BlendsCagriSemaCagri-Sema

Cagrilintide / Semaglutide Blend

Fixed-ratio metabolic blend · cagrilintide 5 mg + semaglutide 5 mg · once weekly

This is the pre-mixed pairing of two once-weekly appetite peptides — the amylin analog Cagrilintide and the GLP-1 receptor agonist Semaglutide — sold as a single lyophilized vial, most often 5 mg of each for 10 mg total in a 1 : 1 ratio. It is the only blend in this library whose exact pair and ratio have been through a large phase 3 trial: under the name CagriSema, cagrilintide 2.4 mg with semaglutide 2.4 mg was tested in 3,417 adults over 68 weeks, and the trial reported a mean body-weight reduction of 20.4% against 3.0% on placebo. That evidence belongs to a fixed-dose combination product from Novo Nordisk which, as of September 2026, is not approved by the FDA or anywhere else — a New Drug Application was filed in December 2025 and is still under review. Semaglutide on its own is an approved medicine; cagrilintide is not approved in any form. The two act on separate satiety pathways, which is the whole reason they are paired, and the same trial reported gastrointestinal side effects in about four in five participants.

TL;DRThe whole page · in 30 seconds

Two appetite pathways · Once-weekly · Trial-tested pairing · Slow titration

The most-studied pairing in obesity research, in one vial. Cagrilintide copies amylin and Semaglutide copies GLP-1 — two different fullness signals, two different receptors — and the 68-week phase 3 trial of the pair reported 20.4% mean body-weight reduction against 3.0% on placebo. One injection a week, both halves stepped up together.

The basics

A pre-mixed powder: 5 mg cagrilintide + 5 mg semaglutide (a 1 : 1 ratio), taken once a week.
Known as CagriSema. Semaglutide is the Ozempic/Wegovy molecule; cagrilintide is the amylin half that the GLP-1 drugs don't have.

Why people use it

Two satiety levers, not one — amylin and GLP-1 run through separate receptors, so the appetite effect adds rather than overlaps.
The largest trial result of any pairing here — 20.4% mean weight reduction over 68 weeks in 3,417 people, and 22.7% among those who stayed on it.
More than either half alone — in the same trial, semaglutide alone reached 16.1% and cagrilintide alone 11.8%, against 22.7% for the pair.
One weekly shot for both — the two share a ~7-day half-life, so they ramp and dose on the same schedule.

How to run it

Dose: Work up to 48 units (4.8 mg of blend = 2.4 mg of each); start at 5 units (0.5 mg = 0.25 mg of each)
How often: Once a week, same day
How: A small injection under the skin — one syringe covers both halves
When: Any time of day; hold the same weekday
Ramp: Step up no faster than every 4 weeks — 5 → 10 → 20 → 34 → 48 units. The slow climb is what keeps nausea manageable

Stacks well with

Protein, creatine and resistance training — not a peptide, but the most important thing to run alongside: a large share of GLP-1 weight loss is lean mass, and appetite suppression makes hitting protein hard.
Ipamorelin + CJC-1295 — a growth-hormone nudge people add to defend lean mass through a long deficit.

Good to know

Gastrointestinal effects are the headline cost — nausea, vomiting, diarrhea, constipation affected about four in five trial participants versus two in five on placebo. Mostly mild and they fade, but the slow ramp is your only real lever.
Semaglutide carries an FDA boxed warning for thyroid C-cell tumors and is contraindicated with a personal or family history of medullary thyroid carcinoma or MEN 2 — that warning travels with any vial containing it.
Weight comes back after stopping. This is chronic-use pharmacology, not a course you finish.
A 10 mg vial is only about two doses at the 2.4 mg target — plan supply around that, not around a month.
In a 2026 head-to-head at 84 weeks, the pair reached 23% weight loss but did not beat tirzepatide 15 mg.

Bottom line: The strongest trial evidence behind any pairing on this site, run as one weekly shot with both halves titrated together — and a supply and side-effect profile that punishes rushing.

