Cagrilintide
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Route(s): Subcutaneous
Typical vial sizes: 5, 10, 20 mg
Dosing window: Anytime
Receptor / target: Amylin
Properties: Incretin
Pre-mixed: No
Unverified protocol notes
Standard Protocol
| Timeframe | Dose | Notes |
|---|---|---|
| Weeks 1-4 | 0.25mg once weekly | Initiation phase. |
| Weeks 5-8 | 0.5mg once weekly | Standard dose. |
| Weeks 9-12 | 1.0mg once weekly | Advanced escalation. |
| Weeks 13+ | 2.4mg once weekly | Maximum dose. |
Unverified protocol note; not label dosing unless graded otherwise on this page.
Alternative: Micro-Stacking
| Timeframe | Dose | Notes |
|---|---|---|
| Weeks 1-8 | 0.125mg to 0.25mg once weekly | When stacked with Tirzepatide or Semaglutide, kept very low to avoid extreme gastric paralysis. |
Unverified alternative protocol; not an approved-label regimen unless graded otherwise on this page.
Protocol logic check
Independent evidence
Regulatory status: investigational not FDA approved
Storage
No independently verified storage guidance found. Treat any unverified storage claim as unverified, and see the general storage guidance in the FAQ.
Contraindications (limited evidence)
- Severe gastroparesis or clinically significant delayed gastric emptying: amylin receptor activation further slows gastric motility; may produce complete gastric stasis. Limited / unverified
- Concurrent use with CagriSema (cagrilintide + semaglutide fixed combination): results in double-dosing of cagrilintide. Limited / unverified
- High-dose stacking with GLP-1 agonists at full therapeutic doses: combined gastric emptying inhibition can produce extreme gastroparesis and severe caloric restriction; always micro-dose when stacking. Limited / unverified
- Type 1 diabetes mellitus without insulin dose adjustment: amylin agonism slows glucose absorption; risk of unpredictable hypoglycemia. Limited / unverified
- Hypoglycemia unawareness: gastroparesis caused by amylin agonism delays glucose absorption and may blunt early hypoglycemia recognition. Limited / unverified
- Pregnancy: insufficient safety data. Limited / unverified
- Breastfeeding: insufficient safety data. Limited / unverified
- Known hypersensitivity or anaphylaxis to cagrilintide or any formulation excipient. Limited / unverified
- Active bowel obstruction or severe inflammatory bowel disease: GI motility impairment will worsen symptoms. Limited / unverified
- Planned general anesthesia or elective surgery: additive gastric emptying delay with any co-administered GLP-1 agent significantly raises pulmonary aspiration risk; follow pre-operative fasting and drug discontinuation protocols. Limited / unverified
- End-stage renal disease: safety data limited. Limited / unverified
- Pediatric use: safety and efficacy not established. Limited / unverified
Side effects (limited evidence)
- Nausea: most common adverse effect; driven by amylin receptor activation in the area postrema (the brain's "nausea center"); typically mild to moderate in monotherapy. Limited / unverified
- Nausea significantly amplified when stacked with GLP-1 agonists: dual-pathway stimulation of GI motility centers produces additive nausea far exceeding either compound alone. Limited / unverified
- Vomiting: more common in stacking protocols than monotherapy. Limited / unverified
- Extreme fullness and early satiety: primary pharmacological effect; can become pathological at high combined doses with GLP-1 agonists. Limited / unverified
- Inadequate caloric intake: at high stack doses, subjects may be physically unable to consume sufficient calories; requires active monitoring. Limited / unverified
- Gastroparesis: clinically significant delayed gastric emptying; risk amplified substantially when combined with any GLP-1 compound. Limited / unverified
- Diarrhea. Limited / unverified
- Constipation. Limited / unverified
- Abdominal pain and cramping. Limited / unverified
- Decreased appetite: intended pharmacological effect. Limited / unverified
- Hypoglycemia: low risk in monotherapy; elevated risk when stacked with insulin, sulfonylureas, or high-dose GLP-1 agonists; delayed gastric absorption alters glucose uptake kinetics. Limited / unverified
- Fatigue and lethargy: frequently secondary to insufficient caloric intake, particularly during aggressive stacking protocols. Limited / unverified
- Headache. Limited / unverified
- Dizziness. Limited / unverified
- Injection site reactions: redness, swelling, itching; well-tolerated in most subjects. Limited / unverified
- Administration site conditions: higher rate of injection site adverse events versus semaglutide monotherapy in combination trial data (RR 3.27 in CagriSema vs. semaglutide alone). Limited / unverified
- Elevated LDL-C: modestly higher LDL cholesterol observed in combination therapy versus semaglutide alone (MD +0.29 mmol/L); clinical significance uncertain. Limited / unverified
- Higher serious adverse event rate in monotherapy versus semaglutide: observed in meta-analysis data (RR 1.83); warrants careful monitoring. Limited / unverified
- Pulmonary aspiration risk under general anesthesia: significantly elevated in combination with any GLP-1 agent. Limited / unverified
- Rapid weight regain upon discontinuation: expected without lifestyle intervention. Limited / unverified
Compatibility
The relationships below come from the source site's internal engine and were not verified independently. Treat them as a starting point for a conversation with a clinician. They carry no safety guarantee.
Reported synergistic:
Reported contraindicated combinations: