CagriSema Dosage, half-life & reference guide
Also known as Cagrilintide/semaglutide · Cagrilintide-semaglutide · Cagri-Sema · Cagri + Sema
Two weekly drugs in one regimen: cagrilintide, a long-acting version of the fullness hormone amylin, and semaglutide, the GLP-1 drug in Wegovy and Ozempic. Amylin and GLP-1 curb appetite through partly different routes, so together they go further than either alone; Novo Nordisk filed it for FDA approval in December 2025.
- Studied range
- 0.25–2.4 mgstarting dose 0.25 mg
- How often
- Weekly
- Evidence
- ●●●
Established - Route
- SubQ injection
Studied in research — not a recommendation.
How it works.
Weekly combination of two long-acting hormone analogues: cagrilintide, an amylin analogue that acts on amylin and calcitonin receptors, and semaglutide, a GLP-1 receptor agonist. Amylin and GLP-1 curb appetite through partly different brain pathways, so their effects add up: in REDEFINE 1 the pair lost more weight than either drug alone. Doses are written per component (2.4 mg/2.4 mg is 2.4 mg of each). Not approved: Novo Nordisk filed it with the FDA in December 2025, and a decision is expected in the fourth quarter of 2026.
Commonly reported: Strong appetite suppression and early fullness, with nausea, vomiting or constipation through the dose steps. In its main trial people lost about 20% of body weight on average at 68 weeks, more than on semaglutide alone; it is not approved yet.
Week by week.
What to expect in the first 8 weeks
- Onset
- Days–2 weeks
- Peak effect
- 68+ weeks
- Duration
- Ongoing
Day 1–28 · 0.25 mgRCT
The 0.25 mg start
You're on the first step, 0.25 mg of each drug. The trials start low to let the gut get used to two appetite signals at once. Commonly reported: appetite dipping within days, and some nausea after the first shots.
The science
In the phase 2 trial in type 2 diabetes (Frias 2023), cagrilintide started at 0.25 mg and semaglutide at 0.24 mg for 4 weeks, then both stepped up every 4 weeks (0.5, 1.0, 1.7, 2.4 mg) to reach 2.4 mg each by week 16, to mitigate GI side effects (protocol NN9838-4862, NCT04982575). REDEFINE 1 also escalated over 16 weeks (Garvey 2025).
Sources- Frias et al. (2023)
- Garvey et al. (REDEFINE 1) (2025)
Updated Oct 2026
Day 29–364 · 0.5 mgRCT
0.5 mg of each
At 0.5 mg of each, commonly reported: smaller portions and meals ending sooner. REDEFINE 1 let people stay on a lower step when a higher one did not suit them.
The science
REDEFINE 1 ran a flexible protocol in which people could adjust their dose; after 68 weeks, 57.3% of those on CagriSema were on the highest dose (Novo Nordisk, December 2024). Its trial-product estimand counted any of the trial doses as taken as intended (Verma 2026).
Sources- Novo Nordisk (REDEFINE 1 headline results) (2024)
- Verma et al. (2026)
Updated Oct 2026
Any dayRCT
What CagriSema is built on
Three published phase 3 trials back CagriSema, and it lost more weight than semaglutide alone. Against tirzepatide 15 mg (REDEFINE 4) it averaged 23.0% at 84 weeks vs 25.5%, short of its goal of matching it. It is under FDA review, with a decision expected in late 2026.
The science
REDEFINE 1 (Garvey 2025, 3,417 adults), REDEFINE 2 (Davies 2025, 1,206 adults with type 2 diabetes) and REDEFINE 5 (Yamauchi 2026, 331 adults in Japan and Taiwan: −18.4% vs −11.9% for semaglutide alone at 68 weeks). REDEFINE 4 (Novo Nordisk, February 2026; open-label, 809 adults, 84 weeks): 23.0% vs 25.5% for tirzepatide 15 mg on the efficacy estimand and 20.2% vs 23.6% on the treatment-regimen estimand; the non-inferiority endpoint was not met. Novo Nordisk filed for FDA approval in December 2025 and expects a US decision in the fourth quarter of 2026.
Sources- Garvey et al. (REDEFINE 1) (2025)
- Davies et al. (REDEFINE 2) (2025)
- Yamauchi et al. (REDEFINE 5) (2026)
- Novo Nordisk (REDEFINE 4 headline results) (2026)
- Novo Nordisk (H1 2026 report) (2026)
Updated Oct 2026
With BPC-157Community
Why people add BPC-157 to CagriSema
The climb on two appetite drugs can be hard on the stomach, and some people add BPC-157, first studied as a stomach-protecting peptide, hoping to ease it. Commonly reported: smoother step-ups; no trial has tested the pairing.
The science
BPC-157 is a fragment of a body protection compound first isolated from human gastric juice, and its gut research is almost all in animals (Sikiric 2018). No trial has tested the pairing; the pattern comes from community reports.
Sources- Sikiric et al. (2018)
Updated Oct 2026
After week 8
Day 57–364 · 1 mgRCT
1 mg of each, halfway up
1 mg of each is the middle step. Commonly reported: food noise quieter and fullness arriving early in a meal, with GI side effects most noticeable in the days after a step-up.
The science
Semaglutide acts on GLP-1 receptors and cagrilintide on amylin and calcitonin receptors (Fletcher 2021). Amylin, released with insulin, promotes satiety and slows stomach emptying (Volčanšek 2025), the rationale for pairing the two. REDEFINE 1 reported GI side effects in 79.6% on the combination vs 39.9% on placebo, mainly transient and mild to moderate (Garvey 2025).