Molecular identity

Specs

Composition: Cagrilintide 5 mg · Semaglutide 5 mg = 10 mg per vial (10 mg + 10 mg = 20 mg vials also sold)Cross-source vendor agreement
Ratio: 1 : 1 by mass — 50 % cagrilintide · 50 % semaglutideCalculated
Structure / class: Fixed-ratio, co-lyophilized blend of an amylin analog and a GLP-1 receptor agonist — not a new molecule; each component keeps its own identity and pharmacologyCross-source vendor agreement
Cagrilintide (5 mg): C194H312N54O59S2 · 4409 g/mol · CAS 1415456-99-3 · acylated long-acting amylin analogPubChem CID 171397054
Semaglutide (5 mg): C187H291N45O59 · 4113.58 g/mol · CAS 910463-68-2 · acylated GLP-1(7-37) analogPubChem CID 56843331
Molecular target: Two receptor systems — amylin receptors (AMY1R/AMY3R) plus the calcitonin receptor for cagrilintide, and the GLP-1 receptor for semaglutidePMID 34288673 · DailyMed (Wegovy)
Half-life (per component): Both about a week — cagrilintide ~7 days (~159–195 h, secondary PK aggregation), semaglutide ~7 days; the matched duration is why one weekly schedule suits bothPMID 33894838 · DailyMed (Wegovy)Half-life curve →
Trial evidence: The 2.4 mg + 2.4 mg pairing was tested in REDEFINE 1, a 68-week phase 3 trial in 3,417 adults (NCT05567796) — the only combination on this site whose exact pair and ratio have phase 3 dataPMID 40544433
Regulatory status: The combination is not approved by the FDA or any other regulator; an NDA was filed 2025-12-18 and remains under review as of September 2026. Cagrilintide is not approved in any form; semaglutide is approved as a single agent. WADA 2026: GLP-1 agonists monitored, not prohibited; cagrilintide not namedRegulatory status tracker (Drugs.com)

Plain English

Mechanism

A blend is a packaging decision, not a new drug — but this one is unusual, because the packaging matches a real investigational medicine. The vial holds two separate peptides freeze-dried together in fixed proportions, so every draw carries both in the vial's ratio. Nothing about that changes how either molecule works; it changes only how you measure them. What is different here is that the pairing itself, at these proportions, has been studied: cagrilintide 2.4 mg with semaglutide 2.4 mg is the combination Novo Nordisk developed as CagriSema and carried through phase 3.

Semaglutide supplies the GLP-1 signal. It is a long-acting analog of glucagon-like peptide-1, the gut hormone released after eating, and switching on the GLP-1 receptor slows gastric emptying, increases the sense of fullness, and produces glucose-dependent insulin release. It is the molecule sold as Ozempic and Wegovy, and it is the only component here that is an approved medicine.

Cagrilintide supplies the amylin signal — a different hormone through a different receptor. Amylin is co-released with insulin from the pancreas and signals fullness while slowing the stomach; cagrilintide is an acylated, long-acting analog of it that acts at the amylin receptors and the calcitonin receptor. It is not an incretin, and that is precisely the point: amylin and GLP-1 converge on appetite through separate circuits, so combining them is expected to add rather than overlap. The single-agent arms of the phase 3 trial are the cleanest illustration — each alone produced less weight reduction than the two together.

The two also happen to share a roughly week-long half-life, which is why a single weekly schedule suits both and why a fixed-ratio vial is practical here in a way it is not for peptides on mismatched cadences. Read the evidence level precisely, though: the trial data belong to a fixed-dose combination product manufactured to a specification, administered under trial supervision with a mandated titration. A lyophilized research vial containing the same two molecules is not that product, has no regulatory review behind it, and carries none of that oversight.

Sources:PubChem CID 56843331 PubChem CID 171397054 PMID 34288673 DailyMed (Wegovy)PMID 40544433 PMID 33894838

Why people reach for it

Potential benefits

This pairing draws interest for one reason above all: it is the combination with real trial evidence behind it, rather than a ratio someone assembled. Here is what the research reports and what people pursue it for.

