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Peptide stack

Cagrilintide + Semaglutide (CagriSema)

The one stack on this list with real trial data behind it.

Also known as: CagriSema

Combination has clinical trial data

Reviewed 2026-09-12
Not a recommendation. This page explains why a combination is discussed together in research or community circles — it is not an endorsement of stacking these compounds. See each component's own page for full detail, dosing and safety notes.

COMPONENTS in this stack

Why these are combined

CagriSema pairs cagrilintide (amylin agonist) with semaglutide (GLP-1 agonist) as a fixed-dose combination, and it's been through actual Phase 3 trials. A meta-analysis of seven RCTs (n=8,069) found it beat semaglutide alone by 7.58 kg and cagrilintide alone by 9.24 kg. The REDEFINE 1 trial confirmed higher rates of hitting anthropometric targets versus either drug solo. Semaglutide itself is an approved drug (Ozempic/Wegovy), not a research peptide, so it doesn't have its own page here.

Mechanism & pharmacokinetics

Unusually for a stack on this page, the pharmacokinetics were matched by design rather than assembled from mismatched parts: both cagrilintide (a lipidated amylin analog) and semaglutide (a lipidated GLP-1 analog) are engineered for roughly week-long half-lives, which is why the fixed-dose co-formulation CagriSema is dosed once weekly, same as either drug alone. Mechanistically they act on separate receptor systems (amylin receptor for cagrilintide, GLP-1 receptor for semaglutide) that both feed into satiety and gastric-emptying regulation through overlapping but non-identical hypothalamic and brainstem circuits — the premise being additive appetite suppression rather than one drug amplifying the other's pharmacology. This is the one stack on this page with actual Phase 3 trial data behind the combination itself, not just each ingredient separately.

Citations

Typical community protocol

Trial dosing used a once-weekly subcutaneous injection at a 2.4 mg/2.4 mg target dose, titrated up over several months, matching semaglutide's dosing schedule.

Safety notes

Safety: Mostly GI side effects (nausea, vomiting, diarrhea) plus injection-site reactions; fatigue is more common than with semaglutide alone. Lean mass drops along with fat, same as other GLP-1 drugs.
Community notes (anecdotal — not clinical evidence)

The most closely watched combination in obesity medicine right now, and unlike everything else on this page, it's backed by trial data rather than forum logic.