Cagrilintide
Long-Acting Amylin Receptor AgonistinvestigationalAlso known as: NN9838, AM833, Long-Acting Amylin Analog
A long-acting amylin receptor agonist in clinical development for obesity, designed for weekly subcutaneous injection and being studied in combination with semaglutide (CagriSema) for enhanced weight loss.
Overview
Cagrilintide is a long-acting acylated amylin analog developed by Novo Nordisk for the treatment of obesity. Amylin is a 37-amino acid peptide co-secreted with insulin from pancreatic beta cells that promotes satiety, slows gastric emptying, and suppresses glucagon. Native amylin (pramlintide/Symlin) requires injection before each meal due to its short half-life. Cagrilintide's acylation enables once-weekly dosing. In Phase 2 trials, cagrilintide alone produced up to 10.8% weight loss. The most exciting development is CagriSema — the combination of cagrilintide with semaglutide 2.4mg — which in Phase 2 achieved unprecedented 15.6% weight loss at 32 weeks, surpassing either agent alone. Phase 3 trials (REDEFINE program) are underway, positioning CagriSema as a potential next-generation obesity treatment.
Mechanism of Action
Cagrilintide activates amylin receptors (calcitonin receptor + RAMPs): (1) Activates area postrema and nucleus tractus solitarius in the brainstem to reduce food intake and promote satiety; (2) Slows gastric emptying, prolonging post-meal fullness; (3) Suppresses postprandial glucagon secretion; (4) Complements GLP-1 agonism through distinct but synergistic satiety pathways; (5) Acylation with a C18 fatty diacid enables albumin binding and weekly dosing; (6) May have effects on reward-based eating behavior through mesolimbic pathways.
Molecular Formula
Acylated amylin analog (~4 kDa + acyl chain)
Molecular Weight
~4200 g/mol
Sequence
Modified human amylin with amino acid substitutions and C18 fatty diacid acylation
Dosage Protocols
Dose Range
1.2mg – 4.5mg
Frequency
Once weekly
Route
subcutaneous
Cycle Length
Ongoing
Phase 2 tested doses from 0.3mg to 4.5mg weekly. CagriSema combines cagrilintide 2.4mg + semaglutide 2.4mg weekly. Dose escalation over several weeks to mitigate GI side effects.
Source: Phase 2/3 clinical trial protocols
🧮 Personalized Dosage Calculator
💰 Estimated Pricing
Typical Supply
Pre-filled pen
Last Updated
2026-02
Novo Nordisk amylin analog. In combination with semaglutide (CagriSema) in late-stage trials. Not yet widely available as standalone.
⚠️ Prices are estimates based on publicly available data and may vary significantly by vendor, location, and prescription status. This is not medical or financial advice.
Side Effects
| Effect | Severity |
|---|---|
| Nausea | moderate |
| Vomiting | moderate |
| Diarrhea | mild |
| Constipation | mild |
| Injection site reactions | mild |
Pros & Cons
CagriSema combination shows best-in-class weight loss potential (15.6%+ in Phase 2)
Novel amylin pathway provides additive weight loss on top of GLP-1 agonism
Once-weekly dosing improves convenience over pramlintide (3x daily)
Synergistic mechanism may allow lower doses of each component
Still in Phase 3 trials — not yet approved or commercially available
GI side effects are common, especially during titration
Long-term safety profile not yet established
Research Studies
🩸 Blood Work
HbA1c
Amylin analog affects blood sugar regulation
Fasting Blood Glucose
Monitor for hypoglycemia risk
Lipid Panel
Baseline metabolic markers
Kidney Function (BMP/CMP)
Monitor renal function
Pancreatic Enzymes (Lipase/Amylase)
Amylin is co-secreted with insulin from pancreas
Long-acting amylin analog, often studied in combination with semaglutide (CagriSema). Blood sugar monitoring is critical as amylin enhances insulin's glucose-lowering effects.
Legal Status
Investigational drug in Phase 3 clinical trials (Novo Nordisk REDEFINE program). Not yet approved by any regulatory agency. CagriSema (cagrilintide + semaglutide) combination is the lead development candidate.
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