Two appetite pathways instead of one — Its defining appeal. Amylin and GLP-1 reduce food intake through separate receptors, so the pair is expected to add rather than duplicate — the reason this specific combination was developed at all rather than another GLP-1.
The largest trial result behind any pairing on this site — In the 68-week REDEFINE 1 trial in 3,417 adults, the pair reported a 20.4% mean reduction in body weight against 3.0% on placebo, and 22.7% among participants who remained on treatment.
More than either half on its own — The same trial ran single-agent arms of both components: 16.1% for semaglutide alone and 11.8% for cagrilintide alone against 22.7% for the pair, all on the same estimand in the same trial — the clearest evidence that the two levers add rather than overlap.
One weekly injection for both halves — Both components have a roughly week-long half-life, so a single weekly shot and a single titration schedule cover both — practically simpler than running two vials on two ramps.
An honest counterweight — In a 2026 head-to-head over 84 weeks the pair reached 23% weight reduction but did not meet its endpoint of matching tirzepatide 15 mg, and the combination is not approved by any regulator. The evidence is real and it is also not a clean win.

Sources:PMID 40544433 PMID 34798060 Regulatory status tracker (Drugs.com)

What the trials report and what people pursue this pairing for — not proven outcomes for any individual, and not a medical claim. The trial figures belong to a supervised fixed-dose combination product administered with a mandated titration and lifestyle intervention, not to a research vial.

Implied timing

Best time to dose

Implied best time

Anytime (consistent, weekly)

Pick one day of the week and hold it. Neither component has a time-of-day requirement; what matters is the seven-day interval and never advancing the dose faster than every four weeks.

Both components have a roughly week-long half-life, so blood levels are governed by which day you inject rather than which hour — the same logic each component page applies on its own.
Timing relative to meals is not critical for a subcutaneous injection of either molecule, though many people take it on a lower-activity day because gastrointestinal effects are heaviest in the first day or two after a step up.
The interval is the part worth protecting: a consistent seven-day gap keeps levels steady, and a shift of a couple of days on a given week is tolerable without restarting the ramp.
The real timing decision on this page is not the hour but the calendar — each titration rung is held a minimum of four weeks before the next.

No study establishes an ideal time of day for either component — this is reasoned from their week-long half-lives and how the trials scheduled dosing. The weekly interval and the four-week titration steps are the timing that actually matters here.

Sources:DailyMed (Wegovy)PMID 33894838

How to run it

Dosing & protocol

The titration is the protocol. Both halves of this blend climb together on the trial's schedule — 0.25 mg of each, then 0.5, 1.0, 1.7 and 2.4, each rung held at least four weeks — and because the ratio is fixed, one number moves both. That is the blend's real convenience and its real constraint. Everything below is the trial's dosing translated onto a research vial; it is not an approved label, and the combination has no regulator's sign-off behind it.

Trial doses, not an approved regimen: the cagrilintide-plus-semaglutide combination is not approved anywhere and cagrilintide is not approved in any form. Semaglutide is a prescription medicine whose trials were run with prescriber oversight, mandated titration and lifestyle support — none of which comes with a vial. Every number here is the published trial schedule, not a recommendation.

Titration schedule (both halves together)

Standard mix 10 mg + 1 mL = 10,000 mcg/mL total, which is 5,000 mcg/mL of each — so one unit on a U-100 syringe is 50 mcg of each component.

Weeks 1–4 — 5 units:: 0.25 mg of each. The starter rung for tolerability — semaglutide's own starting dose exactly, and below the 0.3–0.6 mg that cagrilintide's page gives for starting it alone. The fixed ratio decides this, not either component's own protocol.
Weeks 5–8 — 10 units:: 0.5 mg of each. The first meaningful step; appetite suppression is commonly noticed around here.
Weeks 9–12 — 20 units:: 1.0 mg of each. A pairing tested in its own phase 3 arm rather than merely a waypoint, which is worth knowing if a lower maintenance dose is the goal.
Weeks 13–16 — 34 units:: 1.7 mg of each. Also a trialed pairing.
Week 17 onward — 48 units:: 2.4 mg of each — the phase 3 target. Hold at the last tolerated rung rather than pushing through gastrointestinal effects; the schedule is a ceiling to approach, not a staircase to finish.

Subcutaneous administration

One weekly injection into subcutaneous fat covers both components.

