PRODUCT

Cagrilintide (5 mg Vial)

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Quickstart Highlights

Cagrilintide is a long‑acting acylated analogue of the pancreatic hormone amylin, designed for once‑weekly subcutaneous administration[1]. It activates central amylin receptors to promote satiety, slow gastric emptying, and reduce food intake[2][3]. In phase 2 and phase 3 trials, cagrilintide produced dose‑dependent weight loss with a predominantly gastrointestinal side‑effect profile[4][5].

Reconstitute: Add 3.0 mL bacteriostatic water → ~1.67 mg/mL concentration.
Typical weekly range: 0.6–4.5 mg once weekly (gradual titration over 4–6 weeks).
Easy measuring: At 1.67 mg/mL, 1 unit = 0.01 mL ≈ 0.0167 mg (16.7 mcg) on a U‑100 insulin syringe.
Storage: Lyophilized: store frozen at −20 °C (−4 °F); after reconstitution, refrigerate at 2–8 °C (35.6–46.4 °F) and use within 30 days.

Molecular Info

Chain Length:37 amino acids
Sequence Type:Amylin receptor agonist
Molecular Weight:4,409.01 Da
Amino Acid Sequence:Lys-Cys-Asn-Thr-Ala-Thr-Cys-Ala-Thr-Gln-Arg-Leu-Ala-Asn-Phe-Leu-Val-His-Ser-Ser-Asn-Asn-Phe-Gly-Pro-Ile-Leu-Pro-Pro-Thr-Asn-Val-Gly-Ser-Asn-Thr-Tyr-NH₂
Modification:N-terminal lipidation with γ-glutamic acid spacer and C20 fatty diacid

Research Indications

Weight Loss

moderate

Superior Obesity Treatment
Phase 3 trials demonstrate 22.7% weight loss with CagriSema combination, outperforming existing therapies
Type 2 Diabetes Weight Management
15.7% weight loss in diabetic patients with concurrent glycemic improvements
Sustained Weight Maintenance
Long-acting formulation supports sustained weight loss throughout treatment period

Metabolic

effective

Glucose Control Enhancement
Phase 2 trials show 2.2% HbA1c reduction with CagriSema combination versus semaglutide alone
Insulin Sensitivity Improvement
Amylin receptor activation enhances insulin sensitivity and glucose metabolism
Gastric Emptying Regulation
Controlled gastric emptying improves postprandial glucose control and satiety

Appetitecontrol

effective

Dual Pathway Satiety
Amylin and calcitonin receptor activation provides robust appetite suppression via hindbrain pathways
Food Preference Modulation
Central nervous system effects influence food choices and eating behaviors
Early Satiation Induction
Promotes feeling of fullness with smaller meal portions, supporting caloric restriction

Reconstitution

Draw 3.0 mL bacteriostatic water with a sterile syringe.
Inject slowly down the vial wall; avoid foaming or vigorous agitation.
Gently swirl or roll until fully dissolved (do not shake).
Label with date and concentration; refrigerate at 2–8 °C (35.6–46.4 °F) , protected from light.
Label with date and concentration; refrigerate at 2–8 °C (35.6–46.4 °F), protected from light.

Interactions

Semaglutide

Synergistic

CagriSema combination demonstrates enhanced weight loss (22.7% vs 16.1% semaglutide alone) and improved glycemic control through complementary GLP-1 and amylin pathways.

Tirzepatide

Compatible

No known direct interactions. Both are effective weight loss agents with different mechanisms - cagrilintide targets amylin/calcitonin receptors while tirzepatide targets GLP-1/GIP receptors.

Retatrutide

Use Caution

Both cause significant GI effects (gastroparesis, nausea). Cagrilintide (amylin agonist) and Retatrutide (triple GLP-1/GIP/glucagon agonist) have different mechanisms but compounded GI side effects create substantial risk. Not recommended without specialist supervision.

Liraglutide

Compatible

Phase 2 trials show similar efficacy profiles with no adverse interactions. Both GLP-1 agonists and amylin analogs work through distinct satiety pathways.

Insulin

Monitor Combination

Monitor glucose levels closely as cagrilintide affects gastric emptying and may alter insulin absorption timing. May require insulin dose adjustments in diabetic patients.

Metformin

Compatible

Well-tolerated combination demonstrated in Phase 2/3 trials. No pharmacokinetic interactions observed between cagrilintide and metformin.

SGLT2 Inhibitors

Compatible

Clinical trials included patients on SGLT2 inhibitors with no safety concerns. Both mechanisms complement each other for diabetes and weight management.

Pramlintide

Avoid Combination

Both are amylin receptor agonists with overlapping mechanisms. Combination would provide no additional benefit and may increase risk of gastrointestinal side effects.

