Cagrilintide Dosage: Titration Chart & Schedule
Investigational drug. Cagrilintide is not FDA approved. The doses below come from published clinical trials run under medical supervision. They are a record of what the studies did, not a prescribable regimen or a protocol to follow on your own.
Cagrilintide is a long-acting amylin analog dosed once weekly. It is best known as the amylin half of CagriSema, Novo Nordisk's combination with semaglutide. This page documents the titration schedule the trials actually used, the difference between the phase 2 and phase 3 doses, how cagrilintide is dosed alongside semaglutide, and the reconstitution math behind the numbers.
Cagrilintide Dosage at a Glance
This page compares two research settings. The phase 3 CagriSema regimen in REDEFINE 1 used a once-weekly subcutaneous target of 2.4 mg cagrilintide plus 2.4 mg semaglutide, with a 16-week escalation period and flexibility during treatment. The earlier phase 2 monotherapy trial tested weekly targets up to 4.5 mg. A study target is not a general-use dose, and this comparison does not claim to cover every subsequent development program.
The Trial Titration Schedule
The table summarizes the planned combination escalation explicitly listed in the REDEFINE 2 original paper, which studied adults with overweight or obesity and type 2 diabetes. Each amount applies to each component, cagrilintide and semaglutide, once weekly. REDEFINE 1, in adults without diabetes, likewise reports four-week increases from 0.25 mg to a 2.4 mg target of each component over 16 weeks. For separate drug-specific information, see semaglutide and tirzepatide; their schedules are not interchangeable with this combination trial.
| Weeks | Weekly Dose of Each Component | Step |
|---|---|---|
| 1–4 | 0.25 mg | Initiation |
| 5–8 | 0.5 mg | Early titration |
| 9–12 | 1.0 mg | Mid titration |
| 13–16 | 1.7 mg | Late titration |
| 17+ | 2.4 mg | Maintenance |
Week ranges count the first treatment week as week 1. These were planned steps, not proof that every participant followed this exact calendar. Investigators could delay escalation or reduce doses for tolerability and other protocol-defined clinical concerns. The papers do not establish that a faster ramp improves weight loss or that everyone adapts within four weeks.
Phase 2 Monotherapy Doses (Up to 4.5 mg)
Lau and colleagues’ 2021 phase 2 trial studied adults without diabetes who had obesity, or overweight with hypertension or dyslipidaemia. Weekly cagrilintide targets were compared with placebo and daily liraglutide 3.0 mg over 26 weeks, including up to six weeks of escalation. The table lists randomized target arms, not successive steps in one person's schedule.
Estimated weight reduction ranged from 6.0% to 10.8% across cagrilintide doses versus 3.0% with placebo under the trial-product estimand, which assumes adherence. At 4.5 mg, reduction was 10.8% versus 9.0% with liraglutide. Gastrointestinal events occurred in 41–63% across cagrilintide arms versus 32% with placebo. These findings support further study; they do not establish the former claim that an efficacy plateau and rising side effects explain the later combination's dose selection.
| Weekly Dose | Trial Role |
|---|---|
| 0.3 mg | Lowest phase 2 arm |
| 0.6 mg | Low-mid arm |
| 1.2 mg | Mid arm |
| 2.4 mg | Selected for CagriSema |
| 4.5 mg | Highest target in this phase 2 trial |
Cagrilintide With Semaglutide (CagriSema)
In REDEFINE 1, the combination target was cagrilintide 2.4 mg plus semaglutide 2.4 mg once weekly. The pairing joins an amylin analog and a GLP-1 receptor agonist, not two interchangeable doses of the same drug. For where the combination sits against tirzepatide, see CagriSema vs tirzepatide.
A target is not the same as everyone's achieved dose. Novo Nordisk's December 2024 headline report describes a flexible protocol and reports 57.3% of combination participants at the highest dose at week 68. That sponsor-reported snapshot should not be interpreted as a requirement to reach the target or as proof that a lower dose is optimal. Trial coadministration does not establish compatibility for mixing other preparations in one syringe.
Cagrilintide With Tirzepatide: What the Evidence Says
A common search is how to dose cagrilintide alongside tirzepatide. The cited trials do not establish a dosing schedule for that combination. In particular, REDEFINE 4 assigns CagriSema and tirzepatide to separate comparison groups. Finding both names in a study record is not evidence that they were used together.
Combining different appetite-related mechanisms is a research hypothesis, and personal reports can raise useful questions. They do not determine how much additional benefit, nausea or other harm the pairing causes. Neither an automatic doubling of gastrointestinal risk nor a safe add-on dose follows from those mechanisms. Discuss proposed combinations with the treating clinician rather than transferring the CagriSema schedule to tirzepatide.
Reconstitution and Measuring the Dose
The published phase 2 study describes a specific trial intervention, not a preparation protocol for other products. Do not infer that every powder should be mixed with bacteriostatic water. Product-specific instructions must establish any diluent, preparation, storage and discard requirements; a trial dose alone supplies none of those instructions. Our preparation and measurement guide explains why these details must be distinguished from arithmetic.
