Cagrilintide dosage: every dose the trials used, the titration, and what is not established

Three patterns stand out. First, the highest dose ever given was 4.5 mg a week, in the phase 1b and phase 2 studies; no trial has gone above it ^[1][2]. Second, every phase 3 trial used 2.4 mg or lower. The manufacturer took 2.4 mg forward after the dose-finding trial, and later trials added 1.0 mg and 1.7 mg combination doses ^[4]. Third, most of the large trials gave cagrilintide with semaglutide, so their results describe the combination, not cagrilintide alone. The cleanest single-drug figures are the phase 2 dose-finding trial and the cagrilintide-only arm of REDEFINE 1.

Results labelled topline come from company announcements and have not yet been published in a journal. The two ways of counting weight loss, treatment-policy and trial-product (or efficacy) estimands, explain why one trial can be quoted as both 20.4% and 22.7%; the CagriSema record explains the difference.

Starting dose. The published abstracts give the target doses and the escalation period but not every intermediate step. The phase 1b trial is explicit that both drugs went up in 4-week intervals over 16 weeks ^[1]. The phase 2 trial reached its doses, including 4.5 mg, within an escalation period of up to six weeks ^[2]. The full step-by-step phase 3 schedule sits in the trial protocols; this page does not reproduce step sizes that the cited documents do not state.

Flexible dosing in phase 3. REDEFINE 1 let participants adjust their dose. At week 68, 57.3% of people on CagriSema were on the highest dose, against 82.5% on cagrilintide alone and 70.2% on semaglutide alone ^[6]. In other words, a large share of trial participants ended the study on less than the target dose, and the headline results include them.

Why the slow step-up. In the dose-finding trial, 41% to 63% of people across the cagrilintide doses reported gastrointestinal adverse events against 32% on placebo, mostly nausea (20% to 47% against 18%) ^[2]. Escalation is how trials manage that, and it is a property of the trial schedule, not a personal plan.

Trials gave between 0.16 mg and 4.5 mg once a week, and the dose that phase 3 tested at scale is 2.4 mg once a week ^[1][2][3]. In the dose-finding trial, weight loss rose with dose, from 6.0% at 0.3 mg to 10.8% at 4.5 mg over 26 weeks ^[2]. The 4.5 mg arm beat liraglutide 3.0 mg by 1.8 percentage points. The phase 3 programme nonetheless went forward at 2.4 mg, not 4.5 mg ^[3].

None of this adds up to a weekly amount for a person. Three things stand in the way:

• No dose is established for unapproved use. Cagrilintide has no label. The trial doses were chosen for defined populations, under monitoring, by the manufacturer.
• The trial product is not what circulates. Every trial used the manufacturer's own material; the CagriSema trials used a dual-chamber pen holding both drugs ^[11]. Powder sold as research cagrilintide has no verified identity, purity or content, so a milligram figure on its label is not the same quantity the trials gave.
• Most results are combination results. The largest trials paired cagrilintide with semaglutide, so their numbers do not describe cagrilintide alone.

Searches such as "how much cagrilintide should I take" are answered here with that boundary: the doses studied, and the fact that none of them is a recommendation.

Cagrilintide is a long-acting analogue of amylin, a hormone the pancreas releases with insulin. It activates both amylin and calcitonin receptors ^[12], and a 2025 study traced its effect on body weight to amylin receptors 1 and 3 in the brain ^[13]. What makes it weekly is its half-life.

In the phase 1b trial, cagrilintide had a half-life of 159 to 195 hours, about a week, with peak levels 24 to 72 hours after injection ^[1]. Exposure rose in proportion to dose across 0.16 to 4.5 mg, and cagrilintide did not change semaglutide's exposure or elimination, which is what made a single weekly injection of both practical. A dedicated study found that kidney or liver impairment did not meaningfully change cagrilintide exposure after a single dose ^[14].

Pramlintide, the only approved amylin drug, is injected before major meals ^[15]. The difference in schedule is the main thing that separates the old and new generation of amylin analogs; the mechanism is covered in how cagrilintide works.

No trial reconstituted cagrilintide from a vial of powder. The phase 3 programme used a pre-filled, single-use dual-chamber pen, and a 2026 usability study tested whether adults could operate it after standard training ^[11]. So there is no published reconstitution protocol for cagrilintide, and no published stability data for powder mixed with water outside the manufacturer's process.

A reconstitution chart converts three numbers into a fourth: milligrams in the vial, millilitres of diluent, and a chosen dose give a volume and a number of syringe units. That arithmetic is exact, and the cagrilintide calculator does it with the formula shown, next to the trial doses from the chart above. What the arithmetic cannot supply is whether the vial holds the stated amount of cagrilintide, or anything else. The milligram figure on an unregulated vial is a claim, not a measurement.

Searches for a sema cagri blend describe the one combination that was tested, and the doses are those in the chart above. The trials gave a fixed-dose product with both drugs escalated together; mixing two separately sourced powders is not the intervention those trials studied. The step-by-step CagriSema schedule is covered in CagriSema dosing schedule.

A cagri tirz blend has no trial behind it. The combination has never been given to people in a published or registered study; tirzepatide appears in the cagrilintide programme only as the drug CagriSema was compared against. Each drug's own doses, reported separately, and what the head-to-head trials found, are on cagrilintide with tirzepatide. The retatrutide evidence, one rat study, is on cagrilintide with retatrutide.

What it is. Cagri is short for cagrilintide, a once-weekly amylin analogue developed by Novo Nordisk ^[18]. "Cag peptide" and "cagri peptide" in searches refer to the same molecule.

Benefits measured in trials. Alone at 2.4 mg, cagrilintide produced 11.8% weight loss over 68 weeks against 2.3% on placebo when everyone stayed on treatment ^[6]. With semaglutide it produced 20.4% against 3.0% in the treatment-policy analysis ^[3], and in type 2 diabetes it lowered HbA1c more than semaglutide alone by 0.16 points ^[9]. Gastrointestinal adverse events affected 79.6% on the combination and 39.9% on placebo, mainly mild to moderate and transient ^[3].

Status on 29 October 2026. Not approved anywhere. Novo Nordisk filed CagriSema with the FDA on 18 December 2025 ^[16] and says a decision is expected in the fourth quarter of 2026 ^[4]. Cagrilintide on its own was moved into a dedicated phase 3 programme, RENEW, announced for the fourth quarter of 2025 ^[18]. Until a label exists, no dose on this page is a prescribing dose.