Injection site:: Abdomen (at least two inches from the navel), outer thigh, or upper arm. Rotate week to week to avoid lipohypertrophy — the fatty lumps that come from repeatedly using one spot.
Measuring the dose:: Drawn on a U-100 insulin syringe. At the standard 10 mg + 1 mL mix: 5 units = 0.25 mg of each · 10 units = 0.5 mg · 20 units = 1.0 mg · 34 units = 1.7 mg · 48 units = 2.4 mg. The calculator on this page shows the split for any vial size or water volume.
Day of the week:: One consistent day; the hour does not matter. A shift of up to a couple of days on a given week is tolerable, and many pick a day where a rough evening is least disruptive.
Food window:: Not critical for the injection itself. Meal composition matters for comfort rather than absorption — smaller, lower-fat meals through the titration weeks are the usual advice, since a slowed stomach handles heavy fatty meals worst.

Supply — the constraint people miss

This blend runs out faster than any other on the site, because the doses are milligrams rather than micrograms.

A 10 mg vial is about two maintenance doses:: At 4.8 mg of blend per week (2.4 mg of each), 10 mg gives two full doses. A 20 mg (10 mg + 10 mg) vial gives four. Plan supply in weeks, not months.
Early rungs stretch much further:: At the 5-unit starter a 10 mg vial holds twenty doses on paper — but a reconstituted vial should be used within about four weeks, so the practical limit is the calendar, not the contents. Mix what the next few weeks need.
Duration, not cycles:: Neither component is cycled the way research peptides are. The trials ran 68 weeks of continuous use, and weight regain after stopping is well documented for this class — the effect holds while dosing continues.

Reconstitution at a glance

The on-page calculator does this live and splits every draw; the quick reference for the standard 10 mg vial:

Mixing:: 10 mg vial + 1 mL bacteriostatic water = 10,000 mcg per mL of blend, which is 5,000 mcg/mL of each component. One unit on a U-100 syringe delivers 50 mcg of each.
Why 1 mL:: It puts each component at the same 5 mg/mL the semaglutide page uses alone, so the familiar rungs — 5, 10, 20, 34 and 48 units — carry over unchanged. Mixing a 10 mg vial in 2 mL instead would put the 2.4 mg target at 96 units, almost the entire syringe.
What the split assumes:: A 1 : 1 vial. That matches every dose pairing tested so far (2.4/2.4, 1.7/1.7, 1.0/1.0). It does not match the planned high-dose arm of 2.4 mg cagrilintide with 7.2 mg semaglutide — a 1 : 1 vial cannot produce that, and no arithmetic on this page applies to it.

Sources:PMID 40544433 DailyMed (Wegovy)PMID 33894838 Regulatory status tracker (Drugs.com)

Substrate the signal needs

Nutritional cofactor precision

This blend's cofactor priorities come from its cost profile rather than its mechanism. It suppresses appetite hard, which makes protein intake the binding constraint; it slows the stomach, which drives nausea and constipation; and the weight lost includes a substantial share of lean mass. Almost everything worth doing alongside it addresses one of those three.

Reasoned from GLP-1 and amylin pharmacology plus conventional weight-loss nutrition applied to this pairing's known trade-offs — not a study of supplements with this blend. Supplement doses are general evidence-based ranges.

Supply the substrate — protein, creatine, resistance training

The single most important thing to run alongside. A large share of the weight lost on this class is lean mass, and suppressed appetite makes protein the hardest target to hit.

Protein:: 1.6–2.0 g per kilogram of body weight daily. With appetite blunted, eat protein first at every meal — protein before vegetables, vegetables before starch. Shakes are often the practical way to close the gap.
Creatine:: 3–5 g of creatine monohydrate daily, no loading phase needed. One of the best-evidenced supplements for preserving lean mass in a calorie deficit.
Resistance training:: Two or three sessions a week of compound movements. Without a signal to keep muscle, adequate protein alone will not fully prevent lean-mass loss.

Mitigate the gastrointestinal cost

The titration schedule is the main lever and it is free — do not rush it. These reduce what a slow ramp cannot.

