CagriSema (cagrilintide + semaglutide)
Fixed-dose combination of cagrilintide (long-acting amylin analog, 2.4 mg) + semaglutide (GLP-1 agonist, 2.4 mg). Dual-mechanism: GLP-1 drives satiety + insulin, amylin adds independent satiety + gastric emptying modulation. 20.4% body weight reduction at 68 weeks (REDEFINE 1).
This compound sits in research-grey territory. The caveats below carry more weight than for FDA-approved entries — read them.
Novo Nordisk's amylin + GLP-1 combination rationale: amylin (secreted by pancreatic beta cells alongside insulin) acts via calcitonin receptor in the hypothalamus to independently reduce food intake and slow gastric emptying — a mechanism that doesn't overlap with GLP-1 satiety signaling. The combination produces additive satiety from two mechanistically distinct pathways. REDEFINE 1 (Phase 3, 68 weeks, 3,417 adults without T2D): 20.4% mean weight reduction vs 3.0% placebo. REDEFINE 4 (head-to-head vs tirzepatide 15 mg, 84 weeks): CagriSema 23.0% vs tirzepatide 25.5% — CagriSema non-inferior but NOT superior. NDA submitted to FDA December 18, 2025. FDA review expected 2026. Cleanest path to FDA approval in this cluster.
HONEST FRAMING — DO NOT pitch CagriSema as better than tirzepatide: REDEFINE 4 head-to-head (84 weeks) shows CagriSema 23.0% vs tirzepatide 15 mg 25.5% — non-inferior, NOT superior. Wegovy (semaglutide 2.4 mg alone) is the relevant comparator for the semaglutide component — CagriSema adds ~4-6% weight loss over Wegovy via the cagrilintide component. GI side effects class-wide. Novo Nordisk funded all REDEFINE trials — treat claims as B-grade.
External links to PubMed searches, ClinicalTrials.gov, and FDA materials. We do not host papers — we point at canonical sources.
NDA submitted to FDA December 18, 2025. FDA review expected 2026. Not yet approved. Cagrilintide as a standalone compound is on the 503A-restricted list — no compounding path until FDA approval.
Pre-filled with this compound's published dose range: cagrilintide 2.4 mg + semaglutide 2.4 mg, once weekly (Phase 3 dose — not yet approved) · once weekly subcutaneous — NDA under FDA review as of Dec 2025; no approved dosing yet
Calculator is a discussion tool. Verify reconstitution + dosing with a qualified provider. Stack is not a prescription source. Use sterile technique and inspect every vial.
Distilled themes from named communities — Reddit threads, forums, creator commentary. Not direct quotes; not clinical evidence. Useful for calibrating expectations against what real self-experimenters report.
Cohort is Wegovy plateau users primarily. The amylin add-on framing resonates — 'same semaglutide but with something extra.' Head-to-head vs tirzepatide data lands honestly: most users accept non-inferior is still good. FDA approval watch is active — the NDA filing date is known and community is tracking review timeline.