% vs -2.4% placebo (treatment-policy estimand) |
| CagriSema | Cagrilintide 2.4 mg plus semaglutide 2.4 mg; amylin/calcitonin plus GLP-1 receptors | Novo Nordisk | REDEFINE 1, 68 weeks (Garvey 2025) | Weight -20.4% vs -3.0% placebo (treatment-policy estimand); -22.7% vs -2.3% (trial product estimand, Busetto 2026) |
| Tirzepatide | Dual GIP and GLP-1 receptor agonist | Eli Lilly | SURMOUNT-1, 72 weeks (Jastreboff 2022) | Weight -15.0%, -19.5% and -20.9% at 5, 10 and 15 mg vs -3.1% placebo (treatment-regimen estimand) |
The table is a summary, not a ranking. The trials differ in length, in how they handled treatment discontinuation, and in who they enrolled. None of the trials cited here compared CagriSema with tirzepatide. Researchers working on incretin compounds can find a similar comparison for a triple agonist in our retatrutide research guide.
Semaglutide acts on the GLP-1 receptor. Tirzepatide adds the GIP receptor. Cagrilintide works through a separate hormone system, the calcitonin receptor family, and has been studied both alone and alongside semaglutide.
Two trials report the components side by side. In Frias 2023, among 92 adults with type 2 diabetes, cagrilintide alone produced more weight loss than semaglutide alone over 32 weeks (-8.1% versus -5.1%) but a smaller HbA1c reduction (-0.9 versus -1.8 percentage points) (Frias 2023). In the much larger REDEFINE 1, among adults without diabetes, the pattern reversed on weight: -11.8% with cagrilintide alone versus -16.1% with semaglutide alone at 68 weeks, under the trial product estimand (Busetto 2026). In both trials, the combination produced more weight loss than either component.
Cagrilintide is an investigational compound. A search of DailyMed, the National Library of Medicine’s database of FDA-submitted drug labels, returns no results for cagrilintide as of September 2026 (DailyMed search). Neither cagrilintide nor CagriSema is FDA approved. Pramlintide, by contrast, has an FDA label (SYMLIN label).
For laboratory work, cagrilintide is most useful as a tool for questions about calcitonin-family receptor pharmacology. Published work points to several areas:
Any such work should use analytically verified material, with identity confirmed by mass spectrometry and purity confirmed by HPLC. It should also follow the institutional approvals that apply to in vitro or animal research.
CagriSema is the investigational combination of cagrilintide 2.4 mg and semaglutide 2.4 mg tested in the REDEFINE 1 and REDEFINE 2 phase 3 trials (Garvey 2025; Davies 2025).
Semaglutide is a GLP-1 receptor agonist, while cagrilintide acts on amylin and calcitonin receptors. The single-drug comparison depends on the trial: cagrilintide produced more weight loss than semaglutide in the 92-person Frias 2023 trial and less in the 3,417-person REDEFINE 1 trial (Busetto 2026). See the comparison section above.
No. As of September 2026, DailyMed lists no FDA label for cagrilintide or CagriSema.
Peptides For Sale supplies cagrilintide for in vitro and preclinical research in two sizes: cagrilintide 5 mg vials and cagrilintide 10 mg vials. Request the certificate of analysis for each lot before use, and confirm that identity and purity data match your experimental requirements.
Research use only. All products sold on this site are intended strictly for in vitro laboratory research and preclinical study by qualified professionals. They are not drugs, foods, or cosmetics, are not intended for human or veterinary use, and must not be used to diagnose, treat, cure, or prevent any disease. Nothing in this article is medical advice or guidance for personal use. Clinical trial results described here refer to investigational products studied under regulated conditions and do not apply to research-grade materials.