Oral Contraceptives

Requires Timing

Delayed gastric emptying may affect absorption of oral contraceptives. Space administration by 1 hour before cagrilintide injection.

Protocol Overview

Goal:Support satiety, reduce food intake, and promote weight management over time[2][4].
Schedule:Weekly subcutaneous injections for 12–16 weeks (or longer as appropriate).
Dose Range:0.6–4.5 mg weekly with gradual titration every 2 weeks.
Reconstitution:3.0 mL per 5 mg vial (~1.67 mg/mL) for practical volume measurements.
Storage:Lyophilized frozen; reconstituted refrigerated; avoid repeated freeze–thaw cycles.

Dosage Protocols

Start:0.6 mg weekly for the first 2 weeks to assess tolerability.
Target:4.5 mg weekly by Weeks 7–8; maintain at this dose.
Frequency:Once per week (subcutaneous) on the same day each week.
Timing:Any consistent time; rotate injection sites.

Dosage Protocols

Weight Loss (Monotherapy):2.4 mg weeklyOnce weekly
Weight Loss (CagriSema):2.4 mg + semaglutide 2.4 mgOnce weekly
Type 2 Diabetes Management:2.4 mg weeklyOnce weekly
Dose Escalation Protocol:0.25 mg → 0.5 mg → 1.0 mg → 1.7 mg → 2.4 mgWeekly increases over 16 weeks
Combination Diabetes Therapy:2.4 mg + SGLT2 inhibitorOnce weekly
Cardiovascular Risk Reduction:2.4 mg weeklyOnce weekly

Route:injectable

Storage Instructions

Lyophilized:Store at −20 °C (−4 °F) in dry, dark conditions; minimize moisture exposure.
Reconstituted:Refrigerate at 2–8 °C (35.6–46.4 °F); use within 30 days and avoid freeze–thaw cycles.

Important Notes

Practical considerations for consistency and tolerability.

Use new sterile syringes for each injection; dispose in a sharps container.
Rotate injection sites (abdomen, thighs, upper arms) weekly to reduce local irritation.
Gradual dose escalation minimizes gastrointestinal side effects such as nausea[4][6].
Document weekly dose, injection site, and any adverse effects to maintain consistency.
For maintenance doses requiring >1.0 mL, ensure you have appropriately sized syringes (3 mL).

Reconstitution

Reconstitute slowly down side of vial, swirl gently (don't shake)
Verify solution is clear - any cloudiness or particles indicates fibril formation, discard immediately
Store refrigerated (2-8°C), inspect for clarity before each injection
Allow to reach room temperature 15-30 minutes before injection
Inject subcutaneously in abdomen, thigh, or upper arm, rotating sites weekly

Route:injectable

How It Works

Cagrilintide is an acylated, long‑acting analogue of amylin—a hormone co‑secreted with insulin from pancreatic beta cells[2][7]. Native amylin promotes satiation, slows gastric emptying, and inhibits postprandial glucagon secretion[8][9]. By acting on central amylin receptors (particularly in the area postrema and hindbrain), cagrilintide reduces appetite and energy intake[3][10]. Lipid modifications extend its half‑life to approximately 160–195 hours, enabling once‑weekly dosing[6][11].

Lifestyle Factors

Pair with a balanced, protein‑forward diet tailored to individual energy needs.
Combine resistance training and aerobic activity to support metabolic health and preserve lean mass.
Prioritize adequate sleep (7–9 hours) and stress management for adherence and recovery.
Monitor hydration and electrolytes, especially if experiencing gastrointestinal side effects.

Injection Technique

Clean the vial stopper and skin with alcohol; allow to air dry completely.
Pinch a skinfold; insert the needle at 45–90° into subcutaneous tissue[13].
Do not aspirate for subcutaneous injections; inject slowly and steadily.
Hold for 5–10 seconds before withdrawing the needle to ensure complete delivery.
Rotate sites systematically (abdomen, thighs, upper arms) each week to avoid lipohypertrophy[14].

Benefits and Side Effects

Benefits

Weight reduction: In the phase 2 trial, cagrilintide 4.5 mg weekly produced approximately 10.8% body weight loss over 26 weeks versus 3.0% with placebo[4].
Combination therapy: When combined with semaglutide 2.4 mg (CagriSema), phase 3 REDEFINE trials showed approximately 20% weight loss at 68 weeks, exceeding results with either agent alone[5][12].
Dose‑dependent efficacy: Higher doses (2.4–4.5 mg) demonstrate greater weight loss than lower doses (0.3–1.2 mg)[4].

Side Effects

Injection‑site reactions: Occasional mild redness or irritation at subcutaneous injection sites.

Cagrilintide (5 mg Vial)

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