Cagrilintide

Cagrilintide is a long-acting amylin analog. Amylin is a hormone your pancreas releases alongside insulin after meals. It slows gastric emptying, reduces glucagon secretion, and promotes satiety through a different mechanism than GLP-1 drugs.

Novo Nordisk is developing it as part of CagriSema, a combination with semaglutide. The idea is that stacking two different satiety pathways gives better results than either alone. Early trial data supports this.

Dosing follows a similar titration pattern to semaglutide: start at 0.25 mg weekly and work up to 2.4 mg. It's injected subcutaneously once a week.

Appetite reduction and early satiety within the first week or two. As a standalone, the weight loss is more modest than GLP-1 agonists, with trial data showing around 10 to 11% body weight loss at 2.4 mg over 32 weeks.

The real promise is in the combination with semaglutide (CagriSema), where the two mechanisms together produced greater results than either alone.

Nausea and GI discomfort are the most common, similar to other peptides in this space. Injection site reactions have been reported. Because amylin slows gastric emptying, bloating and fullness after meals can be more pronounced than with GLP-1 drugs alone.

Hypoglycemia risk is low when used without insulin, but worth monitoring if you're stacking with other glucose-lowering compounds.

Refrigerate at 36 to 46°F. Reconstitute with bacteriostatic water. Good for about 28 days after reconstitution. Standard handling: don't freeze, avoid direct sunlight, swirl rather than shake.