The short answer
They act on different hormones: cagrilintide is a long-acting analogue of amylin, the fullness hormone the pancreas releases with insulin, and semaglutide is a GLP-1 receptor agonist. Semaglutide is FDA-approved; cagrilintide isn’t approved on its own, and it is the amylin half of Novo Nordisk’s CagriSema. Both are weekly shots.
Side by side
| Compared | Cagrilintide | Semaglutide |
|---|---|---|
| Category | Metabolic & GLP-1 | Metabolic & GLP-1 |
| Also known as | Cagri, AM833, NNC0174-0833 | Ozempic, Wegovy |
| What it is | A long-acting version of amylin, the fullness hormone the pancreas releases alongside insulin, given as a weekly shot. | A GLP-1 receptor agonist that mimics a gut hormone your body releases after eating: it reduces appetite and slows stomach emptying. |
| How it works | Long-acting, lipidated analogue of amylin, the satiety hormone the pancreas releases with insulin. It activates amylin receptors and the calcitonin receptor (a non-selective amylin agonist); amylin promotes fullness, slows stomach emptying and holds back glucagon after meals. A fatty-acid chain stretches its half-life to about a week, so it is a weekly shot, usually run beside a GLP-1. Not approved on its own: it is the amylin half of Novo Nordisk's CagriSema. | GLP-1 receptor agonist that reduces appetite, slows gastric emptying, and improves glucose metabolism. FDA-approved for T2DM and obesity. Titrate dose slowly to minimize GI side effects. |
| Commonly reported | Feeling full sooner and portions shrinking, with nausea or constipation after step-ups and some injection-site reactions. It is not approved on its own. | The constant background thoughts about food ("food noise") go quiet and portions shrink without effort, with nausea worst in the first days after each dose step. FDA-approved for type 2 diabetes, weight management, heart-risk reduction and MASH, with about 15% average weight loss at 68 weeks in its main trial. |
| Studied range | Research range: 0.25–2.4 mg, starting dose 0.25 mg. Studied in research — not a recommendation. | FDA label: 0.25–2.4 mg, starting dose 0.25 mg. |
| How often | Weekly | Weekly SubQ |
| Half-life | ~1 week (measured in people: 159–195 hours in a phase 1b trial) | ~1 week (FDA label) |
| Route | SubQ injection | SubQ injection |
| Typical run | Trials run it continuously: 26 weeks in phase 2, 68 weeks in phase 3. Community use is mostly as a weekly add-on to a GLP-1. | FDA-approved for ongoing use. Community uses indefinitely or until goal weight reached, then tapers. |
| Evidence | Established: clinical trials or FDA-approved use exists | Established: clinical trials or FDA-approved use exists |
| Common side effects | Nausea, constipation, diarrhea, injection-site reactions | Nausea, vomiting, diarrhea, constipation, decreased appetite, fatigue, pancreatitis risk |
- Category
- CagrilintideMetabolic & GLP-1
- SemaglutideMetabolic & GLP-1
- Also known as
- CagrilintideCagri, AM833, NNC0174-0833
- SemaglutideOzempic, Wegovy
- What it is
- CagrilintideA long-acting version of amylin, the fullness hormone the pancreas releases alongside insulin, given as a weekly shot.
- SemaglutideA GLP-1 receptor agonist that mimics a gut hormone your body releases after eating: it reduces appetite and slows stomach emptying.
- How it works
- CagrilintideLong-acting, lipidated analogue of amylin, the satiety hormone the pancreas releases with insulin. It activates amylin receptors and the calcitonin receptor (a non-selective amylin agonist); amylin promotes fullness, slows stomach emptying and holds back glucagon after meals. A fatty-acid chain stretches its half-life to about a week, so it is a weekly shot, usually run beside a GLP-1. Not approved on its own: it is the amylin half of Novo Nordisk's CagriSema.
- SemaglutideGLP-1 receptor agonist that reduces appetite, slows gastric emptying, and improves glucose metabolism. FDA-approved for T2DM and obesity. Titrate dose slowly to minimize GI side effects.
- Commonly reported
- CagrilintideFeeling full sooner and portions shrinking, with nausea or constipation after step-ups and some injection-site reactions. It is not approved on its own.
