Cagrilintide Reconstitution Calculator
Cagrilintide (AM833, NNC0174-0833) is a long-acting analogue of amylin, the pancreatic hormone co-secreted with insulin that induces satiety. It is not a GLP-1 receptor agonist and has no incretin activity of its own: it acts at amylin and calcitonin receptors, slowing gastric emptying and suppressing glucagon. Native amylin cannot be used as a drug because it aggregates into amyloid fibrils, so cagrilintide is a stabilised, lipidated version engineered for once-weekly subcutaneous injection. It is investigational everywhere, and most of its human data comes from co-administration with semaglutide as CagriSema.
Curated by Dosavy from published literature and regulator labels. Published 1 September 2026, last reviewed 5 September 2026. No clinician reviews this page.
Enter a target dose above to see the draw.
What the evidence says
| Experience | Route | Range | Frequency |
|---|---|---|---|
| Beginner | Subcutaneous | 0.3–0.6 mg[1][2]The low end of the phase 2 dose-finding range and the escalation entry point used in later trials. The phase 2 monotherapy trial randomised participants to 0.3 mg or 0.6 mg once weekly among its five dose arms over 26 weeks, with a dose-escalation period of up to 6 weeks; the thorough QT study started participants at 0.6 mg once weekly before escalating. These are protocol doses from registered trials, not a licensed starting regimen. | Once weekly |
| Intermediate | Subcutaneous | 1.2–2.4 mg[1][3][4]2.4 mg once weekly is the dose the programme settled on: it is the cagrilintide component of CagriSema and it is the monotherapy comparator arm carried into phase 3. In the 68-week phase 3 REDEFINE 1 trial, 302 participants received cagrilintide 2.4 mg alone; in phase 3 REIMAGINE 2 in type 2 diabetes, separate arms received cagrilintide 2.4 mg alone and cagrilintide 1.0 mg with semaglutide 1.0 mg. 1.2 mg is an intermediate phase 2 dose arm. Reached by stepwise escalation, not started at. | Once weekly |
| Advanced | Subcutaneous | 4.5 mg[1][2]The highest dose of cagrilintide administered to humans in the published trials in this packet: the top arm of the phase 2 monotherapy dose-finding trial (26 weeks) and the top cohort of the phase 1b co-administration trial with semaglutide 2.4 mg. Note that the development programme did not carry 4.5 mg forward (phase 3 uses 2.4 mg), so the higher dose is 'studied', not 'selected'. There is no human evidence of any kind above 4.5 mg once weekly. | Once weekly |
- BeginnerSubcutaneous
Once weekly
The low end of the phase 2 dose-finding range and the escalation entry point used in later trials. The phase 2 monotherapy trial randomised participants to 0.3 mg or 0.6 mg once weekly among its five dose arms over 26 weeks, with a dose-escalation period of up to 6 weeks; the thorough QT study started participants at 0.6 mg once weekly before escalating. These are protocol doses from registered trials, not a licensed starting regimen.
- IntermediateSubcutaneous
Once weekly
2.4 mg once weekly is the dose the programme settled on: it is the cagrilintide component of CagriSema and it is the monotherapy comparator arm carried into phase 3. In the 68-week phase 3 REDEFINE 1 trial, 302 participants received cagrilintide 2.4 mg alone; in phase 3 REIMAGINE 2 in type 2 diabetes, separate arms received cagrilintide 2.4 mg alone and cagrilintide 1.0 mg with semaglutide 1.0 mg. 1.2 mg is an intermediate phase 2 dose arm. Reached by stepwise escalation, not started at.
- AdvancedSubcutaneous
Once weekly
The highest dose of cagrilintide administered to humans in the published trials in this packet: the top arm of the phase 2 monotherapy dose-finding trial (26 weeks) and the top cohort of the phase 1b co-administration trial with semaglutide 2.4 mg. Note that the development programme did not carry 4.5 mg forward (phase 3 uses 2.4 mg), so the higher dose is 'studied', not 'selected'. There is no human evidence of any kind above 4.5 mg once weekly.
Published ranges, reported as the literature states them and numbered to the sources at the foot of this page. Not a recommendation.
Cagrilintide at a glance
- Category
- GLP-1
- Half-life
- Not established
- Routes
- Subcutaneous
- Regulatory status
- Not approved
- Also sold as
- AM833, NNC0174-0833, long-acting amylin analogue, amylin receptor agonist, CagriSema component
Mechanism
A long-acting analogue of amylin, the pancreatic hormone co-secreted with insulin that induces satiety. It is NOT a GLP-1 receptor agonist and has no incretin activity of its own; it acts at amylin and calcitonin receptors, slowing gastric emptying, suppressing glucagon and reducing food intake through a satiety pathway distinct from GLP-1. Native amylin is unusable as a drug because it aggregates into amyloid fibrils, and the approved short-acting analogue pramlintide needs three daily injections; cagrilintide is a stabilised, lipidated analogue engineered for once-weekly subcutaneous dosing. Its clinical development is dominated by co-administration with semaglutide (CagriSema), where the two satiety mechanisms are additive.