Arithmetic only: concentration in mg/mL equals drug amount in mg divided by final solution volume in mL. The volume for an independently specified amount equals that amount divided by concentration. On a U-100 syringe, one unit corresponds to 0.01 mL, not one milligram or one microgram; individual graduation lines may span more than one unit. For a purely hypothetical 5 mg in a final 2 mL, concentration is 2.5 mg/mL; 1 mg corresponds to 0.4 mL or the 40-unit position on a U-100 scale. These numbers are not a cagrilintide preparation or dosing recommendation. The peptide reconstitution calculator checks this conversion, not product identity, purity, sterility, stability or treatment suitability.
Side Effects and Why Titration Is Slow
In REDEFINE 1, gastrointestinal events affected 79.6% of combination participants versus 39.9% with placebo and were mainly transient and mild to moderate. These are combination-study rates, not cagrilintide-alone rates or a prediction for one person. Escalation was part of the studied regimen, but the trial does not establish a universal gut-adaptation deadline or show that faster escalation improves outcomes. For broader symptom context, see our GLP-1 guide.
Regulatory Status in 2026
US status checked September 9, 2026: FDA states that cagrilintide is not a component of an approved drug and cannot be used in compounding under federal law. Novo Nordisk announced its CagriSema application in December 2025; an application is not an approved prescribing label. This regulatory distinction does not erase the clinical research, but the research does not authorize every preparation marketed under the molecule's name.
A label or sales claim alone cannot verify a particular product's concentration, purity, sterility or stability. Conversely, the absence of approval is not a laboratory measurement proving every sample has the same defect. Keep regulatory authorization, evidence of benefit and product-quality verification separate. For other developing obesity medicines, whose status must be checked individually, see retatrutide, survodutide, and mazdutide.
Related Guides
Frequently Asked Questions About Cagrilintide
There is no FDA-approved standard cagrilintide dose. REDEFINE 1 studied a once-weekly target of 2.4 mg cagrilintide with 2.4 mg semaglutide after a 16-week escalation period, with dose flexibility rather than a requirement that everyone remain at the target. The earlier phase 2 monotherapy trial tested targets up to 4.5 mg weekly. These are distinct research regimens, not interchangeable personal instructions.
The REDEFINE 2 paper specifies once-weekly CagriSema doses of 0.25, 0.5, 1.0 and 1.7 mg of each component for four weeks per step, then a 2.4 mg target of each component after 16 weeks. REDEFINE 1 also reports four-week increases from 0.25 mg to 2.4 mg of each component over 16 weeks. Investigators could delay escalation or reduce doses; this describes trial treatment, not a schedule for a different product or personal use.
Lau and colleagues’ 2021 phase 2 monotherapy trial tested weekly target doses of 0.3, 0.6, 1.2, 2.4 and 4.5 mg. Thus 4.5 mg was the highest target in that particular trial, not a universal maximum or a personal dosing limit. The later REDEFINE 1 trial used 2.4 mg cagrilintide with 2.4 mg semaglutide. Those study choices do not, by themselves, explain every dose-selection decision or establish a regimen for another product.
The trials cited here do not establish a cagrilintide-plus-tirzepatide regimen. REDEFINE 4 compares CagriSema against tirzepatide in separate groups; it does not test adding cagrilintide to tirzepatide. Online accounts of that combination remain anecdotal, not a validated dose or quantified benefit-risk comparison. Do not infer a safe schedule or a doubling of side-effect risk from the individual medicines’ mechanisms.
The REDEFINE 1 combination target was 2.4 mg cagrilintide plus 2.4 mg semaglutide once weekly. Equal target amounts do not mean the molecules are interchangeable or that every participant remained at that dose. The trial allowed dose adjustments. These results do not supply instructions for combining separate products or mixing them in one syringe.
A published trial dose does not establish how to prepare a different product. There is no universal bacteriostatic-water instruction here: preparation requires product-specific directions, including any diluent and storage requirements. Arithmetic uses the amount of drug divided by the final solution volume; it cannot verify identity, purity, sterility or suitability. U-100 syringe markings describe volume, not a fixed amount of cagrilintide.
As checked September 9, 2026, cagrilintide is not an ingredient in an FDA-approved drug. Novo Nordisk submitted CagriSema for US approval in December 2025; submission is not approval. FDA also states that cagrilintide cannot be used in compounding under federal law. Regulatory status and evidence from trials are separate questions: a trial dose does not establish the quality or suitability of another preparation.
Charts can mix monotherapy target arms, combination escalation steps and individual dose adjustments. Lau’s phase 2 trial included up to six weeks of escalation; REDEFINE 1 specified a 16-week escalation period. Neither a list of target arms nor a maximum target describes what every participant received. Check the named trial, population, formulation, timing and whether the number is a target or achieved dose.