Cagrilintide Dosing Protocol: Weekly Titration, Reconstitution Math & Research (2026)

Cagrilintide Quick Start

Cagrilintide (AM833) is a 37-amino-acid analog of amylin, the pancreatic hormone co-secreted with insulin that signals satiety and slows gastric emptying. A C20 fatty-diacid side chain binds albumin and stretches its half-life to roughly a week, so it is dosed once weekly by subcutaneous injection. It is investigational: studied alone in a 26-week Phase 2 trial and, combined with semaglutide as CagriSema, through the Phase 3 REDEFINE program. It is the first long-acting amylin analog to reach late-stage development.

This guide is an educational research reference. It does not diagnose, treat, or prescribe, and is not medical advice. Consult a licensed clinician before considering any compound.

Cagrilintide Dosing Protocol

Every cagrilintide trial dosed it once weekly, subcutaneously, with stepwise escalation to manage gastrointestinal effects. The Phase 2 monotherapy study escalated to maintenance doses of 0.3 to 4.5 mg; the Phase 3 CagriSema program escalates cagrilintide over 16 weeks to a 2.4 mg maintenance dose (0.25 → 0.5 → 1.0 → 1.7 → 2.4 mg, roughly four weeks per step). The ladder below follows that 2.4 mg pathway. The units column assumes the 2 mL reconstitution worked out in the next section (5 mg/mL, 1 mg = 20 units). These are research-planning references, not personal dosing recommendations.

Cycle guidelines

Escalation, not the final dose, is where most GI events occur. The clinical program held a step rather than reduced the dose when tolerability was the issue.

Cagrilintide Reconstitution Guide

Cagrilintide ships as a lyophilized powder in a 10 mg vial. Because the early steps are small (0.25–0.5 mg), a 2 mL reconstitution gives a readable 5-to-10-unit draw and a round 5 mg/mL concentration. A 1 mL fill doubles the concentration for smaller draws at the maintenance dose; 3 mL fits the vial but gives non-round unit figures.

Reconstitution steps

1. Inspect the vial. Confirm the label, the 10 mg strength, and that the powder looks dry and intact.
2. Wipe the stoppers. Use an alcohol swab on both the bacteriostatic water and peptide vial stoppers.
3. Draw the chosen volume. 2 mL (or 1 mL for a more concentrated solution) into the vial — this is the number that sets every concentration figure above.
4. Inject down the wall. Release the water slowly down the inside wall, not directly onto the powder.
5. Swirl, do not shake. Roll gently until dissolved. Shaking foams and can damage the peptide.
6. Verify clarity. Solution should be clear and colorless. Discard if cloudy or particulate.
7. Label and refrigerate. Note the date and volume added on the vial, then store at 2–8 °C. Do not freeze the reconstituted solution.

See the bacteriostatic water guide for diluent handling, or the reconstitution calculator to work any other volume.

How Cagrilintide Works

Amylin is co-released with insulin from pancreatic beta cells after a meal and acts on the area postrema and hypothalamus to signal fullness, slow gastric emptying, and suppress post-meal glucagon. Native amylin has a half-life of minutes and aggregates readily, which is why the first amylin analog, pramlintide, has to be injected before each meal. Cagrilintide solves both problems: sequence substitutions prevent aggregation, and a C20 diacid lipid side chain binds albumin so the peptide circulates for about a week. Pharmacologically it activates both the amylin receptors (calcitonin receptor + RAMP complexes) and the calcitonin receptor itself, which is why it is sometimes described as a dual amylin and calcitonin receptor agonist.

Who Should Avoid Cagrilintide

Cagrilintide is investigational and has no approved labeling; the cautions below transfer from the amylin-analog class (pramlintide labeling) and from its trial exclusion criteria.

Cagrilintide Side Effects & Safety

Timeline & What to Monitor

Cagrilintide Evidence Context

Storage & Handling

Cagrilintide vs Other Appetite-Pathway Compounds

Cagrilintide Formats & Sourcing

Cagrilintide is supplied as a lyophilized powder in a single 10 mg vial. There is no pre-reconstituted pen or spray format. Batch-specific Certificates of Analysis are issued per lot; always verify the strength on the label against the figures used here before calculating anything.

Strengths are listed as sold; confirm against the product page and the batch COA before calculating anything.

References

1. Lau DCW, et al. Once-weekly cagrilintide for weight management in people with overweight and obesity: a multicentre, randomised, double-blind, placebo-controlled and active-controlled, dose-finding phase 2 trial. Lancet (2021).
2. Enebo LB, et al. Safety, tolerability, pharmacokinetics, and pharmacodynamics of concomitant administration of multiple doses of cagrilintide with semaglutide 2.4 mg for weight management: a randomised, controlled, phase 1b trial. Lancet (2021).
3. Frias JP, et al. Efficacy and safety of co-administered once-weekly cagrilintide 2.4 mg with once-weekly semaglutide 2.4 mg in type 2 diabetes: a multicentre, randomised, double-blind, active-controlled, phase 2 trial. Lancet (2023).
4. Garvey WT, et al. Coadministered cagrilintide and semaglutide in adults with overweight or obesity (REDEFINE 1). N Engl J Med (2025).
5. Kruse T, et al. Development of cagrilintide, a long-acting amylin analogue. J Med Chem (2021).
6. Boyle CN, et al. Amylin — its role in the homeostatic and hedonic control of eating and recent developments of amylin analogs to treat obesity. Mol Metab (2018).