Cagrilintide vs Semaglutide
Verdict: This is a comparison that ends in a partnership. Semaglutide works the GLP-1 incretin pathway; cagrilintide is a long-acting amylin analog working the satiety signal your pancreas co-releases with insulin. Alone, cagrilintide's ~10-11% weight loss doesn't beat semaglutide's ~15%. But because the pathways are complementary, the combination (CagriSema) posted the numbers that made headlines — which is why cagrilintide rarely appears in protocols by itself.
Side by side
| Cagrilintide | Semaglutide | |
|---|---|---|
| Typical dose | 250 mcg–2.4 mg | 250 mcg–2.4 mg |
| Frequency | 1x weekly | 1x weekly, titrated up over months |
| Administration | subcutaneous injection | subcutaneous injection |
| Common vials | 5 mg, 10 mg | 2 mg, 5 mg, 10 mg |
| Typical mix | 5 mg + 2 ml water | 5 mg + 2 ml water |
| Units for typical dose | 20 units (500 mcg) | 20 units (500 mcg) |
Two different satiety signals
GLP-1 agonists slow gastric emptying and act on hindbrain and hypothalamic appetite circuits. Amylin analogs like cagrilintide act on the area postrema and promote meal-ending satiation — you stop eating sooner, rather than not starting. Mechanistically they are additive, not redundant, which is the entire rationale for combining them.
What the trials show
Cagrilintide monotherapy phase 2: roughly 10.8% weight loss at the highest dose over 26 weeks. Semaglutide 2.4 mg: ~15% over 68 weeks. CagriSema (2.4 mg + 2.4 mg): phase-3 REDEFINE program reported ~23% — approaching surgical territory. All the usual cross-trial caveats apply.
Dosing and practicalities
Both are once-weekly subcutaneous compounds titrated slowly to manage nausea. In research settings cagrilintide is typically run 0.3 → 2.4 mg weekly. As a standalone research compound it is less available and less studied than semaglutide; nearly all current interest is in the combination.
Can you stack them?
This is the rare 'vs' page where stacking IS the answer: the fixed-ratio combination of both is the clinically studied path. Running cagrilintide alone mainly makes sense when GLP-1 agonists aren't tolerated.
More comparisons
Educational comparison based on commonly published research protocols — not medical advice or an endorsement of any compound.