CagriSema

This vial pairs 5 mg of cagrilintide with 5 mg of semaglutide, a 1:1 research-chemical version of Novo Nordisk's CagriSema combination.

Human trialsFixed-ratio blend reference

Also known as: Cagrilintide / Semaglutide

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A fixed-ratio blend requires component-aware arithmetic. Vial composition is kept separate from target amounts so component strengths are never presented as dose suggestions.

Per-component concentration math

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Vial strength is not a target amount

Each listed number identifies how much of one component is present in the full vial. It does not establish how much of the blend to draw or how often.

How to read the dosing on this page

Blend-level rows

Reported protocols describe how sources reconstitute and draw this vial as a whole, each tied to where it was said.

Component rows

Each peptide's own page reports what studies and guides describe for it alone; the leading rows are repeated below.

One draw, every component

The ratio is fixed by the vial, so a draw sized for one component sets the amount of all the others at the same time.

Molecular profile of each component

CagriSema is 2 peptides in one vial. Each profile below is PubChem's record for that peptide, read from its own library page; the vial amount is what the label states for this blend, not an amount per draw.

Cagrilintide5 mg per vial

Formula
C194H312N54O59S2
Molar mass
4,409 g/mol
CAS number
1415456-99-3
Amino acids
38
Sequence
Lys(C20 diacid-gamma-Glu)-Cys-Asn-Thr-Ala-Thr-Cys-Ala-Thr-Gln-Arg-Leu-Ala-Glu-Phe-Leu-Arg-His-Ser-Ser-Asn-Asn-Phe-Gly-Pro-Ile-Leu-Pro-Pro-Thr-Asn-Val-Gly-Ser-Asn-Thr-Pro-NH2 (cyclic disulfide between the cysteines at positions 3 and 8 of the amylin numbering)
Class
Long-acting synthetic analog of the pancreatic hormone amylin, lipidated with a C20 fatty diacid and carrying a C-terminal amide

PubChem CID 171397054Cagrilintide page

Semaglutide5 mg per vial

Formula
C187H291N45O59
Molar mass
4,114 g/mol
CAS number
910463-68-2
Amino acids
31
Sequence
His-Aib-Glu-Gly-Thr-Phe-Thr-Ser-Asp-Val-Ser-Ser-Tyr-Leu-Glu-Gly-Gln-Ala-Ala-Lys(C18 diacid-gamma-Glu-AEEA-AEEA)-Glu-Phe-Ile-Ala-Trp-Leu-Val-Arg-Gly-Arg-Gly
Class
Synthetic acylated 31-residue analog of human glucagon-like peptide-1; GLP-1 receptor agonist with Aib at position 2 and a C18 fatty diacid attached to lysine 20 through two AEEA linkers and a glutamate spacer

PubChem CID 56843331Semaglutide page

Reported protocols for CagriSema

What published studies and recent community write-ups report about amounts, timing and course length. 4 clinical and 3 community-reported rows, each linked to its source. These are descriptions of what others report, not instructions, and nothing here is medical advice.