Ginger:: 1–2 g with meals, or as tea. One of the better-supported non-pharmaceutical options for nausea.
Vitamin B6:: 25–50 mg with meals on heavy-nausea days — the classic nausea adjunct.
Meal composition:: Smaller, lower-fat, protein-and-vegetable-first meals through the titration weeks. Heavy fatty meals sit longest in a slowed stomach and produce the worst nausea.
For constipation:: 25–35 g total daily fiber weighted toward soluble sources, 300–400 mg elemental magnesium as glycinate or citrate at bedtime, and 2–2.5 L of water a day — food volume falls sharply, and so does the fluid that came with it.

Cover the micronutrient gap

Eating substantially less means consuming substantially less of everything, which is silent but cumulative.

Electrolytes and a broad multivitamin:: Sodium, potassium and magnesium all fall when food volume drops. A daily multivitamin as baseline insurance, with attention to B12, iron, calcium and vitamin D — the nutrients where a sustained deficit shows up first.

Sources:DailyMed (Wegovy)PMID 33567185 PMID 40544433

Combinations + timing

Stacking notes + timing windows

This blend already occupies two of the three appetite axes in wide use, which makes most additions redundant rather than synergistic. The useful partners address what it costs you rather than adding another satiety signal.

Combinations reasoned from mechanism, not tested head-to-head — and the blend itself has no regulatory approval. Doses are the partner peptides' own page conventions; "reached for" describes where people go, not a proven indication.

The blend + Ipamorelin / CJC-1295

A growth-hormone partner for the lean-mass problem this class creates — a different axis entirely.

Why it works:: The calorie deficit this blend produces takes lean mass along with fat. Ipamorelin and CJC-1295 raise the body's own growth-hormone pulse, which favors fat mobilization and lean-tissue retention — a hormonal axis the blend does not touch.
The protocol:: The blend on its weekly schedule; Ipamorelin 200–300 mcg subcutaneously at bedtime on an empty stomach, with CJC-1295 no-DAC 100 mcg alongside it, or the pre-mixed CJC-1295 / Ipamorelin blend. The GH pair must be fasted; this blend does not care about food.
Outcome:: Reached for by people who are already lean or who depend on muscle for performance, and who want the weight lost to skew toward fat.

The blend + BPC-157, during the ramp

A gut-comfort adjunct for the titration window, when gastrointestinal effects peak.

Why it works:: BPC-157 is studied for gut-lining healing and gastrointestinal motility in rodent models. The nausea and discomfort from this pairing concentrate in the first days after each step up, which is where an adjunct would matter if it matters at all.
The protocol:: BPC-157 250–500 mcg subcutaneously daily through the 16-week ramp, then reassess. Reasoned from mechanism — no trial has tested this combination.
Outcome:: Reached for on tolerability through the titration window, not for the weight outcome itself.

What not to add

The redundancy cases are worth naming, because they are the common mistakes.

Another incretin:: Tirzepatide, Liraglutide or Retatrutide on top of this blend is the same receptor family twice. You mostly stack the gastrointestinal side effects; the 2026 head-to-head also suggests tirzepatide alone is a serious comparator rather than an addition.
More cagrilintide or semaglutide:: Adding either component separately breaks the 1 : 1 ratio the trial evidence rests on. If you want a different ratio, the honest move is separate vials with each dose tracked against its own page — not a blend plus a top-up.

Sources:PMID 40544433 Regulatory status tracker (Drugs.com)

Reconstitution math

Reconstitution calculator

Calculated for a 1 mL U-100 insulin syringe (100 units/mL).

Peptide per vial

BAC water added

Desired dose

Units per dose

Draw to this mark on a U-100 syringe

This dose contains

Cagrilintide2.4 mg
Semaglutide2.4 mg

Fixed ratio — every draw carries all of the vial's peptides in the same proportions; only the total changes.

Volume per dose: 0.48 mL
Doses per vial: 2
Concentration: 10 mg/mL

One vial lasts

Daily: 2 days
Every other day: 4 days
5×/week: 2 days

Large draw (48 units). Double-check the vial size and dose — a mcg/mg mix-up produces values like this.

Research use only. Not for human consumption. Outputs are reference values based on research literature — verify all measurements independently.

