Cagrilintide (5 mg Vial) Dosage Protocol
Cagrilintide is a long-acting amylin analog developed by Novo Nordisk. Amylin is a pancreatic peptide co-secreted with insulin that promotes satiety, slows gastric emptying, and suppresses post-meal glucagon. Cagrilintide is under Phase 3 investigation in combination with semaglutide (CagriSema) for obesity.
⚡ Quickstart Highlights
Dosing & Reconstitution Guide
Route: Subcutaneous | Frequency: Once weekly
| Phase | Weekly Dose | U-100 Units | Volume | Duration |
|---|---|---|---|---|
| Weeks 1–4 | 0.3 mg (300 mcg) | 12 units | 0.12 mL | Starting dose |
| Weeks 5–8 | 0.6 mg | 24 units | 0.24 mL | |
| Weeks 9–12 | 1.2 mg | 48 units | 0.48 mL | |
| Weeks 13–16 | 1.7 mg | 68 units | 0.68 mL | |
| Weeks 17+ | 2.4 mg | 96 units | 0.96 mL | Target maintenance |
Reconstitution Steps
- Draw 2.0 mL bacteriostatic water into a sterile syringe.
- Inject slowly down the inside glass wall of the vial; avoid foaming.
- Gently swirl until dissolved. Do not shake.
- Label with reconstitution date. Refrigerate at 2–8°C; use within 28 days.
Supplies Planning
| Item | 16 Weeks | 28 Weeks |
|---|---|---|
| Cagrilintide vials (5 mg) | 4 vials | 7 vials |
| Insulin syringes (U-100) | 16 | 28 |
| Bacteriostatic water (10 mL) | 1–2 × 10 mL | 2–3 × 10 mL |
| Alcohol swabs | 1 × 100-pack | 1 × 100-pack |
Mechanism of Action
Cagrilintide is a fatty acid-conjugated amylin analog designed for once-weekly dosing. Natural amylin (IAPP) is co-secreted with insulin from pancreatic β-cells and acts on amylin receptors in the brainstem (area postrema and nucleus tractus solitarius) to promote satiety, slow gastric emptying, and suppress post-meal glucagon secretion. Its half-life of minutes limits clinical utility; cagrilintide's fatty acid conjugation extends this to approximately 7–8 days.
When combined with semaglutide (GLP-1 agonist), the dual mechanism produces complementary and additive effects: cagrilintide's amylin receptor satiety signaling reinforces semaglutide's GLP-1 receptor-mediated appetite suppression, potentially explaining the greater weight loss observed in early CagriSema trials relative to either agent alone.
Research Findings & Safety Profile
- Phase 2 CAGRA trial: cagrilintide 2.4 mg showed dose-dependent weight reduction of up to 10.8% at 26 weeks.
- CagriSema Phase 2 data: combination produced approximately 15.6% weight loss vs 5.1% placebo at 32 weeks — exceeding semaglutide monotherapy.
- Phase 3 REDEFINE 1/2 trials ongoing as of 2025.
- Common adverse effects: nausea, vomiting, injection-site reactions — overlapping with other weight management peptides.
- Once-weekly dosing enabled by fatty acid conjugation to albumin (same approach as semaglutide).
- Not FDA approved; investigational compound in clinical development.
Storage
| State | Temperature | Duration | Notes |
|---|---|---|---|
| Lyophilized | −20°C (−4°F) | Up to 24 months | Dry, dark conditions |
| Reconstituted | 2–8°C (35–46°F) | Up to 28 days | Avoid freeze-thaw; protect from light |