ContextDoseFrequencyRouteCourseSource
Clinical4 rows
Phase 3 REDEFINE 1, obesity or overweight without diabetes3,417 adults with a BMI of 30 or more, or 27 or more with a weight-related complication, in 22 countries; 2,108 received the combination2.4 mg of cagrilintide with 2.4 mg of semaglutide, after a start at 0.25 mg of eachOnce weekly, dose increased every 4 weeks until 2.4 mg of each was reached by week 16Subcutaneous, as a fixed-dose combination from a dual-chamber single-use pen68 weeks: 16 weeks of escalation, 52 weeks of maintenance, then a 7-week off-treatment follow-upNone; investigators could delay a step or reduce the dose for adverse effects, and participants could stay on a submaximal doseNew England Journal of Medicine (PubMed)2025
Weight fell 20.4% with the combination against 3.0% on placebo (intention-to-treat), with 16.1% for semaglutide alone and 11.8% for cagrilintide alone on the adherence analysis reported by the sponsor. Gastrointestinal events affected 79.6% of the combination group against 39.9% on placebo, peaked during escalation and were mostly mild to moderate; 5.9% stopped for adverse events against 3.5% on placebo. The pen and escalation details come from the full text; the drug was manufacturer-supplied, not a lyophilised vial.
Phase 3 REDEFINE 2, type 2 diabetes with obesity or overweight1,206 adults with type 2 diabetes, a BMI of 27 or more and HbA1c between 7% and 10%, in 12 countries; 904 received the combination2.4 mg of cagrilintide with 2.4 mg of semaglutide at targetOnce weeklySubcutaneous68 weeks, with lifestyle intervention in both armsNoneNew England Journal of Medicine (PubMed)2025
Weight fell 13.7% against 3.4% on placebo, and 73.5% of the combination group reached an HbA1c of 6.5% or less against 15.9% on placebo. Gastrointestinal events were reported by 72.5% against 34.4%, most of them transient and mild or moderate. The registry record lists the 68-week primary endpoint and a 75-week safety window; the trial completed in February 2025.
Phase 2 trial in type 2 diabetes, two drugs co-administered92 adults with type 2 diabetes and a BMI of 27 or more on metformin with or without an SGLT2 inhibitor, at 17 sites in the USACagrilintide and semaglutide each escalated to 2.4 mg, given as co-administered once-weekly injectionsOnce weeklySubcutaneous32 weeksNoneThe Lancet (PubMed)2023
HbA1c fell 2.2 percentage points with the combination against 1.8 with semaglutide alone and 0.9 with cagrilintide alone, and weight fell 15.6% against 5.1% and 8.1%. Time in glucose range rose from 45.9% to 88.9% on the combination. Adverse events were reported by 68% of the combination group, mostly mild or moderate gastrointestinal events, with no level 2 or 3 hypoglycaemia. This trial, registered as NCT04982575, gave the two peptides as separate products rather than from one vial.
Phase 1b multiple-ascending-dose trial of the combination96 adults aged 18-55 with a BMI of 27.0-39.9 and no other health problems, at one centre in the USACagrilintide 0.16, 0.30, 0.60, 1.2, 2.4 or 4.5 mg with semaglutide 2.4 mgOnce weekly, both drugs co-escalated every 4 weeks over 16 weeks, then 4 weeks at the target doseSubcutaneous, two separate injections20 weeks of dosing, then 5 weeks of follow-upNoneThe Lancet (PubMed)2021
This is the first human study of the pairing. Weight fell 15.7% with cagrilintide 1.2 mg and 17.1% with 2.4 mg at week 20, against 9.8% for the pooled placebo groups that received semaglutide alone, with no lifestyle intervention. Cagrilintide exposure rose in proportion to dose and did not change semaglutide exposure or elimination; half-lives were 159-195 hours for cagrilintide and 145-165 hours for semaglutide, which is the pharmacokinetic basis for a once-weekly combination. Of 566 adverse events, 37% were gastrointestinal.
Community-reported3 rows
Community chart for the 5 mg / 5 mg combo vial0.25 mg + 0.25 mg (5 units) rising to 2.4 mg + 2.4 mg (48 units) per week, at 1 mL of bacteriostatic water per vialOnce weekly on the same day, stepping up every 4 weeksSubcutaneous, rotating abdomen, thigh and upper arm16 weeks of escalation, then maintenance from week 17None described; the page says doubling up after a missed dose is not part of any reference scheduleCommunity resource2026
This July 2026 page converts the REDEFINE ladder to syringe units for a 10 mg combo vial made up with 1 mL (10 mg/mL total, 5 mg/mL of each): 5, 10, 20, 34 and 48 units for the 0.25, 0.5, 1.0, 1.7 and 2.4 mg steps. It points out that one vial holds only about two maintenance doses, that both peptides move together with every draw so neither can be advanced alone, and that independently sourced vials do not guarantee the ratio, purity or sterility of the manufactured product, so the trial schedule cannot be mapped cleanly onto them.
Community calculator default for a 10 mg vial2.4 mg of total peptide per injection, which is 48 units at 2 mL of bacteriostatic water or 24 units at 1 mLOnce weeklySubcutaneous, abdomen, thigh or upper armAbout 4 injections per vial; the page gives 28 days for the reconstituted vialNot specifiedCommunity resource2026
This calculator describes 2 mL per 10 mg vial (5 mg/mL) as the community standard, drawn from what it calls 15 community reports, and lists lower, higher and upper variants of 1.2, 3.6 and 4.8 mg. Its 2.4 mg figure is total peptide, so at the 1:1 ratio each injection carries 1.2 mg of cagrilintide and 1.2 mg of semaglutide, half the trial maintenance dose of each; the page does not spell this out, which is the main trap with blend arithmetic. It also notes that the real product is a pre-filled pen that needs no reconstitution.

How a course is commonly described

  1. Weeks 1-4: 0.25 mg of eachClinical

    REDEFINE 1 started every participant on 0.25 mg of cagrilintide and 0.25 mg of semaglutide once weekly from a dual-chamber pen. The 1:1 ratio of the research vial matches this step, but a draw from a 10 mg vial made up with 1 mL is 5 units for the pair.

  2. Weeks 5-16: four-weekly steps to 2.4 mg of eachClinical

    The dose rose every 4 weeks until 2.4 mg of each drug was reached by week 16; community charts reproduce the intermediate steps as 0.5, 1.0 and 1.7 mg. Nausea, vomiting and diarrhoea peaked in this window and fell afterwards, while constipation stayed roughly constant.

