Cagrilintide (AM833, codenamed NNC0174-0833) is a long-acting amylin analog from Novo Nordisk. Amylin is a hormone released alongside insulin that signals fullness and slows how fast the stomach empties, and cagrilintide was built to stretch that signal across a whole week. You take it once weekly as a subcutaneous injection. Most people know it as the amylin half of CagriSema, the fixed-dose combination with semaglutide 2.4 mg.
Note on regulatory status. Standalone cagrilintide is still investigational. Novo Nordisk submitted CagriSema (cagrilintide + semaglutide) to the FDA in late 2025/early 2026 and it is under review, but neither the combination nor standalone cagrilintide is FDA-approved as of mid-2026. Since there is no approved drug label, the storage and shelf-life figures below follow general peptide community practice rather than an official monograph.
What Is Cagrilintide (AM833)?
Amylin works alongside GLP-1 but acts on a separate receptor system, which is why combining the two adds up to stronger appetite suppression than either alone. Cagrilintide carries a fatty-acid modification that binds to albumin and drags its elimination half-life out to 159-195 hours, roughly 7-8 days. That is what makes once-weekly dosing workable (Enebo 2021, Lancet, PMID 33894838). A long tail like this is typical of weekly injectables; our explainer on peptide half-life and dosing frequency covers how that maps onto a fixed weekly schedule.
Cagrilintide Weight-Loss Evidence
The standalone weight-loss data come from a phase 2 dose-finding trial in 706 adults with overweight or obesity. Weekly cagrilintide was tested at 0.3, 0.6, 1.2, 2.4, and 4.5 mg against both placebo and liraglutide 3.0 mg. At 26 weeks the 4.5 mg dose delivered about 10.8% mean weight loss, compared with 3.0% for placebo and 9.0% for liraglutide, and the response climbed steadily with dose (Lau 2021, Lancet, PMID 34798060).
Cagrilintide Dosing Schedule
Every published protocol ramps the dose up slowly to keep nausea in check, the same way GLP-1 drugs are started. In the trials the escalation ran from a 0.25-0.3 mg starting dose, roughly doubling every few weeks toward a 2.4 mg target, with 4.5 mg explored as the top monotherapy dose (Lau 2021, Lancet, PMID 34798060).
Cagrilintide Titration Ladder
| Phase | Weekly Dose | Typical Duration | Notes |
|---|---|---|---|
| Start | 0.25 mg | 4 weeks | Minimize early nausea |
| Step 2 | 0.5 mg | 4 weeks | Assess tolerance |
| Step 3 | 1.0 mg | 4 weeks | GI effects usually peak here |
| Step 4 | 1.7 mg | 4 weeks | Optional intermediate step |
| Target | 2.4 mg | Ongoing | Dose used in CagriSema |
The 2.4 mg target is the same dose that carried into the phase 3 program. In the phase 2 type 2 diabetes trial, cagrilintide 2.4 mg added to semaglutide 2.4 mg produced 15.6% weight loss at 32 weeks, versus 5.1% for semaglutide alone and 8.1% for cagrilintide alone (Frias 2023, Lancet, PMID 37364590). People exploring standalone use tend to stop titrating once nausea is manageable rather than pushing all the way to the 4.5 mg ceiling.
How and Where to Inject
Inject subcutaneously into the abdomen, thigh, or back of the upper arm, and rotate the site each week. The half-life is long enough that you should pick one day a week and stick to it. If you miss a dose you can take it within a couple of days, but never double up.
Cagrilintide Reconstitution
Cagrilintide arrives as a lyophilized powder. Reconstitute it with bacteriostatic water (0.9% benzyl alcohol).
For a 5 mg vial, add 1 ml of bacteriostatic water to get 5 mg/ml. For a 10 mg vial, add 2 ml for the same 5 mg/ml. At 5 mg/ml, 1 unit on a 100-unit insulin syringe equals 50 mcg, which keeps the titration math simple:
- 0.25 mg = 5 units
- 0.5 mg = 10 units
- 1.0 mg = 20 units
- 2.4 mg = 48 units
Wipe the stopper with alcohol, run the water slowly down the inside wall of the vial, and swirl gently. Do not shake it, since that can shear the peptide. The solution should come out clear and colorless. Keep reconstituted vials at 2-8°C and use them within about 4 weeks, the standard window for storing reconstituted peptides held cold. Unopened lyophilized vials last roughly two years refrigerated. You can scale any vial size with the cagrilintide calculator.
What to Expect From Cagrilintide
Weight loss with amylin analogs comes on gradually over months, not weeks, and it is driven mostly by a smaller appetite and feeling full earlier at meals. In REDEFINE 1, the phase 3 trial of the CagriSema combination in 3,417 adults without diabetes, on-treatment weight loss hit 22.7% at 68 weeks, versus 16.1% for semaglutide alone, 11.8% for cagrilintide alone, and 2.3% for placebo (Garvey 2025, NEJM, PMID 40544433). Cagrilintide is the weaker single agent of that trio, so on its own expect something more modest than the combination headline numbers.
Cagrilintide Side Effects and Safety
The main side effects are gastrointestinal: nausea, vomiting, diarrhea, constipation, and a drop in appetite. They are mostly mild to moderate and cluster during dose escalation (Lau 2021, Lancet, PMID 34798060). In the phase 1b study, gastrointestinal disorders made up about 37% of reported adverse events (Enebo 2021, Lancet, PMID 33894838). Injection-site reactions happen too. The usual fix for GI symptoms is to slow the titration, which is a familiar pattern across the injectable peptides covered in our peptide side effects overview.
Because standalone cagrilintide has no approved label, what we know about long-term safety, contraindications, and drug interactions is limited to the trial record. This guide is educational and is not medical advice. Cagrilintide sold as a research chemical is not a substitute for a prescribed, quality-controlled medication, and anyone considering an amylin analog for weight management should work with a clinician.
References
- Enebo LB, et al. Safety, tolerability, pharmacokinetics, and pharmacodynamics of concomitant administration of multiple doses of cagrilintide with semaglutide 2.4 mg for weight management: a phase 1b trial. Lancet. 2021. PMID 33894838. https://pubmed.ncbi.nlm.nih.gov/33894838/
- Lau DCW, et al. Once-weekly cagrilintide for weight management in people with overweight and obesity: a dose-finding phase 2 trial. Lancet. 2021. PMID 34798060. https://pubmed.ncbi.nlm.nih.gov/34798060/
- Frias JP, et al. Efficacy and safety of co-administered once-weekly cagrilintide 2.4 mg with once-weekly semaglutide 2.4 mg in type 2 diabetes: a phase 2 trial. Lancet. 2023. PMID 37364590. https://pubmed.ncbi.nlm.nih.gov/37364590/
- Garvey WT, et al. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity (REDEFINE 1). N Engl J Med. 2025. PMID 40544433. https://pubmed.ncbi.nlm.nih.gov/40544433/