- SemaglutideThe constant background thoughts about food ("food noise") go quiet and portions shrink without effort, with nausea worst in the first days after each dose step. FDA-approved for type 2 diabetes, weight management, heart-risk reduction and MASH, with about 15% average weight loss at 68 weeks in its main trial.
- Studied range
- CagrilintideResearch range: 0.25–2.4 mg, starting dose 0.25 mg. Studied in research — not a recommendation.
- SemaglutideFDA label: 0.25–2.4 mg, starting dose 0.25 mg.
- How often
- CagrilintideWeekly
- SemaglutideWeekly SubQ
- Half-life
- Cagrilintide~1 week (measured in people: 159–195 hours in a phase 1b trial)
- Semaglutide~1 week (FDA label)
- Route
- CagrilintideSubQ injection
- SemaglutideSubQ injection
- Typical run
- CagrilintideTrials run it continuously: 26 weeks in phase 2, 68 weeks in phase 3. Community use is mostly as a weekly add-on to a GLP-1.
- SemaglutideFDA-approved for ongoing use. Community uses indefinitely or until goal weight reached, then tapers.
- Evidence
- CagrilintideEstablished: clinical trials or FDA-approved use exists
- SemaglutideEstablished: clinical trials or FDA-approved use exists
- Common side effects
- CagrilintideNausea, constipation, diarrhea, injection-site reactions
- SemaglutideNausea, vomiting, diarrhea, constipation, decreased appetite, fatigue, pancreatitis risk
Typical run: Community practice — opinions vary. Not a clinical recommendation.
Week by week
Each entry’s cards by day window, as the compound pages show them. Day 1 is the day you start it.
Cagrilintide
- Day 1–28 · 0.25 mg The 0.25 mg start
- Day 29–364 · 0.5 mg 0.5 mg, the second step
- Day 57–364 · 1 mg 1 mg, the middle step
- Day 85–364 · 1.7 mg 1.7 mg, the step before 2.4 mg
- Day 113+ · 2.4 mg 2.4 mg, the phase 3 dose
Semaglutide
- Day 1–28 · 0.25 mg Gut is adapting
- Day 29–56 · 0.5 mg Appetite shifts are real now
- Day 57–112 · 1 mg Clinically useful weight loss kicks in
- Day 113–140 · 1.7 mg Max submaximal step
- Day 141–364 · 2.4 mg Full dose — the working dose
- Day 365+ Plateau territory — new baseline
Together or one or the other
Cagrilintide and semaglutide are a common stack: cagrilintide lists semaglutide among its common stacks.
The two in one regimen: CagriSema
RCT · Cagrilintide
With semaglutide: the CagriSema pair
This is the pairing with trial data. Together, as CagriSema, the two averaged 22.7% weight loss at 68 weeks for people who stayed on treatment, against 16.1% for semaglutide alone; in the trials both stepped up together every 4 weeks.
Questions people ask
How long do cagrilintide and semaglutide last?
The half-life of cagrilintide is ~1 week (measured in people: 159–195 hours in a phase 1b trial). The half-life of semaglutide is ~1 week (FDA label).
How often are cagrilintide and semaglutide taken?
Cagrilintide: weekly. Route: SubQ injection. Semaglutide: weekly SubQ. Route: SubQ injection.
How are cagrilintide and semaglutide dosed in research?
The research range for cagrilintide is 0.25–2.4 mg, with a 0.25 mg starting dose. Studied in research — not a recommendation. The FDA label range for semaglutide is 0.25–2.4 mg, with a 0.25 mg starting dose.
What are the common side effects of cagrilintide and semaglutide?
For cagrilintide, the library lists: nausea, constipation, diarrhea, injection-site reactions. For semaglutide: nausea, vomiting, diarrhea, constipation, decreased appetite, fatigue, pancreatitis risk.
Are cagrilintide and semaglutide taken together?
Cagrilintide and semaglutide are a common stack: cagrilintide lists semaglutide among its common stacks. This is the pairing with trial data. Together, as CagriSema, the two averaged 22.7% weight loss at 68 weeks for people who stayed on treatment, against 16.1% for semaglutide alone; in the trials both stepped up together every 4 weeks.
Each one in full
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Log every dose of cagrilintide or semaglutide, with reminders on your schedule. 7 days free on the yearly plan for new subscribers.