Sources- Fletcher et al. (2021)
- Volčanšek et al. (2025)
- Garvey et al. (REDEFINE 1) (2025)
Updated Oct 2026
Day 85–364 · 1.7 mgRCT
1.7 mg of each, one step from the top
1.7 mg of each is the last step before the 2.4 mg maintenance dose. In the trials, GI side effects were mostly mild to moderate and faded with time.
The science
In phase 1b (Enebo 2021), the two were co-escalated every 4 weeks over 16 weeks; at week 20, cagrilintide 2.4 mg plus semaglutide 2.4 mg gave 17.1% weight loss vs 9.8% for semaglutide with placebo. Novo Nordisk reported GI events with CagriSema as mostly mild to moderate and diminishing over time in both REDEFINE 1 and REDEFINE 4.
Sources- Enebo et al. (2021)
- Novo Nordisk (REDEFINE 1 headline results) (2024)
- Novo Nordisk (REDEFINE 4 headline results) (2026)
Updated Oct 2026
Day 113+ · 2.4 mgRCT
2.4 mg/2.4 mg, the maintenance dose
2.4 mg of each is the maintenance dose Novo Nordisk filed. In REDEFINE 1, average weight loss at 68 weeks was 20.4% counting everyone randomized, and 22.7% for people who stayed on treatment.
The science
REDEFINE 1 (Garvey 2025; 3,417 adults without diabetes): −20.4% vs −3.0% on placebo (treatment-policy); on the trial-product estimand −22.7%, vs −16.1% for semaglutide alone, −11.8% for cagrilintide alone and −2.3% for placebo (Busetto 2026). REDEFINE 2 (Davies 2025; 1,206 adults with type 2 diabetes): −13.7% vs −3.4%, and 73.5% reached an HbA1c of 6.5% or less.
Sources- Garvey et al. (REDEFINE 1) (2025)
- Busetto et al. (2026)
- Davies et al. (REDEFINE 2) (2025)
Updated Oct 2026
Day 1 is the day you start it.
Phase 3 REDEFINE 1 and 2 (NEJM 2025), REDEFINE 5 (Lancet Diabetes Endocrinol 2026) and the REDEFINE 4 headline results (Novo Nordisk, 2026). Under FDA review; not approved.
Clinical trial data
A typical run.
Run notes
- Cycle
- Studied as an ongoing weekly treatment: 68 to 84 weeks in phase 3. Not approved yet; Novo Nordisk filed for US approval in December 2025.Community practice — opinions vary. Not a clinical recommendation.
- Timing
- Once weekly. Doses are per component: 2.4 mg/2.4 mg is 2.4 mg of cagrilintide plus 2.4 mg of semaglutide. In the trials both stepped up together every 4 weeks over 16 weeks (0.25, 0.5, 1.0, 1.7, then 2.4 mg of each), and REDEFINE 1 let people stay on a lower step. These are trial escalations, not an approved regimen.
- Route
- SubQ injection
- Stacks
- BPC-157 (GI support)
Safety.
Common side effects
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Abdominal pain
Interactions
It already contains a GLP-1 drug (semaglutide), so it is not combined with another GLP-1, and adding separate cagrilintide or semaglutide doubles up a component. Semaglutide slows stomach emptying, which can affect how oral medicines are absorbed, and with insulin or a sulfonylurea the glucose lowering adds up, raising the risk of low blood sugar (semaglutide labels). Discuss your medicines with your clinician.
Safety notes
CagriSema has no label yet. In REDEFINE 1, GI side effects (nausea, vomiting, diarrhea, constipation, abdominal pain) affected 79.6% on CagriSema vs 39.9% on placebo, mainly passing and mild to moderate; in REDEFINE 2 (type 2 diabetes), 72.5% vs 34.4%. Its semaglutide half carries the semaglutide labels' warnings: the boxed warning for thyroid C-cell tumors seen in rodents (human relevance not determined; the labels rule it out for anyone with a personal or family history of medullary thyroid carcinoma or MEN 2), plus pancreatitis, gallbladder disease and low blood sugar with insulin or a sulfonylurea. These are trial and label findings; review them with your clinician.
Goes with.
Questions people ask.
What is CagriSema?
Two weekly drugs in one regimen: cagrilintide, a long-acting version of the fullness hormone amylin, and semaglutide, the GLP-1 drug in Wegovy and Ozempic. Amylin and GLP-1 curb appetite through partly different routes, so together they go further than either alone; Novo Nordisk filed it for FDA approval in December 2025.
How is CagriSema dosed in research?
The research range for CagriSema is 0.25–2.4 mg, weekly, with a 0.25 mg starting dose. Studied in research — not a recommendation.
How long does CagriSema last?
The half-life of CagriSema is ~1 week for each component (measured in people: cagrilintide 159–195 hours and semaglutide 145–165 hours in a phase 1b trial).
What do people report on CagriSema?
Commonly reported on CagriSema: strong appetite suppression and early fullness, with nausea, vomiting or constipation through the dose steps. In its main trial people lost about 20% of body weight on average at 68 weeks, more than on semaglutide alone; it is not approved yet.
Is CagriSema safe?
The research basis for CagriSema is established: clinical trials or FDA-approved use exists. Common side effects in the library: nausea, vomiting, diarrhea, constipation and abdominal pain.
What does CagriSema stack with?
Common stacks for CagriSema: BPC-157 (GI support).
Research.
Reference.
- Cadence
Weekly
- Half-life
~1 week for each component (measured in people: cagrilintide 159–195 hours and semaglutide 145–165 hours in a phase 1b trial)
- Research basis
●●●
EstablishedClinical trials or FDA-approved use exists
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