CagriSema

Metabolic

Also known as cagrilintide + semaglutide

Fixed 1:1 combination of cagrilintide and semaglutide. Filed with the FDA, not approved.

Read this first

A fixed-ratio dual-chamber product cannot be meaningfully reproduced from separate single-peptide vials.

How it works

Pairs amylin and GLP-1 signalling in one weekly injection. Delivered through a dual-chamber pen that keeps the two peptides separate until the moment of injection. Neither affects the other's exposure or elimination.

Subcutaneous

In the body

Half-life

7.1 days

Time to peak

24 h

90% gone after

23.5 d

Builds up to

2.02×

Steady state after about 35.8 d at once weekly.

Shape of a single dose, modelled as one compartment with first-order absorption. The peak is normalised to 100% because bioavailability and volume of distribution are not published for most of these compounds.

Two components with different curves: cagrilintide 159 to 195 hours, semaglutide 145 to 165 hours. The single figure here is an approximation of both.

Doses

250 mcg, 2.4 mgonce weeklyClinical trial

Doses refer to each component; the two are always equal.

REDEFINE escalation to 2.4/2.4 mg

REDEFINE-1 and REDEFINE-2, NEJM 2025 · 68 weeks total

wk 1, 4250 mcg4 weeks
wk 5, 8500 mcg4 weeks
wk 9, 121 mg4 weeks
wk 13, 161.7 mg4 weeks
wk 17, 682.4 mg52 weeks

Four-week steps reaching the maintenance dose at week 16. Both trials allowed staying on a lower dose rather than dropping out, only about 57 to 62% of participants were on the full dose at week 68.

What is in it

2.4 mgCagrilintide
2.4 mgSemaglutide

What a dose delivers

mcg

1.325 mgCagrilintidein usual rangeusually 300 mcg, 4.5 mg per dose, once weeklyhalf-life 7.4 days
1.325 mgSemaglutidein usual rangeusually 250 mcg, 7.2 mg per dose, once weeklyhalf-life 6.7 days

Side effects

Gastrointestinal effects in 79.6% of participants in REDEFINE-1, against 39.9% on placebo
Injection site reactions notably higher than either component alone, 12.2% versus 2.6% for semaglutide
Discontinuation for adverse events 5.9% in obesity, 8.4% in type 2 diabetes
Gallbladder disorders 4.1%

Cautions

Not approved. Filed with the FDA in December 2025; a decision is expected during 2026.
Inherits the semaglutide class warning on medullary thyroid carcinoma and MEN 2.

Status

Investigational. In its only head-to-head trial (REDEFINE-4, February 2026) it failed to show non-inferiority to tirzepatide 15 mg, 23.0% versus 25.5% weight loss at 84 weeks.

Sources

Reference information for personal record-keeping. Not medical advice, and not a recommendation to use any of these compounds.