  3. Weeks 17-68: maintenance, then 7 weeks off treatmentClinical

    Maintenance at 2.4 mg of each ran for 52 weeks to the week 68 endpoint, followed by a 7-week off-treatment follow-up. Investigators could hold a step or reduce the dose, and participants were allowed to finish the trial on a submaximal dose.

  4. After week 68: extension without drugClinical

    The registry record describes a second part in which selected participants from the combination and placebo arms are followed for about 2 more years without study medicine, to see what happens to weight and weight-related disease after stopping. That extension was still running in October 2026.

  5. Community vial arithmeticCommunity-reported

    Community charts walk the same 16-week ladder from a 5 mg / 5 mg vial, which at the 2.4 mg + 2.4 mg maintenance step holds only about two weekly doses, so a course consumes a vial every fortnight once escalation is complete.

  • The research vial is not the trial product. REDEFINE 1 and 2 used a manufacturer-made fixed-dose combination in a dual-chamber single-use pen, and the earlier phase 1b and phase 2 trials gave the two drugs as separate injections; nobody has studied a co-lyophilised 1:1 powder of unverified ratio, purity or sterility.
  • CagriSema is Novo Nordisk's name for its own investigational product, which the company filed with the FDA in December 2025 and which is not approved in the US or EU. Vendors have simply borrowed the name for a vial that has nothing to do with the company or its trials.
  • Because the vial is 1:1 by mass, every draw carries equal milligrams of each peptide, so the trial ladder can only be walked with both drugs at once, which is also how the trials did it. The trap is in the units: a '2.4 mg' draw from a 10 mg vial at 5 mg/mL is 1.2 mg of each drug, not 2.4 mg of each.
  • Gastrointestinal effects were the dose-limiting problem in every trial, hitting 79.6% of the combination group in REDEFINE 1 against 39.9% on placebo, and the four-week steps exist to manage them. In the trials, people who could not tolerate the target dose stayed on a lower one rather than stopping.
  • Both peptides are acylated and dissolve slowly; a vendor page allows 5-10 minutes of gentle swirling, and community guides give the reconstituted vial 28-30 days refrigerated. These are vendor and community conventions, not stability data on the mixture.
Sources for this section (11)
  1. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or ObesityNew England Journal of Medicine (PubMed)2025Clinical
  2. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity (open-access full text)Amsterdam UMC research repository2025Clinical
  3. Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 DiabetesNew England Journal of Medicine (PubMed)2025Clinical
  4. Efficacy and safety of co-administered once-weekly cagrilintide 2.4 mg with once-weekly semaglutide 2.4 mg in type 2 diabetes: a multicentre, randomised, double-blind, active-controlled, phase 2 trialThe Lancet (PubMed)2023Clinical
  5. 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 trialThe Lancet (PubMed)2021Clinical
  6. A Research Study to See How Well CagriSema Helps People With Excess Body Weight Lose Weight (REDEFINE 1, NCT05567796)ClinicalTrials.gov2026Clinical
  7. A Research Study to See How Well CagriSema Helps People With Type 2 Diabetes and Excess Body Weight Lose Weight (REDEFINE 2, NCT05394519)ClinicalTrials.gov2026Clinical
  8. Novo Nordisk announces FDA submission of CagriSema for weight managementNovo Nordisk (company press release)2025Clinical

Plus 3 community resources (dosing guides, forum threads and vendor write-ups), reported above but not linked.

Reported protocols by component

What sources report for each peptide on its own. In CagriSema the vial ratio fixes the proportions, so one draw delivers every component at once and none can be raised without the others. The first rows from each component's table are shown here; its page carries the rest, each linked to its source. Descriptions of what others report, not instructions.

Cagrilintide

  • ClinicalPhase 2 dose-finding trial in obesity
    Reported amount
    0.3, 0.6, 1.2, 2.4 or 4.5 mg maintenance, started at 0.3 mg for the lowest arm and 0.6 mg for all the others
    Frequency
    Once weekly, stepped up every 2 weeks
    Route
    Subcutaneous self-injection with a pen
    Course
    26 weeks, including up to 6 weeks of escalation, then 6 weeks of follow-up without treatment
    The Lancet (PubMed), 2021
  • Community-reportedCommunity standalone titration ladder
    Reported amount
    0.25 mg, then 0.5, 1.0, 1.7 and 2.4 mg
    Frequency
    Once weekly, stepping up every 4 weeks
    Route
    Subcutaneous
    Course
    16 weeks of escalation, then maintenance at 2.4 mg from week 17
    Community resource, 2026
  • ClinicalPhase 3 REDEFINE 1, cagrilintide alone arm
    Reported amount
    2.4 mg maintenance
    Frequency
    Once weekly
    Route
    Subcutaneous
    Course
    68 weeks
    New England Journal of Medicine, 2025
6 more rows on the Cagrilintide page

