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Fat loss

Cagrilintide

Long-acting amylin agonist that adds synergistic weight loss on top of GLP-1 drugs.

Investigational (Phase 3) Fat loss Fitness & muscle

Reviewed 2026-09-12
Full name
NN2640 (long-acting amylin receptor agonist)
Also known as
long-acting amylin analog, amylin agonist
Regulatory status
Investigational (Phase 3) | Pending FDA approval

Origin

Novo Nordisk built cagrilintide as a long-acting amylin receptor agonist derived from human amylin, the pancreatic hormone co-secreted with insulin. Lipidation technology extends its half-life for once-weekly dosing, unlike first-generation amylin analogs that needed daily injections. Development accelerated after Phase 2/3 data showed enhanced efficacy combined with semaglutide in the fixed-dose CagriSema.

Mechanism

Activates amylin receptors (AMYR) and calcitonin receptors (CTR) in the hindbrain and hypothalamus, suppressing appetite, slowing gastric emptying, and driving satiation through neural circuits distinct from GLP-1 agonism. Combined with a GLP-1 agonist, activation in complementary brain regions produces additive satiety.

Research summary

Evidence

Meta-analyses of Phase 2/3 trials show cagrilintide monotherapy produces about 6% body weight reduction; the CagriSema combination adds 7-10% weight loss beyond semaglutide alone. Adverse events are mostly gastrointestinal and dose-related, with no unexpected safety signals so far. Trials run 12-52 weeks; there's no data on safety or durability beyond 1-2 years.

Evidence tier: Investigational (Phase 3) — see the methodology note for how this is assessed.

Citations

Reported benefits

  • weight loss (6-10% body weight reduction)
  • reduced waist circumference
  • improved glycemic control in diabetic subsets
  • reduced hunger and food motivation

Dosing protocols reported in the literature & community

These are protocols reported by compounding pharmacies, published trials, or self-experimentation communities — not a prescription. Start low, especially for anything new.

Reported dosing protocols
RouteReported protocol
Subcutaneous injectionOnce-weekly: escalation from 0.25 mg to target maintenance doses of 2.0-2.4 mg (monotherapy) or 2.4 mg when combined with semaglutide (CagriSema).

Side effects

  • nausea (dose-dependent)
  • vomiting
  • diarrhea
  • gastric reflux
  • injection site reactions
  • fatigue

Safety notes

Safety: GI adverse events are the limiting factor: grade 3 nausea/vomiting hits 5-20% of users at higher doses. Caution advised for anyone with a pancreatitis history. No major cardiac, renal, or hepatic signals so far, but safety beyond 2 years isn't established.
Community & reddit notes (anecdotal — not clinical evidence)

Anecdotal reports describe it as a potent satiety agent, more nausea-inducing than GLP-1 monotherapy alone. It's not available outside trials, and black-market sourcing brings potency variance and purity concerns.

Used in stacks

Community combinations that include Cagrilintide — see each stack page for the combination-specific rationale and evidence.