From the studies

Side effects from research

Semaglutide carries an FDA boxed warning for thyroid C-cell tumors: in rodents it caused dose- and duration-dependent thyroid C-cell tumors, and whether it causes them in humans, including medullary thyroid carcinoma, is unknown. It is contraindicated in people with a personal or family history of medullary thyroid carcinoma or MEN 2. That warning applies to any vial containing semaglutide, whether or not the vial carries a label saying so.

Gastrointestinal effects dominate the reported adverse-event profile. In the phase 3 trial of this pairing they affected 79.6% of participants against 39.9% on placebo — nausea, vomiting, diarrhea, constipation and abdominal pain — and were mainly transient and mild to moderate. They are dose-related, which is the entire reason the titration exists. Semaglutide's label additionally warns on pancreatitis, gallbladder disease, acute kidney injury from dehydration, diabetic retinopathy complications and hypoglycemia when combined with insulin or a sulfonylurea. Cagrilintide has no approved label and therefore no comparable post-marketing safety surveillance at all — its safety picture is trial data only.

Two things are specific to taking these two as one fixed-ratio vial. You cannot lower one component without lowering the other, so a side effect attributable to one half can only be managed by dropping the whole dose or moving to separate vials. And the trial evidence that makes this pairing attractive was generated under prescriber supervision, with a mandated titration, lifestyle support and monitoring — none of which is present when the same molecules come from a research vial. The honest reading is that the efficacy data are strong and the conditions that produced them are absent.

Finally, the class caveats carry over unchanged: a substantial fraction of the weight lost is lean mass rather than fat, and weight is regained after stopping. This is chronic-use pharmacology, and the benefit lasts as long as the dosing does.

Sources:DailyMed (Wegovy)DailyMed (Ozempic)PMID 40544433 PMID 33567185 Regulatory status tracker (Drugs.com)

As reported in literature

Research dosing ranges

Unusually for a blend page, there is trial evidence for the combination itself — so these rows are the real thing rather than the components' separate literature. Read the estimands: REDEFINE 1 pre-specified the treatment-policy estimand, which counts everyone randomized including those who stopped, and that is the 20.4% figure the publication leads with. The widely quoted 22.7% is the trial-product estimand, which describes participants who remained on treatment. Both are legitimate; they answer different questions.

Dose	Route	Model	Outcome	Sources:
2.4 mg + 2.4 mg weekly	Subcutaneous	Human — phase 3, 68 weeks, n=3,417 (REDEFINE 1)	−20.4% mean body weight vs −3.0% placebo (treatment-policy estimand; difference −17.3 points)	PMID 40544433
2.4 mg + 2.4 mg weekly	Subcutaneous	Human — same trial, trial-product estimand	−22.7% vs −2.3% placebo among participants remaining on treatment; semaglutide alone −16.1%, cagrilintide alone −11.8%	Regulatory status tracker (Drugs.com)
2.4 mg + 2.4 mg weekly	Subcutaneous	Human — phase 3 safety, 68 weeks (REDEFINE 1)	Gastrointestinal adverse events 79.6% vs 39.9% placebo; mainly transient, mild-to-moderate	PMID 40544433
2.4 mg + 2.4 mg weekly	Subcutaneous	Human — phase 3 head-to-head, 84 weeks vs tirzepatide 15 mg (REDEFINE 4)	23% weight reduction reported (if-all-adhere estimand); did not meet the non-inferiority endpoint against tirzepatide	Regulatory status tracker (Drugs.com)
Multiple ascending	Subcutaneous	Human — phase 1b, cagrilintide with semaglutide 2.4 mg	Established the tolerability and PK basis for co-administration	PMID 33894838
2.4 mg weekly (cagrilintide alone)	Subcutaneous	Human — phase 2 dose-finding, 26 weeks	Dose-dependent weight reduction as monotherapy	PMID 34798060
2.4 mg + 2.4 mg vs each alone	Subcutaneous	Human — same trial, single-agent arms (trial-product estimand)	−22.7% combination vs −16.1% semaglutide alone, −11.8% cagrilintide alone, −2.3% placebo	Regulatory status tracker (Drugs.com)
2.4 mg + 2.4 mg weekly	Subcutaneous	Human — phase 2, type 2 diabetes, 32 weeks	Combination exceeded both single agents on weight in a second trial	PMID 37364590
2.4 mg weekly (semaglutide alone)	Subcutaneous	Human — phase 3 obesity, 68 weeks (STEP-1)	−14.9% mean body weight vs −2.4% placebo	PMID 33567185

Quick answers

Frequently asked

What exactly is in this vial, and is it CagriSema?