Semaglutide

  • ClinicalFDA label, Wegovy injection
    Reported amount
    0.25 mg start, then 0.5 mg, 1 mg, 1.7 mg, maintenance 2.4 mg (1.7 mg accepted); up to 7.2 mg for adults needing further weight reduction
    Frequency
    Once weekly, same day each week, with or without food
    Route
    Subcutaneous, abdomen, thigh or upper arm
    Course
    16 weeks of escalation, then open-ended maintenance
    DailyMed, National Library of Medicine, 2026
  • Community-reportedCompounded vial titration chart
    Reported amount
    0.25 mg weeks 1 to 4, 0.5 mg weeks 5 to 8, 1 mg weeks 9 to 12, then up to 2-2.4 mg
    Frequency
    Once weekly
    Route
    Subcutaneous from a multi-dose compounded vial
    Course
    12 weeks of escalation, then prescriber-set maintenance
    Community resource, 2026
  • ClinicalFDA label, Wegovy tablets
    Reported amount
    1.5 mg days 1 to 30, 4 mg days 31 to 60, 9 mg days 61 to 90, then 25 mg maintenance
    Frequency
    Once daily, on an empty stomach in the morning with no more than 4 ounces of plain water, then nothing by mouth for at least 30 minutes
    Route
    Oral tablet, swallowed whole
    Course
    90 days of escalation, then open-ended maintenance at 25 mg
    US Food and Drug Administration, 2026
9 more rows on the Semaglutide page

Overview

This vial pairs 5 mg of cagrilintide with 5 mg of semaglutide, a 1:1 research-chemical version of Novo Nordisk's CagriSema combination. Unlike every other blend in this library, the combination itself has a clinical programme: a phase 1b and a phase 2 trial gave the two drugs as separate weekly injections, and the phase 3 REDEFINE 1 and REDEFINE 2 trials used a dual-chamber pen escalated from 0.25 mg of each to 2.4 mg of each over 16 weeks, producing 20.4% weight loss at 68 weeks in adults without diabetes and 13.7% in type 2 diabetes. Novo Nordisk filed the combination with the FDA in December 2025 and it is not approved anywhere; the lyophilised 5 mg / 5 mg vial sold by research vendors is not the trial product, and CagriSema is the company's name for its own product, borrowed by sellers who have no connection to it.

What researchers are exploring

This educational summary has not yet been independently source-verified and should not be treated as an established finding.

  • 1

    What is CagriSema?

    Combination therapy targeting complex metabolic pathways

  • 2

    Structural Stability and Bioavailability

    Optimised for durability and sustained signaling

  • 3

    Research on CagriSema

    From early studies to human trials

  • 4

    Future Prospects

    The evolving role of multi-pathway peptides

  • 5

    Study Highlights

    Key findings from preclinical and clinical research

Recorded blend variants

Each number is the vial amount for that component. It is not a per-draw amount.

5 / 5 mg
Cagrilintide
5 mg
Semaglutide
5 mg

Identity, limitations and unknowns

Technical fields and limitations remain subject to source verification.

Molecular profile

Sequence
Combination of semaglutide and cagrilintide
Molecular Formula
Varies based on combination
Synonyms
AM833, Cagrilintide-Semaglutide

Sources

10 curated references, each with its journal, year and study model, plus 3 community resources reported but not linked.

  1. Cagrilintide (PubChem CID 171397054)PubChem, National Library of Medicine2026Not graded
  2. Semaglutide (PubChem CID 56843331)PubChem, National Library of Medicine2026Not graded
  3. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or ObesityNew England Journal of Medicine (PubMed)2025Human
  4. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity (open-access full text)Amsterdam UMC research repository2025Human
  5. Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 DiabetesNew England Journal of Medicine (PubMed)2025Human
  6. Efficacy and safety of co-administered once-weekly cagrilintide 2.4 mg with once-weekly semaglutide 2.4 mg in type 2 diabetes: a multicentre, randomised, double-blind, active-controlled, phase 2 trialThe Lancet (PubMed)2023Human
  7. 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 trialThe Lancet (PubMed)2021Human
  8. A Research Study to See How Well CagriSema Helps People With Excess Body Weight Lose Weight (REDEFINE 1, NCT05567796)ClinicalTrials.gov2026Human
  9. A Research Study to See How Well CagriSema Helps People With Type 2 Diabetes and Excess Body Weight Lose Weight (REDEFINE 2, NCT05394519)ClinicalTrials.gov2026Human
  10. Novo Nordisk announces FDA submission of CagriSema for weight managementNovo Nordisk (company press release)2025Human

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