Research Reference
CagriSema
Investigational combination of cagrilintide and semaglutide
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CagriSema is an investigational combination of cagrilintide and semaglutide being studied for obesity. It is not FDA approved.
Dosing Reference
Reconstitution
Add 2 mL bacteriostatic water to the 10 mg vial. Resulting concentration: 5 mg/mL.
| Dose | Syringe Units | mL Volume | Schedule |
|---|---|---|---|
| 1.6 mg | 32 units | 0.32 mL | SubQ, once weeklyPhase 3 starting dose |
| 2.4 mg | 48 units | 0.48 mL | SubQ, once weeklyPhase 3 mid dose |
| 3.2 mg | 64 units | 0.64 mL | SubQ, once weeklyPhase 3 target dose |
Math assumes U-100 insulin syringes (1 mL = 100 units). Verify your syringe matches before use. Round half-units to the nearest visible mark.
Reconstitution
CagriSema is an investigational fixed-dose combination of cagrilintide (amylin analog) + semaglutide (GLP-1 agonist), in phase 3 trials (Novo Nordisk). It is supplied as a pre-filled pen or lyophilized vial for subcutaneous use. Compounded research-peptide forms are not FDA-approved.
For a compounded 10 mg vial reconstituted with 2 mL, the concentration is 5 mg/mL; a 2.4 mg dose draws to 48 units (0.48 mL) on a U-100 syringe. Store per manufacturer directions; compounded forms are not FDA-approved.
Cycling Protocol
Phase 3 trials (REDEFINE for obesity) titrate CagriSema weekly over several weeks to a target dose, then maintained long-term. No fixed cycle end; studied as chronic weekly therapy.
Routes of Administration
Subcutaneous injection (only established route): Once weekly into the abdomen, thigh, or upper arm. Any time of day, independent of meals.
No oral, intranasal, or intravenous route is established. Compounded forms are not FDA-approved.
Stacking Protocols
| Stack | Components | Purpose | | --- | --- | --- | | Combination + Lifestyle | CagriSema + diet/exercise | Phase 3 obesity protocol |
Combining multiple GLP-1 agonists is not recommended. CagriSema is investigational and not FDA-approved.
Side Effects & Safety
- Nausea, vomiting, diarrhea, constipation — common, usually transient
- Hypoglycemia — risk, especially combined with insulin/sulfonylureas
- Pancreatitis — rare; discontinue if suspected
- Injection-site reactions — common
- Thyroid C-cell tumors — in rodents (semaglutide component); avoid in MTC/MEN2 history
CagriSema is investigational (phase 3) and not FDA-approved. Compounded research-peptide forms are not FDA-approved.
Research Basis
CagriSema is an investigational fixed-dose combination of cagrilintide (a long-acting amylin analog) and semaglutide (a GLP-1 receptor agonist), developed by Novo Nordisk.
Mechanism: Combined amylin and GLP-1 receptor agonism — amylin suppresses glucagon and slows gastric emptying; GLP-1 increases insulin secretion and suppresses appetite. The dual mechanism targets additive weight loss.
Clinical evidence: Phase 2 demonstrated greater weight loss than semaglutide alone; phase 3 (REDEFINE) ongoing for obesity. Not FDA-approved.
Investigational — not FDA-approved. Compounded research-peptide forms are not FDA-approved.