The common research vial holds 5 mg of cagrilintide and 5 mg of semaglutide freeze-dried together in a 1 : 1 ratio, and 10 mg + 10 mg vials are also sold. CagriSema is Novo Nordisk's name for the fixed-dose combination of the same two molecules at 2.4 mg each. They are the same pair of peptides at the same ratio, but a research vial is not the manufactured product, has not been through regulatory review, and comes without the supervision the trials had.

Is it approved?

No. The combination is not approved by the FDA or any other regulator; a New Drug Application was filed on 18 December 2025 and remained under review as of September 2026. Cagrilintide is not approved in any form. Semaglutide alone is approved as Ozempic, Wegovy and Rybelsus.

Is the weight loss really 22.7%?

Both figures you will see are from the same trial and measure different things. The publication's primary figure is a 20.4% mean reduction against 3.0% on placebo, using the treatment-policy estimand, which counts everyone randomized including those who stopped early. The 22.7% figure is the trial-product estimand, describing participants who stayed on treatment. Marketing tends to quote the second; the trial itself led with the first.

How much of each peptide is in a 10-unit draw?

At the standard mix of 10 mg in 1 mL, each component sits at 5,000 mcg/mL, so one unit on a U-100 syringe is 50 mcg of each and 10 units is 0.5 mg of each. The full titration lands on 5, 10, 20, 34 and 48 units for 0.25, 0.5, 1.0, 1.7 and 2.4 mg apiece. The calculator on this page shows the split for any vial size.

Why does the blend use a 1 : 1 ratio?

Because that is the ratio the trials used. Every dose pairing tested so far — 2.4 with 2.4, 1.7 with 1.7, and 1.0 with 1.0 — keeps the two equal, so a 1 : 1 vial reproduces the studied product at any rung. One exception is worth knowing: a planned higher-dose arm pairs 2.4 mg of cagrilintide with 7.2 mg of semaglutide, and a 1 : 1 vial cannot make that.

How long does a vial last?

Less time than most peptides here, because the doses are milligrams. At the 2.4 mg target a 10 mg vial is about two weekly doses and a 20 mg vial about four. At the starter rung a vial holds far more doses on paper, but a reconstituted vial should be used within roughly four weeks, so the calendar becomes the limit before the contents do.

Primary sources

References

PubChem CID 171397054PubChem CID 171397054 (Cagrilintide)
PubChem CID 56843331PubChem CID 56843331 (Semaglutide, free acid)
PMID 40544433Garvey et al., NEJM 2025 — REDEFINE 1: coadministered cagrilintide and semaglutide, phase 3a, 68 weeks, n=3,417 (NCT05567796)
PMID 33894838Enebo et al., Lancet 2021 (phase 1b cagrilintide + semaglutide)
PMID 34798060Lau et al., Lancet 2021 (phase 2 cagrilintide monotherapy)
PMID 37364590Frias et al., Lancet 2023 (CagriSema phase 2, type 2 diabetes)
PMID 34288673Kruse et al., J Med Chem 2021 (development of cagrilintide)
PMID 33567185Wilding et al., NEJM 2021 (STEP-1, semaglutide 2.4 mg in obesity)
DailyMed (Wegovy)DailyMed — Wegovy (semaglutide) label
DailyMed (Ozempic)DailyMed — Ozempic (semaglutide) label
Regulatory status tracker (Drugs.com)CagriSema regulatory-status tracker — not FDA-approved; NDA filed 2025-12-18; REDEFINE 1 trial-product estimand and REDEFINE 4 topline (23% at 84 weeks, non-inferiority vs tirzepatide 15 mg not met, announced 2026-02-23)
WADA 2026WADA 2026 (GLP-1 agonists on the Monitoring Program, not prohibited; cagrilintide not named)

Reviewed by Ki Researcher Team · Research use only · Not medical advice · Updated 2026-09-01