Reconstitution
There is no approved presentation and no published reconstitution instruction: trial participants self-injected a ready-prepared solution. Any lyophilised powder sold as 'cagrilintide' has unverified identity, purity and peptide content, so the milligram figures from the trials below cannot be assumed to describe what is in such a vial. Amylin analogues in particular are prone to fibril aggregation, which is a formulation problem, not something a home reconstitution can inspect for.
Storage
No approved product and therefore no manufacturer storage instructions exist. Trial material was a solution for subcutaneous self-injection supplied under sponsor-controlled conditions; nothing in this packet establishes stability conditions for material obtained outside a trial.
Frequency in practice
Once weekly by subcutaneous injection in every published trial, after a multi-week dose-escalation period.
Regulatory
Investigational. Cagrilintide (Novo Nordisk) is not approved by the FDA, the EMA or Swissmedic, either as monotherapy or as part of the CagriSema fixed-dose combination with semaglutide. Development is furthest advanced for CagriSema (phase 3 REDEFINE and REIMAGINE programmes); cagrilintide monotherapy has completed a phase 2 dose-finding trial and has been carried as a comparator arm at 2.4 mg into phase 3.
What to know before anything else
Not approved for human use anywhere, as monotherapy or in combination. There is no prescribing information, so there is no boxed warning, no contraindication list, no drug-interaction table and no approved maximum dose. The doses below are trial protocol doses, not a licensed regimen.
Material sold as 'cagrilintide' outside a clinical trial is not the trial drug. Identity, purity, peptide content and sterility are unverified.
Gastrointestinal adverse events (nausea and vomiting in particular) are the dominant adverse effect in every published trial, and the trials used multi-week dose escalation specifically to manage them.
Amylin analogues slow gastric emptying and suppress glucagon. Pramlintide, the only amylin analogue approved in the US, carries a boxed warning for severe insulin-induced hypoglycaemia when used with insulin. No regulator has assessed whether that risk applies to cagrilintide, so anyone using insulin or an insulin secretagogue is in genuinely uncharacterised territory.
Most of the human safety data for cagrilintide comes from trials where it was co-administered with semaglutide 2.4 mg, so adverse effects attributable to cagrilintide alone are less well separated than the volume of trial data suggests.
Two published findings are reassuring but narrow: a thorough QT study found no clinically relevant QTc prolongation in healthy participants, and single-dose studies found renal or hepatic impairment did not meaningfully change pharmacokinetics. Neither speaks to long-term safety.
No published pregnancy, lactation or paediatric data. A paediatric phase 3 trial is only now recruiting.
Reviewed interactions
These are the pairs Dosavy holds reviewed, cited data on. A combination that is not listed here has not been assessed, which is not the same as being safe.
- Cautionwith Semaglutide
This is a real, studied combination (CagriSema) rather than an improvised one, but in the trials both drugs were co-escalated slowly in 4-week steps to their 2.4 mg targets, not bolted together at full dose. Both slow gastric emptying, so the nausea, vomiting and dehydration risk is additive; escalate one step at a time and hold if gastrointestinal symptoms are not settling.[2][3]
Cagrilintide is an amylin analogue and semaglutide a GLP-1 receptor agonist: different receptors, but both slow gastric emptying and suppress appetite, so the gastrointestinal effects add up even though the mechanisms do not duplicate.
Cagrilintide questions
Is cagrilintide approved anywhere?
No. Cagrilintide (Novo Nordisk) is not approved by the FDA, the EMA or Swissmedic, either as monotherapy or as part of the CagriSema fixed-dose combination with semaglutide. Because there is no prescribing information, there is no boxed warning, no contraindication list, no drug-interaction table and no approved maximum dose. Development is furthest advanced for CagriSema in the phase 3 REDEFINE and REIMAGINE programmes; monotherapy has completed a phase 2 dose-finding trial and been carried into phase 3 as a comparator arm.
What doses have actually been given to people in trials?
The phase 2 dose-finding trial published in the Lancet in 2021 (PMID 34798060) randomised adults with overweight or obesity to once-weekly subcutaneous cagrilintide at 0.3, 0.6, 1.2, 2.4 or 4.5 mg, against once-daily liraglutide 3.0 mg and placebo, over 26 weeks including a dose-escalation period of up to six weeks. The programme then settled on 2.4 mg once weekly: that is the monotherapy arm carried into the 68-week phase 3 REDEFINE 1 trial (PMID 40544433), where 302 participants received it. These are trial protocol doses, reached by stepwise escalation, not a licensed regimen.
How does cagrilintide differ from a GLP-1 agonist like semaglutide?
Different receptor family. Semaglutide is an incretin mimetic acting at the GLP-1 receptor; cagrilintide acts at amylin and calcitonin receptors and has no incretin activity. Both reduce food intake and slow gastric emptying, which is why the gastrointestinal effects add up, but the satiety pathways are distinct rather than duplicated. That non-overlap is the whole rationale for combining them as CagriSema, and it is why pairing two GLP-1 agonists was never pursued the same way.
What is CagriSema, and was the combination studied or improvised?
It is cagrilintide co-administered with semaglutide, and it is a studied regimen. The phase 1b trial in the Lancet (PMID 33894838) escalated cagrilintide from 0.16 up to 4.5 mg alongside semaglutide 2.4 mg in six sequential cohorts of 96 participants, stepping both drugs together at four-week intervals over 16 weeks rather than adding them abruptly. The phase 3a REDEFINE 1 trial (PMID 40544433, 3,417 participants) then compared cagrilintide 2.4 mg plus semaglutide 2.4 mg against each agent alone and placebo over 68 weeks. The co-titration is part of the design, not an optional detail.
What are the main safety concerns?
Gastrointestinal adverse events, nausea and vomiting in particular, are the dominant adverse effect in every published trial, which is why the trials used multi-week escalation. Pramlintide, the only amylin analogue approved in the US, carries a boxed warning for severe insulin-induced hypoglycaemia when combined with insulin; no regulator has assessed whether that risk carries over to cagrilintide, so anyone using insulin or an insulin secretagogue is in uncharacterised territory. Two published findings are reassuring but narrow: a thorough QT study found no clinically relevant QTc prolongation in healthy participants, and single-dose studies found renal or hepatic impairment did not meaningfully change pharmacokinetics. Neither speaks to long-term safety, and there are no published pregnancy, lactation or paediatric data.
Is there stability or storage guidance for cagrilintide?
None that comes from a manufacturer. No approved product exists, so no approved storage instructions exist either. Trial material was a ready-prepared solution for subcutaneous self-injection supplied under sponsor-controlled conditions, and nothing in the published record establishes stability conditions for material obtained outside a trial. Storage claims printed on a research-peptide vial, including the expiry date, are unverified.
Do the trial milligram figures describe a vial bought outside a trial?
No, and this is the specific reason the numbers do not transfer. There is no approved presentation and no published reconstitution instruction, because trial participants injected a ready-made solution rather than mixing a powder. Any lyophilised material sold as cagrilintide has unverified identity, purity and peptide content, so a trial dose in milligrams cannot be assumed to describe what is in such a vial. Amylin analogues are also prone to fibril aggregation, which is a formulation problem that no home reconstitution can inspect for. The calculator above converts vial size and mixing volume into mg/ml and syringe units; it says nothing about what the vial contains.
Every number above, and where it came from
4 sources, numbered where they are used. Each one links to the paper or the label itself, not to a summary of it.
- [1]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 · Phase 2 randomised, double-blind, placebo- and active-controlled dose-finding trial
- [2]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 · Phase 1b randomised, placebo-controlled, multiple-ascending-dose trial · n=96
- [3]Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity
The New England Journal of Medicine · 2025 · Phase 3a randomised, double-blind, placebo- and active-controlled trial (REDEFINE 1) · n=3417
- [4]Cagrilintide-semaglutide (CagriSema) versus semaglutide or cagrilintide in people with type 2 diabetes (REIMAGINE 2): a double-blind, randomised, controlled, phase 3 study
The Lancet Diabetes & Endocrinology · 2026 · Phase 3 randomised, double-blind, placebo- and active-controlled trial
The rest of the math
- Reconstitution calculatorVial size and diluent to mg/mL and syringe units, with barrel sizes and IU conversion.
- Vial longevityHow many doses a vial holds and the date it runs out.
- Cost per doseVial price against doses drawn, so two vial sizes can be compared honestly.
- Half-life and decayFirst-order clearance, time to steady state, and what remains at a given hour.
- GLP-1 titration scheduleEscalation steps and week-by-week timing for GLP-1 receptor agonists.
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A calculator answers once and forgets. Dosavy keeps the schedule you set, the doses you actually took, and the reminder for the next one, with the same evidence labels you see on this page.